Lockfield surgery willenhall 9 th may 2014 launching patient access
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Lockfield Surgery Willenhall 9 th May 2014 Launching Patient Access. Agenda. Current Model Surveys from Lockfield Staff Patient’s View Current Workload Ideal Work Your Performance Data A New Way Of Working Summary / Questions. Familiar?. Familiar?. “All gone, call back tomorrow”.

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Lockfield Surgery Willenhall 9 th May 2014 Launching Patient Access

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Lockfield surgery willenhall 9 th may 2014 launching patient access

Lockfield SurgeryWillenhall9th May 2014Launching Patient Access


Agenda

Agenda

  • Current Model

  • Surveys from Lockfield Staff

    • Patient’s View

    • Current Workload

    • Ideal Work

  • Your Performance Data

  • A New Way Of Working

  • Summary / Questions


Lockfield surgery willenhall 9 th may 2014 launching patient access

Familiar?

Familiar?


Lockfield surgery willenhall 9 th may 2014 launching patient access

“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

30% “urgent”

See any GP/locum

Poor continuity

Repeat booking


What do patients think of our service

What do patients think of our service?

  • Admin and Receptionists’ view

  • If they want a certain Dr and have to wait for an appointment they moan an say the service is crap

  • Some patients are very abusive and patronising and GP staff are unable to respond because there is no one to back them up

  • Fed up with the wait for appointments, Fed up with not being able to see their preferred doctor, Fed up with wait on telephones

  • Too many patients having to be put for triage due to lack of GP appointments. Need more commitment from the partners.

  • Nurses’ view

  • Majority generally satisfied. Few verbally complain unable to get appointment when want to or unable to get appointment with GP of their choice.

  • Doctors’ view

  • never enough appts, can't get to see the GP of choice

  • Don’t know


My daily work at present

My daily work at present

  • Admin and Receptionists’ view

  • I get very stressed when patients have been on triage and waiting over 2 hours or more for something as simple as a urine result to be looked at.

  • Frustrated with the whole of the appointment system. Really fed up with being complained at by patients because there are no appts available.

  • GP's screaming they are stressed but they need to be on the front line and deal with the abuse we have to tolerate. Its a very stressful job.

  • Nurses’ view

  • Patients attending with multiple/list of problems but not given time to cover everything. Patient expectation is to still have everything done.

  • Doctors’ view

  • There’s an unfair distribution of workload. Some Doctors spend time troubleshooting patient’s problems whilst others sort problems superficially with poor patient satisfaction who then return.

  • Don’t know


My ideal work

My ideal work

  • Admin and Receptionists’ view

  • More appointments. Continuity of care. Educate our patients on our service and their expectations. Better service makes happier staff and happier patients. No complaints regarding the service or the staff.

  • "happy staff will make happier patients", Overall a more stress free environment and happier staff that want to come to work and not feel as if they have to!!!!!

  • Nurses’ view

  • Interruption free with sufficient time given for the appointment. I don't like to feel rushed as I then have concerns that I may have missed something.

  • Doctors’ view

  • 12 face to face consultations and 12 telephone consultations per session

  • Fair distribution of work. Ability to spend more time with patients for mutual benefit.


If changes are made do you fear losing anything

If changes are made, do you fear losing anything?

  • Admin and Receptionists’ view

  • No fears, I am up for the change if it will make things better, it cant make it worse!!!!! LESS STRESS PLEASE!!!!!

  • I feel in the first few weeks I might struggle . If system makes things easier and stress free I am up for the change.

  • I don't fear the loss of anything but it will be nice to want to come into work instead of dreading it, having no headaches, no verbal abuse from patients or doctors and less stress

  • Nurses’ view

  • No, I only hope that things can improve thus reducing stress levels, and increasing job and patient satisfaction.

  • Doctors’ view

  • PATIENTS MAY NOT ACCEPT CHANGES AND THEN LEAVE THE PRACTICE.

  • Practice should change if its not effective. I fear it wont.


Lockfield surgery willenhall 9 th may 2014 launching patient access

Why do patients call? 52% for a GP, many for nurse, admin, test results (repeat prescriptions additional to this)


Calls by day monday much higher how should this affect capacity planning

Calls by day, Monday much higher – how should this affect capacity planning?


Calls by time of day heavy weighting at 8am suggests little available later on

Calls by time of day – heavy weighting at 8am suggests little available later on


Outcome of requests 22 told to call back another time generating rework

Outcome of requests - 22% told to call back another time, generating rework.


Vast majority of requests are for same day

Vast majority of requests are for same day.


You are seeing about 45 the same day this usually rises to over 80

You are seeing about 45% the same day. This usually rises to over 80%


Lockfield surgery willenhall 9 th may 2014 launching patient access

38% specified a named doctor, similar views from GP, continuity important for 41% of consults, about average.


Gp consultations highest on tuesdays low weds need to think how to match demand highest on mondays

GP consultations – highest on Tuesdays, low Weds. Need to think how to match demand – highest on Mondays.


66 of cases acute clinically best dealt with today

66% of cases acute, clinically best dealt with today.


At present just 22 of consults are by phone

At present, just 22% of consults are by phone


But of those 66 are resolved on the phone good

But of those, 66% are resolved on the phone – good.


Your view is only 6 more consults could have been by phone though this often changes

Your view is only 6% more consults could have been by phone – though this often changes!


Navigator shows your demand is going up week by week this year does it feel like this

Navigator shows your demand is going up week by week this year – does it feel like this?


Key points

Key points

  • Demand heavier on Monday, but not supply. Demand rising fast – any idea why?

  • Patients ring the day they want to be seen, but most have to wait.

  • Demand is high at the start of the day, though it could be worse. Will spread as patients gain confidence.

  • Continuity (choice of doctor) is agreed on by patients and GPs, though not achieved on many occasions

  • Currently some consults by phone, and a good proportion of them are resolved, should work well but with many more calls.


A practice in the patient access community looks sounds feels different

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.


How patient access works

How Patient Access Works

Come and see GP

Admin question

30%

20%

Reception takes call

GP phones patient

60%

60%

Problem solved

10%

20%

Come and see nurse


Lockfield surgery willenhall 9 th may 2014 launching patient access

Your Patient Access Launch Programme

Just 5 Simple StepsTo

Your Happier, Efficient,

More Profitable Practice

Within The Next 12 Weeks


A typical receptionist d ay with patient access

A Typical Receptionist Day With Patient Access

Admin question

20% solve

Per Week,

Patient List Of 8,000

10-12% of patients call

28% on Monday

220 – 270 calls @ 2 mins

7 to 9 hours of calls

Other days 4.5 to 6 hrs

Many more calls will come in the morning, but will spread as a result of good service

Reception takes call

Just 60%

list

for GP

20% book

to see nurse

Nurse


A typical gp day with patient access

A Typical GP Day With Patient Access

Per Week,

Patient List of 8,000

6-8% call for GP

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

40 x 5 mins plus 16 x 10 mins

Total consulting time 6 hrs/day

Availability of nurse consultations can reduce this by ≈ 40 mins/day

Mornings more phone calls, becoming more face-to-face late morning & into afternoon.

Come and see GP

30%

GP phones patient

60%

Problem solved

10%

Come and see nurse


Average wait time to see a gp drops dramatically

Average wait time to see a GP drops dramatically

All data from Clarendon, charts by PA Navigator


How can we help all our patients all day every day

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


Turns out you can rely on the patients

Turns out, you can rely on the patients


The thinking goes like this

The thinking goes like this…

NO

YES

Helping patients

Enhancing professional practice

Evidence based

Measurement for improvement

Saving effort and time

  • No targets

  • No tick boxes

  • No compulsion

  • No “incentivisation”

  • No substitute for the GP-patient relationship


Lockfield surgery willenhall 9 th may 2014 launching patient access

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 always offered the same day

  • 7% list increase with no extra GP sessions needed at Oak Tree Health Centre

We’re now saving20% 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


Lockfield surgery willenhall 9 th may 2014 launching patient access

The Patient Access Launch Programme

Eight ways we support you in leading change and avoiding the pitfalls

Your personal training partner

Key actions checklist week by week

Datalog paperless data capture

Unique Navigator analysis suite

Private online resources portal

Easy to use video tutorials & FAQs

Patient communication materials customised for you, video & leaflet

Expert helpline and rapid response throughout the programme


Lockfield surgery willenhall 9 th may 2014 launching patient access

Step 1 – Consensus

This step equips you to secure the all-important agreement of your partners

  • Explaining the process so that you’re fully informed to make the right decision

  • Leading Change questionnaire to assess your readiness for change

  • Working with you to identify the Change Leader within your practice.


Lockfield surgery willenhall 9 th may 2014 launching patient access

Step 2 - Preparation

Equips you to transition smoothly to your new system

  • Your Own Training Support Partner is with you step-by-step, including:

  • Manager planning by reviewing your rotas and current processes

  • Advising on scheduling, process-changes & your go live date

  • Training on the steps and actions to inform your staff and patients.

  • Staff and patient survey

  • Real Time Paperless Data Capture input by you interpreted by our Navigator software

  • Whole Team Induction led by your Training Support Partner

  • Bespoke Online Resource Portal including Video Tutorials, FAQs and Key Actions Checklist

  • Customised Patient Communication - Video, Leaflet, Poster produced for you.


Lockfield surgery willenhall 9 th may 2014 launching patient access

Step 3 – Launch Day!

  • The exciting, agreed day where you transition to your new system.

  • Your Training Support Partner attends your Launch Day to:

  • Offer support and guidance on the first day you fully implement telephone triage

  • Monitor and advise on controlled face-to-face appointment-setting

  • Answer staff and patient questions

  • Feedback Wall and Patient Survey


Lockfield surgery willenhall 9 th may 2014 launching patient access

Step 4 – Adapt

  • The daily process of becoming embedding the system, building confidence and adjusting it so that it works beautifully for you.

  • Real Time Online Data Capture continues to be input by you

  • Navigator software continues to analyse your activity

  • Your Training Support Partner advises you on emerging patterns so that you can adjust accordingly

  • On-hand help continues from your Training Support Partner to answer your questions and overcome any challenges.


Lockfield surgery willenhall 9 th may 2014 launching patient access

Step 5 – Affirm

  • Review and refine your activity and results.

  • Real Time Data Capture continues to be input by you to equip us to monitor your activity and advise you

  • New Staff and Patient Survey

  • Bespoke Before and After Report produced using Navigator software and presented by your Training Support Partner to review key learnings, maintainprogress, discuss next steps

  • Option of on-going monitoring and support with our Accelerator Programme.


Lockfield surgery willenhall 9 th may 2014 launching patient access

Your step by step guide to a happier practice

Start today

Call 01509 816 293 | email [email protected]

“Patient Access has given us a new lease of life” Dr. Kam Singh


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