Wallington Medical Centre What is it like to be a patient?

1. Wallington Medical CentreWhat is it like to be a patient?

2. Outside a traditional surgery People waiting on the phone, the same, unseen

3. “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

4. Face-to face vs telephone consultations

5. Already 24% of consultations are by phone

6. Sample is small at 17, but of these 88% were resolved on the phone.

7. Requests for appointments are reasonably well spread

8. Confirmed by datalog collection - a good sign

9. But outcome of requests – 17% told to call back – generating more work

10. You are seeing about 100/wk and 40 phone/wk, total of about 6% of your list, well within expectations.

11. Average no of days wait to see a GP is 3.5 days

12. Some appointments are up to 2 weeks ahead

13. Vast majority of requests are for same day.

14. Continuity is about 75%

15. 32% specified a named doctor, interestingly more often important to GPs at 43%, about average.

16. What do patients think of our service? • Administrative staff views • Some complain about lack of appointments but the majority seem ok. • They want more appointments with Dr. • generally patient's are happy. Minority of rude, demanding patients complaining they are unable to make an appointment to see the GP. • Clinical staff views • Overall good but can be long wait for routine appointment which can lead to higher DNA rate. Sometimes inconsistent some patients are offered telephone appointments if they can't get a routine appointment but some are not. • Patients complain that it is difficult to get an appointment with a doctor.......... However having seen a clinician they are usually positive about their experience.

17. My daily work at present • Administrative staff views • Spend most of my time on reception whilst juggling paperwork between callers. Difficult to finish anything. • Mainly administration work; Audits, QOF, etc. Can become stressful when interrupted with patient queries/ reaching QOF targets. • Clinical staff views • Generally manageable as we operate 15min appointments and patients are usually seen on time. • I feel my surgeries are not too stressful, they can be if there are many extras or I will get stressed if the surgery is over-running. Patients do complain about access and it can be stressful to explain to them that we are trying our best.

18. My ideal work • Administrative staff views • I would prefer to be on reception all the time and the patients then get to know you and its easier to explain a difficult situation to them. • Ideal day! Having more time - not feeling rushed to get work done. • Clinical staff views • More structure to the course of my day with greater flexibility. Would like to do more proactive management of LTC patients • Patients arriving on time, surgery running on time, no extras, no interruptions, patients with single problems in each consultation!

19. 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.

20. 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 saving20% of GP working hoursand A&E attends are 50% below Liverpool average- DrChris Peterson, GP at The Elms & Liverpool CCG Urgent Care Lead

21. 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 andsee nurse

22. Golden Rules • If telephone lines open 9am, so do Dr callbacks • All patients are called back – no Doctors appointments made by receptionists • Call back within the hour • All Drs on telephone call backs (exception Duty Dr or locum/trainee) • Call patients in for face to face from mid morning (and mid/late afternoon)

23. Launch programme - just 12 weeksto a happier, less stressful practice Detailed planning Staff survey Patient comms Whole team meeting New deal for patients Predicting demand & matching capacity. Patient & staff feedback Review Launch day Preparation Routine New measures help tuning. Build confidence Affirmation Consensus Yes. Pledge to each other and to patients

24. 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)

25. 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

26. Which is the best pancake? Hot, fresh and crispy Cold and soggy