Transcript Slide 1

Wallington Medical Centre
What is it like to be a patient?
Thoreya Swage
[email protected]
07946 559132
Outside a traditional surgery
People waiting on the phone, the same, unseen
“All gone,
call back
tomorrow”
3 week wait
High DNAs
Repeat booking
Reception
70% “routine”
takes call
Patient
pressure
30% “urgent”
See any GP/locum
Poor continuity
Repeat booking
GP sees
patient
10-min slot
Problem
solved
Face-to face vs telephone consultations
Already 24% of consultations are by phone
Sample is small at 17, but of these 88% were resolved on
the phone.
Requests for appointments are reasonably well spread
Confirmed by datalog collection - a good sign
But outcome of requests – 17% told to call back –
generating more work
You are seeing about 100/wk and 40 phone/wk, total of
about 6% of your list, well within expectations.
Average no of days wait to see a GP is 3.5 days
Some appointments are up to 2 weeks ahead
Vast majority of requests are for same day.
Continuity is about 75%
32% specified a named doctor, interestingly more often
important to GPs at 43%, about average.
What do patients think of our service?
• Administrative staff views
– Some complain about lack of appointments but the majority
seem ok.
– They want more appointments with Dr.
– generally patient's are happy. Minority of rude, demanding
patients complaining they are unable to make an appointment
to see the GP.
• Clinical staff views
– Overall good but can be long wait for routine appointment
which can lead to higher DNA rate. Sometimes inconsistent
some patients are offered telephone appointments if they can't
get a routine appointment but some are not.
– Patients complain that it is difficult to get an appointment with
a doctor.......... However having seen a clinician they are
usually positive about their experience.
My daily work at present
• Administrative staff views
– Spend most of my time on reception whilst juggling paperwork
between callers. Difficult to finish anything.
– Mainly administration work; Audits, QOF, etc. Can become stressful
when interrupted with patient queries/ reaching QOF targets.
• Clinical staff views
– Generally manageable as we operate 15min appointments and
patients are usually seen on time.
– I feel my surgeries are not too stressful, they can be if there are
many extras or I will get stressed if the surgery is over-running.
Patients do complain about access and it can be stressful to explain
to them that we are trying our best.
My ideal work
• Administrative staff views
– I would prefer to be on reception all the time and the patients
then get to know you and its easier to explain a difficult
situation to them.
– Ideal day! Having more time - not feeling rushed to get work
done.
• Clinical staff views
– More structure to the course of my day with greater flexibility.
Would like to do more proactive management of LTC patients
– Patients arriving on time, surgery running on time, no extras,
no interruptions, patients with single problems in each
consultation!
A Practice In The Patient Access Community
Looks, Sounds, Feels 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 Relief of Working Efficiently
Evidence from practices in the Patient Access movement
 60% of calls don’t typically need an appointment
 A rapid and safe system, where patients that need
to be seen are
 7% list increase with no extra GP sessions needed at
Oak Tree Health Centre
We’re now saving
20% of GP working hours and A&E attends are 50%
below Liverpool average - Dr Chris Peterson,
GP at The Elms & Liverpool CCG
Urgent Care Lead
How Patient Access Works
Admin question
Come and
see GP
30%
20%
Reception
takes call
20%
60%
GP phones
patient
10%
Come and
see nurse
60%
Problem
solved
Rules
• If telephone lines open 9am, so do Dr callbacks
• All patients are called back – no Doctors appointments made by
receptionists
• Call back within the hour
• All Drs on telephone call backs (exception Duty Dr or
locum/trainee)
• Call patients in for face to face from mid morning (and mid/late
afternoon)
Launch programme - just 12 weeks
to a happier, less stressful practice
Detailed planning
Staff survey
Patient comms
Whole team
meeting
Preparation
Consensus
Yes.
Pledge to
each other
and to patients
New deal for patients
Predicting demand &
matching capacity.
Patient & staff
feedback
Launch day
Review
Routine
New measures help tuning.
Build confidence
Affirmation
What happens next?
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•
•
•
•
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