1. Blackheath PMS Woodland Surgery What is it like to be a patient?
Thoreya Swage

2. Outside a traditional surgery
Many practices pride themselves on good access, and they are working hard. But with scenes like this, I began to see how good intentions are not enough. They need a method.
People waiting on the phone, the same, unseen

3. GP sees patient 10-min slot
“All gone,
call back
tomorrow”
3 week wait
High DNAs
Repeat booking
Reception takes call
GP sees
patient
10-min slot
70% “routine”
Problem solved
Patient
pressure
See any GP/locum
Poor continuity
Repeat booking
30% “urgent”
Here are the consequences of this approach for most practices and patients.

4. Why do patients call? 65% for a GP, many for nurse, admin, repeat prescription

5. When do they call? Monday much higher

6. Requests: a problem: huge rush at 8am, a few more at 10.

7. Outcome of requests – 12% told to call back. Rework.

8. Vast majority of requests are for same day.

9. 39% specified a named doctor, interestingly more often important to GPs at 52%.

10. GP consultations by day – compare fairly flat line with much higher demand on Mondays

11. 50% of cases acute, clinically best dealt with today
50% of cases acute, clinically best dealt with today. This usually rises to around 60%

12. At present, 21% of consults are by phone

13. Of these, 73% were resolved on the phone.

14. Your view is only 21% more consults could have been by phone – though this often changes!

15. What do patients think of our service?
Administrative staff views
On the whole, pretty good
normally excellent with us able to give same day appointments or telephone triage calls with GP
normally always good
Clinical staff views
we provide enough same day appointments telephone advise & triage
very good service, able to get appointment or speak to doctor with in a day

16. My ideal work Administrative staff views Clinical staff views
I would like the time to be able to finish one task before being several others. I like interacting with the patients on a friendly basis. I think this helps patients to feel more relaxed as they wait to see the Doctor
being able to be of help to all patients and clinicians when called upon. Improving my IT skills.
Clinical staff views
need more time for face to face consultation & telephone triage
more time to have face to face and paper work

17. Key points
Demand variable by day, supply volume match looks OK with Mondays much higher.
Patients ring the day they want to be seen, but most have to wait.
Continuity (choice of doctor) appears more valued by GPs than patients – this can be improved with better access
Currently some consults by phone, but resolve rate is on the low side at 45% which will mean a higher workload. The average is around 60%, saving time and increasing capacity.

18. 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.
When you move to our system, the results are rapid. You get your life back and start to enjoy a more profitable, less stressful practice life and patients are happier, accessing a GP consult usually within 1 hour with greater continuity of contact.

19. 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

20. How Patient Access Works
Reception takes call
GP phones patient
Problem solved
Come and see GP
Admin question
Come and see nurse
20%
10%
30%
60%
With our support, effective telephone triage is simple and works.
The patient phones in. The doctor calls them back. Deal with the problem today. Brilliant. The thinking is to understand patient demand and respond simply and appropriately.
At Patient Access we equip you to easily move to this system.

21. Golden 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)

22. Launch programme - just 12 weeks to a happier, less stressful practice
Detailed planning
Staff survey
Patient comms
Whole team meeting
New deal for patients
Predicting demand & matching capacity.
Patient & staff feedback
Review
Preparation
Launch day
Routine
New measures help tuning.
Build confidence
Affirmation
Consensus
Yes.
Pledge to
each other
and to patients

23. 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)

24. What happens next? Inform the patients Train staff
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

25. Which is the best pancake?
Hot, fresh and crispy
Cold and soggy