ACCESSING THE SERVICE FROM PRIMARY CARE The impact of direct access booking

1. ACCESSING THE SERVICE FROM PRIMARY CARE The impact of direct access booking Dr J A Gibson Consultant Gastroenterologist Mid Staffordshire NHS Trust

2. NHS A Patient Focused Service DIRECT ACCESS BOOKING SYSTEM - PART OF THE NATIONAL BOOKED ADMISSIONS PROJECT

3. AIMS • Consultants, GPs, Health Authority & IT working together to improve booking systems • Gives GPs a simple secure means of bookings patients directly on to operating lists during a consultation at the surgery • Allows patients to choose date & time of their investigation/operation and provides medical information at the time of booking

4. Progress to Date • 1 995 DABS introduced to GPs • 1997 Open access Gastroscopy • 1998 Gastroscopy through DABS • 2000 Procedure available at second site • 2001 Demand for services increased • Booking increased • 2002 Increase in procedures offered

5. Currently 25 practices used the system • During quarter 1/10/2001 to 31/12/2001 53 patients booked for Gastroscopy

6. Example of Current Process HospitalReferral ConsultantPrioritisation Appointment Given GP Consultation ConsultantConsultation Pre-op Assessment Admission TCI Letter Waiting List Anaesthetic Assessment Discharge Recovery Operation

7. Direct Booking GP Consultation Pre-op Assessment by GP Admission Anaesthetic Assessment(Streamlined) Discharge Operation Recovery Process for Direct Access

8. DIRECT ACCESS BOOKING • The Patients view • The GPs view • The Hospitals view

9. Patient views • popular as It speeds up the waiting time • Patient has choice of available dates/times/consultants whilst in Surgery • Reduces anxiety waiting for appointment • Patient can phone to change appointment once on the system

10. GPs views - advantages • Like efficient complete service offered • Providing a patient centred service • Speeds up appointment process • Allows GP to control the waiting list

11. GPs view - disadvantages • Patients are waiting longer for appointments • Question Sets too comprehensive • Time consuming by answering questions on line • Complex referral form • Duplication of paperwork • Simpler to send basic referral

12. Hospital view • Reduction in number of incorrect referrals • Correct patient clinical information provided • Patients have information booklet about the procedure • Patient choice reduces the number of DNAs • Booked Admissions Officer provides Gastro Dept with theatre lists/patient referrals weekly

13. The Future • Increase no of slots available on system • Compatible with all GP systems • Expand services for all open access referrals • Use of system for access to other services • Review the referral form/screen

14. My Thanks to the Patient Access Team Helen Perrin Judith Williams Katherine Aston

15. Thank you for listening

17. New Booked Admissions Process Hospitalreferral to Central Admissions ConsultantPrioritisation Appointment date discussed GP Consultation Consultation and decision made to treat or Nurse led pre-op assessment Consultant to discuss date Booking Clerk to discuss date Operation or treatment Discharge Recovery

18. INTRODUCTION AND PRESENTATION BY DR JOHN GIBSON CONSULTANT GASTROENTEROLOGIST