gallions reach health centre what is it like to be a patient? thoreya swage...
TRANSCRIPT
Outside a traditional surgery
People waiting on the phone, the same, unseen
The traditional model
Reception takes
call
GP sees patient
10 min slot
Problem solved
70% “routine”
30% “urgent”
60%
“All gone.Call backtomorrow”
3 week wait,high DNAs,repeat booking
See any GP/locumPoor continuity,repeat booking
Patientpressure
Rework
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
Monday morning 8.30, Busy day, going full tilt.All carefully worked out.
Dr Chris Barlow of Quorn, oneof the earliest pioneers in 2000
The traditional view of general practice, every problem requires 10 minutes face to face with the GP
One tiny problemPerfect service
• We help all our patients, all day, every day• The Patient Access method makes this a daily reality.
A new principle is at work
Simple, but the whole system changes
PA Navigator measures the flows, which vary by GP & practice.
Reception takes
call
GP phones patient
Problem solved
Come and see GP
Admin question
Come and see nurse
10%
20% 10%
30%
60%
70%
“How are we going to help all our patients, all day, every day?”You answer, over five stages of the programme.
Consensus
Preparation
Staff surveyPatient surveyData captureTrainingSystem setupWhole team
New deal for patientsFeedback wallTest & learnBuild confidence
Launch day
Routine
ReviewEvidence:New measuresNew staff surveyNew patient surveyYour decision
Yes.Pledge toeach otherand to patients
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?
Cold and soggy
Hot, fresh and crispy