Slide 1

Report
P84012 Northenden Group Practice
What is it like to be a patient?
Meena Modi
[email protected]
“How To Get Your Life Back,
Save More Money
and Have Happier Patients
Within The Next 12 Weeks”
Familiar?
Before Patient Access GPs, PMs and receptionists said…
I’m
embarrassed
when I see rows
of patients
waiting
I dread the
inevitable phone
blitz at 8 every
morning
I’m annoyed
by the huge
number of
DNAs
We’re going to
have to get
another GP in
at a cost of
£100,000.00
I can’t take the
aggression from
frustrated patients
We all feel totally
anymore. I can’t magic
drained & I know that
up an appointment
patients aren’t happy
either
Not To Mention The Patients…
Why do I have a 3-
I’m frustrated that I can’t
week wait at my
speak to my GP when I
surgery & yet I hear of
need to. I’m very
others who see their
doctor the same day?
tempted to change
surgeries
We’re told to ring at
8 but can never get
through because
they’ve told everyone
to call at 8.
It’s a joke!
A lot of the time I
don’t even need to
see the GP, so why
can’t I just phone,
save the travel cost,
hassle & my GP’s
time?
“All gone,
call back
tomorrow”
Reception
takes call
3 week wait
High DNAs
Repeat booking
70% “routine”
Patient
pressure
30% “urgent”
See any GP/locum
Poor continuity
Repeat booking
GP sees
patient
10-min slot
Problem
solved
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
A Typical Receptionist Day With Patient Access
Per Week,
Patient List Of 8,000
Admin question
10-12% of patients call
20% solve
28% on Monday
Just 60%
list
for GP
Reception
takes call
220 – 270 calls @ 2 mins
7 to 9 hours of calls
Other days 4.5 to 6 hrs
Many more calls will come in
20% book
to see nurse
Nurse
the morning, but will spread as
a result of good service
A Typical GP Day With Patient Access
Per Week,
Come and see GP
Patient List of 8,000
6-8% call for GP
30%
Mon - 28% of the week
130 to 180 calls on Mon
80-120 calls on other days
Plan for 40 each per GP per day
GP phones patient
60%
40 x 5 mins plus 16 x 10 mins
Total consulting time 6 hrs/day
Availability of nurse consultations
10%
can reduce this by ≈ 40 mins/day
Mornings more phone calls,
becoming more face-to-face late
morning & into afternoon.
Come and see nurse
Problem
solved
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.
Average wait time to see a GP drops dramatically
All data from Clarendon, charts by PA Navigator
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
What do patients think of our service?
• Administrative staff views
–
–
–
–
–
–
–
–
Not happy with current appointment system
Not happy with patient queues outside in mornings
Lack of appts
Difficult for patients to get appts if they don’t call in for one
Patients not happy having to book appts a week ahead
Reception staff at brunt end of disgruntled patients
Struggle for appts thus poor feedback on NHS website
Most patients happy at Gatley
What do patients think of our service?
• Clinical staff views
– Avoid wasting time
– Patients want appts and better continuity
– Current system offers appt with Dr in the morning (open
surgery)
– But bookable appts nearly 7 days in advance
– Difficulty getting thro on phones
– Difficult getting appts when at work
– Often long wait on ‘extras’ list
My daily work at present
• Administrative staff views
– Front reception ; copy / summarising notes
– Scanning; insurance work
• Clinical staff views
Patient access too easy
Inadequate appt times
Working life in surgery has become horrendous over last 6 mths
Patient expectations and demand out of control
Increased chances of patient complaints as patients feel they
can get financial compensation
– Increased paperwork – never enough time to get done during
the day
– Afternoon clinics run late due to complex probs and elderly
patients
–
–
–
–
–
My daily work at present
• Clinical staff views (cont)
– Increased paperwork – never enough time to get done during
the day
– Afternoon clinics run late due to complex probs and elderly
patients
– Phone too many people back
– Sometimes phones not answered / ansaphones
– Too many trivial problems
– Overbooked clinics with inapprop appt times
– Overbooked clinics with inapprop appt times
– Patients struggle for appts
– Poor feedback on NHS wesbite
My ideal work
• Administrative staff views
– Being able to get job in hand done
– Less chasing up / querying meds
– Most admin / reception staff happy with current roles
• Clinical staff views
see as many patients as possible
Also safe and effective consultations
fewer FTF appts; more using technology
shorter surgeries; fewer visits; longer appt times for better
consults
– booked appts only – no extras or unnecessary visits
– patients taking more responsibility for their health
–
–
–
–
My ideal work
• Clinical staff views (cont)
Have a lunch break and time to do paperwork
More telephone triage – opportunity to educate patients
Reduce home visits - mostly not necessary (93% of time)
Seamless and instant flow of information from hospital to GP
via computer links
– Enough time to see patients – flexible appt times
– Good mix of population (young / old/ easy / complex)
problems
–
–
–
–
Fear losses if changes are made?
• Administrative staff views
–
–
–
–
–
–
How would patients request urgent prescriptions?
Loss of jobs?
Elderly moving away unless change is for the better
Not being ale to physically book appt for patients
Job satisfaction?
Appt bookings left to the Drs
• Clinical staff views
–
–
–
–
–
–
–
Safer prescribing, less overload
Difficulty with covering triage when drs away
Lack of freedom to do other activities due to time on phones
More litigation as fewer FTF consults
More pressure on our time – new system hopefully more effective
A system that no-one understands with patients complaining
Unhappy admin staff
Why do patients call? Nearly 60% for GP.
How do patients request help? Very surprising large
proportion are walk ins at 43%
When do they call? A strange double peak at 10am and
3pm – may be delayed submissions?
Do they get what they want? Appears that 93% do, but
with only 124 responses, may not be all
When do they want the GP? Vast majority today, with
some for a week ahead.
Consultations by day: Monday is a little higher
So far 82% of consults are face to face and only 16% by
phone
Already you see 19% of consultations as “face to face not
needed” – this always goes up lots.
Already you are resolving 63% of calls over the phone –
though many others become visits?
Continuity seen as important in quite few consultations,
only 30%. Patient requests 37%.

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