Montgomery Achievements –Highest quality of clinical care as measured by the 150 targets contained within the Quality Framework –Highest vaccination rates in Wales –Medical Director “Excellent Chronic Disease Programme” –Easily meets Welsh Access Targets unlike some of our neighbouring practices –15 minute appointments –Stable partnership with very little use of locums –Excellent feedback from patient questionnaires year on year

Change in Workload for the month of March 2001 and March 2008 Please note that the numbers of appointments and visits for March 2008 are underestimated as Easter was in March this year whereas it was mid April in 2001 Increase in total appointments = 37.4% Of the acute nurse appointment s we know that 35% SEE a doctor too and 31% are discussed with a doctor. I have not broken down the nurse appointments into acute and chronic. Average consultation time for doctors has increased from 10 minutes to 13 minutes. Please note that these figures also include telephone appointments and so do not accurately reflect face to face appointment time. We know that the time allocated for booked appointments has grown from 10 minutes to 15 minutes during this period. Visits Conducted by Doctors in March 2001 = 84 and in March 2008 = 80The above represents only the work undertaken by partners and their directly employed staff and locums.

Nurse Triage & Assessment Questionnaire by Patient 120 patients using the service were serveyed in Jan / Feb 2008 Time to call back by nurse –32 < 5 minutes –77 between 5 and 30 minutes –9 between 30 minutes and 1 hour

Nurse Triage & Assessment Questionnaire by Patient Patient rating of advice: –34 Excellent –28 Very Good –42 Good –8 Fair –2 Poor

Nurse Triage & Assessment Questionnaire by Patient Nurse alone or nurse with doctor? –44 saw a doctor too –57 saw nurse alone

Nurse Triage & Assessment Questionnaire by Patient Time between telephone triage and assessment in surgery –92 < 4 hours – hours –2 next day

Nurse Triage & Assessment Questionnaire by Patient Does the nurse triage give good access to high quality advice and treatment? –112 yes –3 No –5 N/A

Survey of Nurse triage by nurse 223 patient telephone triage encounters –35% call finished with advice only –39% brought up for assessment by nurse –6% Given results over the phone –3% Same day doctor appointment –2% needed further doctor telephone appt –2% doctor visit –2% referred to community nurse

Nurse Urgent Assessment Outcome 100 consultations after initial telephone triage –34% seen by Nurse alone –35% Seen and examined by doctor as well as nurse –31% Nurse consulted with doctor