Tudor House Rectory Road Medical Practice Pathfinder

Tudor House & Rectory Road Medical Practice Pathfinder Harry Longman Harry. Longman@patient-access. org. uk 01509816293 07939148618 Nicci Iacovou Nicci. Iacovou@patient-access. org. uk 07970848573

What is it like to be a patient? Patient wants the doctor – – When do I have to call? Will I be seen? Will they see me when I want to come? Who will I see?

On average, I will wait 4 -5 days, getting longer over last six months

Though in truth this is a blend of 40% chance to be seen on the day (lower than most), or several days wait

Spread of appts booked ahead is quite large

DNA’s running at 40 -50 in a full week – related to days waiting to see GP

To get in on the day I will have to phone at 8 am on the dot and hang on, hoping something left.

Understanding demand volumes by week will be crucial. Currently looks like 1200/week.

By day and hour, matching supply to demand will fine tune the system. This is hard - but will change.

Continuity: chance of seeing my own doctor is 74%, high for the practice size and a good base. • Example: a patient making 5 appts seeing the same doctor 3 times has continuity of 60% • All patients, all doctors, all consultations are included • Highest measured is 80% (Stour, 10, 000 list) • Hard in large practices • Will see before & after • Have assumed data OK

Your data capture: what most patients want is to see the GP, but 25% for NP, nurse

Requests for GP much higher on Monday. Proportion “not agreed” constant around 20%

Volume of appts also flexes by day, but need relatively more on Monday

Most patients ring the surgery first thing, so appts are soon gone – matches EMIS Web data, plus “no”

Most patients want the GP today

15% of patients dealt with by phone consultation

Of the phone consultations, 85% don’t have to come in

Contrast: when asked, is this consultation appropriate? GPs say 85% are, only 5% f 2 f not needed

Continuity is important in 40% of consults

Of that 40%, continuity is achieved 94% of the time.

Patients’ views of our service • Fed up with having to phone again and again…can never get through at 8 am…appts gone by 8. 10 a. m. • Frustration with not being able to get a routine appointment as soon as they would like. • Not enough access to their own GP. • Patients who work have difficulty turning around to come back for an appt we could have given the day they phoned.

My daily work here • Stress…phone is constantly ringing. • Frustrating to tell patients we don’t have any appts • Patients booked in at inappropriate times. • Fear a mistake may be made because we are so busy. • Frustrations with patient demand political decisions beyond our control. • 14 -hour days…often can be as late as 23. 00!!! yet not enough time in the working day for admin tasks. • Frustrating when patients booked in…could have easily have been dealt with over the phone.

My ideal work • More appointments available on the day. • No phones on front desk so can deal with patients in person…designated phone areas and admin areas. • To give a friendly efficient service to patients. • Time in day to read letters, look at path results, plan. • A cheerful, enjoyable place to work, where people work together as a team…where all staff appreciated. • Some way of advising patients re self care v when they actually need to be seen. • I would like a lunch hour (or half hour).

How will the new system change things? Admin question Come and see me 30% 10% Reception takes call 20% 70% GP phones patient 10% Come and see the nurse PA Navigator measures the flows, which vary by GP & practice. 60% Problem solved

How can we help all our patients, all day, every day?

Comments from Victoria Med Centre, recently launched their Patient Access system • I actually had time to have a laugh with a patient. • I wasn’t praying for lunch time to come today. • I don’t feel as drained as I normally do at the end of a morning. • We’re actually smiling! • Patients are more respectful. • It was a piece of cake – more efficient. • I was finished by 12, normally I am still going at 12. 45 pm. • The patients were pleased.

What predicts the outcome? Success Failure • Leadership and teamwork • Purpose, being open to patients • Knowing how you are doing • Learning and adapting from evidence and from peers • Perseverance to make it your own • No change to slot thinking • Patients sink it with complaints • GPs don’t want to change • Staff undermine the change with each other and patients • Lack of understanding demand, overwork