1. © Productive Primary Care Ltd Access System Review - Solutions St Martin’s Practice - Leeds Michelle Webster (Associate) Productive Primary Care Ltd Thursday 6 March 2014

2. Agenda  Refresher of principles of access improvement  Discussion on what your data reveals and identification of any problem areas for your practice, split between  Next steps, etc © Productive Primary Care Ltd

3. Refresher of principles around access improvement © Productive Primary Care Ltd

4. The ABCD of Access Improvement A A ctivity How many appointments did you deliver? B B acklog How many appointments are already booked? C C apacity How many appointments could you deliver? D D emandHow many consultations (of any type) are wanted by your patient population? © Productive Primary Care Ltd

5. Appointment Requests (Demand) Imagine patient demand as a bathtub! Backlog Appointment Supply (Activity)

6. Appointment Requests (Demand) The Solution: Today’s Work Backlog Appointment Supply (Activity)(Capacity) A&EWICOOH Increase Capacity (Short term) Remove the backlog, match capacity to demand Match Capacity to Demand; and Activity to Capacity © Productive Primary Care Ltd + Unmet Need!

7. Discussion on what your data reveals and identifying any problem areas for your practice © Productive Primary Care Ltd

8. Data Collection You’ve collected your data A A ctivity B B acklog C C apacity D D emand © Productive Primary Care Ltd

9. Activity

10. Current Consultations per month c 55 % Dr consultations by phone Relevance to Dr First :  VERY SIGNIFICANT current practice for DOCTORS  VERY SIGNIFICANT current practice for PATIENTS GP Routine slots + extras seen Phone Consults DNAs Patients Actually Seen Total 1097 1271 761025

11. DNA’s DNA Cost 76 x £11 / 4 x 52 = c £ 11,000 per annum GP Routine slots + extras seen Phone Consults DNAs Patients Actually Seen Total 10971271 76 1025

12. Backlog

13. Demand – extract weeks 1&2

14. Demand Estimated v Practice Collected

15. WEEK 1 Chart - Demand/Capacity/Backlog

16. WEEK 2 Chart - Demand/Capacity/Backlog

17. WEEK 3 Chart - Demand/Capacity/Backlog

18. WEEK 4 Chart - Demand/Capacity/Backlog

19. Summary Chart - Demand/Capacity/Backlog

20. Sessions Estimated Practice Collected Current

21. Discussion Items Including :  Similarities between Estimated & Practice Collected!  When looking at different systems always consider relative ‘Unmet Need’  HOTSPOTS : MONDAY a.m. TUESDAY a.m. FRIDAY a.m.  How does it feel in reality ? Chaotic? Pressured?

22. Discussion Items – Which system? Including :  Overall Standard system requires more sessions than any other – and with most Unmet Need  Doctor First requires fewer sessions – whilst minimising Unmet Need  If Backlog worked down and Doctor First adopted, then spare capacity can be used for other clinical/non- clinical work and to ease the pressure at annual leave time

23. What influences the choice to introduce Doctor First?  Understanding of the options available  Practice makeup  Team members attitude to change (particularly doctors)  Result of ABCD assessment Activity Backlog Capacity Demand  Patients

24. Doctor First Patient pathway Patient contacts surgery phone/walk- in/on line Receptionist asks for patient name, DOB, a brief description of problem and enters it onto clinicians call back list. If identified as other query, put on appropriate clinician for routine care. Dr books appt Dr talks to patient Appt needed Appt not wanted Patient’s issues resolved

25. Increasing Appointment Capacity Standard system 18 patients x 10 min = 3 hours Doctor First system 3 people can be consulted by phone in 10 min 18/3 x 10 min = 1 hour 1/3 will want to see Dr = 6 6 patients x 10 min = 1 hour Outcome What took 3 hours now takes 2, or; In 3 hours 27 people can be helped rather than 18 (a 50% increase in productivity) The time saving bit… The increased efficiency bit…

26. Contact Details Dillon.sykes@productiveprimarycare.co.uk Tel: 0800 6990184 (Office) Mobile: 0779 524 8771 Twitter: @ProdPrimCare Website: www.productiveprimarycare.co.ukwww.productiveprimarycare.co.uk Longfields Court, G07 Middlewoods Way Wharncliffe Business Park, Carlton, Barnsley S71 3GN