Most patients want to see the doctor.

1. Priory Medical Group PathfinderWhat is it like to be a patient?Harry Longman, Bill Howlett, Patient Accesswilliam.howlett@patient-access.org.uk

2. Most patients want to see the doctor.

3. All appointments are booked in two manic periods at 8am and 1pm.

4. Consultations per week are steady at a total of about 800 per week, of which about 17% are telephone. Overall 5.3% of patients contact per week, low end

5. You report similar proportions

6. 60% are acute or exacerbations.

7. Just under 50% of appts are booked on the day, others much longer waits.

8. Average days waited to see a GP is around 5 and rising. Wait for a telephone consultation is similar – except for Christmas week!

9. Wide spread of appts booked ahead, up to 4 weeks. Many phone consults booked up to a week ahead.

10. 57% are new cf follow ups.

11. Most face to face appointments are appropriate in your view

12. Your patients appear to be flexible, but some like to be able to see their own doctor.

13. In GPs view, continuity matters in just under half of consults, but in 24% of these it is not achieved

14. Statistically measured, continuity within month is about 62%. This is the chance of seeing the same GP on multiple visits.

15. Receptionists’ view Some pts are very grateful of our help but others can be very rude and demanding. Most common issue is lack of Dr appointments. They are not happy with how long they have to wait on the phones or for appointments. Doctors’ view (Patients) complain about not seeing same doctor each time. they have had to wait weeks for 'this‘ appointment. Admin Inconsistencies make patient service poor at times. What do patients think of our service?

16. Receptionists’ view Dealing with pts via phone and face to face contact can be stressful. It’s hard to try to be helpful and cheerful. Doctors’ view No breaks at all during working day. Never have time to reflect. Each day feels like a 'fire-fight‘ from the moment you walk through the door, until the moment you leave. Admin Frustrating when the service we offer is not the best it can be. Staff do not feel comfortable to "break the rules" in the interest of the patient and common sense. My daily work at present

18. Receptionists’ view Come to work and do my job without getting shouted at. I would like to be able to offer patient more varied app times. I would like to be able to offer patients a better service. Doctors’ view Break in surgery to catch up. Easier access for patients with doctor of their choice. Admin Happy patients = happy staff. A more flexible system that caters to the needs of patients. My ideal work

19. Study of system 2010-11: demand by phone and f2f about equal.We would expect to see f2f only around 40% of phone. Calling in every patient phoned only increases workload.

20. Even with a high level of phone consults, average waiting times to see the GP were rising through 5 days to over 9 at one point. A phonecall was up to 4.

21. Distribution waits from booking to apt shows many in the first week, some at a week, some out at 4 weeks. Probably follow ups - unnecessary

22. But the pattern of demand through the day then was good, no 8am and 1pm rush as there is today. Same service all day.

23. The median response time achieved then was little over an hour. Not bad, but we have many practices below 30 minutes, which saves work.

24. Phone consults were a little shorter than typical (few below 4 mins) but then almost all patients were brought in.

25. Key points from previous experience • You were making a high number of phone consultations, but a roughly equal number face to face, therefore no saving, extra time required • We would expect around 40% bring in rate – this was near 100% • Your average time to see face to face rose through 5 days to 9 – although many were same day, days were filled with many prebookedappts. • Pattern suggests that many were follow ups. We know that these are least likely to be brought in if they are a phone call, about 20% cf 50% new/acute, so it makes no sense to put them in the diary as f2f. • Need to have almost clear days every day to work well • Response times were OK at just over an hour, though many achieve under 30 mins which saves work. • Pattern of demand through the day was good, contrast with today’s rush at 8am and 1pm as demand is choked. • Please take a careful look at our case studies. There is no reason why Priory could not thrive in the same way, giving an outstanding service and saving time and money for the partnership, within weeks.

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

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