Transcript Slide 1

Gallions Reach Health Centre
What is it like to be a patient?
Thoreya Swage
[email protected]
Outside a traditional surgery
People waiting on the phone, the same, unseen
“All gone.
Call back
tomorrow”
The traditional model
3 week wait,
high DNAs,
repeat booking
Reception
takes call
70% “routine” GP sees patient
10 min slot
Patient
pressure
30% “urgent”
See any GP/locum
Poor continuity,
repeat booking
Problem
solved
60%
Face-to-face consultations vs telephone consultations
Appointment bookings by time of day
No of days wait to see a GP
Some appointments are up to two weeks ahead (or more)
About 28% are telephone consultations
75% of telephone consultations resolved there and then
Appropriateness of consultations – about 15% face-to-face
not needed
Length of time for tel vs face-to-face consultations
GP continuity
What do patients think of our service?
• Administrative staff views
– not enough appointments, difficult to get through on the phone
and difficult to get appointments with specific doctors
– lack of appointments, unable to get through on phones
– Patients get frustrated when they are unable to get an
appointment for 2 weeks
– Often patients have to wait for a long time for a call to be
answered in order to make an appointment,
– They have to wait too long for an appointment
• Clinical staff views
– Difficult to make appointment or get through to reception.
– Receptionists obstructive (though clearly just trying to cope
with demand)
– No continuity with the same doctor, difficult to get
appointment on the day or when they want to be seen.
– not seeing the doctor they wanted to.
– difficult to get nurse appointment
My daily work at present
• Administrative staff views
– it is very busy working on the reception and can be difficult
not being able to offer patients what they are asking for
– stresses are caused by arguments with patients because of lack
of appointments
– unable to offer appointments and dealing with upset patients
due to frustration.
• Clinical staff views
– DNAs, inappropriate use of appointments
– Having to follow up other Doctor's patients where I am not
happy to issue sick notes etc or have to catch up on long
history in short period.
– can be very difficult, often older patients need more than 10
mins appointments. Also some patients don’t turn up often and
clump problems together hence you over run, become stressed,
more likely to miss things.
– People who book on the day appointments and don't turn up for
them
My ideal work
• Administrative staff views
– in an ideal world it would be good if every patient could be
offered what they ask for
– I would like to offer patients appointments rather than having
daily arguments about lack of them.
– I would like to help patients in every way, elderly patients
come in for prescriptions I would like to do it there and then
not ask them to come back the next day.
• Clinical staff views
– More appropriate use of appointments. More control over my
work load and continuity with patients.
– for patient to get more flexibility when booking their
appointments .
– Ideally i would like greater continuity with the patients
– I want to manage my workload, I want to be able to know what
is going to be discussed in the appointment before the
consultation
A practice in the Patient Access community looks a little
different
Dr Chris Barlow of Quorn, one
of the earliest pioneers in 2000
Monday morning 8.30,
Busy day, going full tilt.
All carefully worked out.
The traditional view of general practice, every problem
requires 10 minutes face to face with the GP
Perfect service
One tiny problem
A new principle is at work
• We help all our patients, all day, every day
• The Patient Access method makes this a daily reality.
Simple, but the whole system changes
Admin question
Come and see GP
30%
10%
Reception
takes call
20%
70%
GP phones
patient
10%
Come and see
nurse
PA Navigator measures the flows, which vary by GP & practice.
60%
Problem
solved
“How are we going to help all our patients, all day, every day?”
You answer, over five stages of the programme.
Consensus
Yes.
Pledge to
Preparation
each other
and to patients
Staff survey
Patient survey
Data capture
Training
System setup
Whole team
Launch day
New deal for patients
Feedback wall
Test & learn
Build confidence
Routine
Evidence:
New measures
New staff survey
New patient survey
Your decision
Review
What happens next?
•
•
•
•
•
All to agree to a change
Change leader
Decide on a launch date
Do not book any appointments from launch date onwards
Workforce planning (GPs and reception staff)
What happens next?
• Inform the patients
– e.g. flyer, PPG, website, media, answerphone message etc
• Train staff
– Procedure for reception staff to follow
• Support provided by Patient Access training partner – before,
at launch and afterwards
Which is the best pancake?
Hot, fresh and crispy
Cold and soggy