Bodey Medical CentreWhat is it like to be a

patient?Meena Modi

meena.modi@patient-access.org.uk

The agenda

• Your current status • Data illustrating current situation• Fear about change• The new system and what it means to you• Any questions

What do patients think of our service?

• Administrative staff views– Patients not happy. Most appts given out by 8.45 am,

then patients asked to ring back. Not good.– Patients don’t like being told to ring back. System needs

to change• Clinical staff views

– We do very well with emergency appts at the expense of routine appts, but not bad service provided

– Good. Occasional grumbles about appts but infrequent– Constant complaints about bookings in advance with

doctor of choice– Problems getting through phones– Patients would often like to book at specified time with

specified doctor which can’t be done at moment

My daily work at present• Administrative staff views

– Can get stressful when staff ask what to do about appts – don’t have answers!

– Multiple complaints from patients about lack of routine appts

• Clinical staff views– Open access /emergency appts can be stressful,

otherwise ok– Part time GP– Often busy, good work colleagues, sharing of workload

between staff– Constant complaints about bookings in advance with

doctor of choice– Problems getting through phones– Patients would often like to book at specified time with

specified doctor which can’t be done at moment

Reception takes

call

GP sees patient10-min

slot

Problem solved

70% “routine”

30% “urgent”

“All gone,call backtomorrow”

3 week waitHigh DNAsRepeat booking

See any GP/locumPoor continuityRepeat booking

Patientpressure

Just 47% of patients get what they ask for, and 27% are told to call back. Very high rework and

frustrating for all

Most people calling the practice want the doctor

No of contacts each day that week:

• Mon - approx 820 (36% of week)• Tues - approx 470 (20% of week)• Wed - approx 475 (20.9% of

week)• Thurs - approx 270 (11.8% of week)• Fri - approx 235 (10.3% of

week)

No of consultations per day of data week:

• Mon - approx 270• Tues - approx 185• Wed - approx 190• Thurs - approx 135• Fri - approx 115

Demand through the day – heavy pressure at 8-9 am.This can change, smooth out with rapid response.

Patients requesting appts for same day or 2 days ahead. Very unusual – is this because of when they

are released?

Of the phone consults, 43% are resolved. We find typically GPs resolve around 60%

At present 62% of consults are face to face, but at 38% many already are telephone

Already GPs say 10% of consults don’t need to be face to face. This always increases.

GPs view on continuity, important at 38% - lower than national average

Only 26% of patients ask for a named doctor. This is on the low side, is it due to high proportion of

student population?

My ideal work

• Administrative staff views– Would like to be able to offer appts to patient who are

really ill. Lot of NHS wastage on those who don’t need appts

– To be able to give patients appts when they want and not to have patients getting angry with staff

• Clinical staff views– Did not think that the system needed fixing although

accept that it is hard for reception on the front line– An advocate for patients – hence practising medicine!– Calmer at present with structured day and patients less

disgruntled as able to get appts with me

Fear losses if changes are made?

• Administrative staff views– The elderly may suffer as they don’t like change– Some patients may not like the new system as they like to

be ale to plan and book ahead• Clinical staff views

– Patients may lose choice of doctor as we will need to spread workload evenly

– Fear of rise in complaints and increased hassle during consultations – which we don’t have at present

– Loss of patient confidence– Currently have safety net with pre-booked follow up appts– Working day may become chaotic with on call/ open access

system

The new system and whatit will mean

Reception takes call

GP phones patient

Problem solved

Come and see GP

Admin question

Come and see nurse

20%

20% 10%

30%

60%

60%

How Patient Access Works

A Typical Receptionist Day With Patient Access

Reception takes call

Admin question

20% solve

20% bookto see nurse

Just 60% list

for GP

Nurse

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

GP phones patient

Problem solved

Come and see GP

Come and see nurse

10%

30%

60%

A Typical GP Day With Patient Access

Per Week, Patient List of 8,000

6-8% call for GP Mon - 28% of the week130 to 180 calls on Mon80-120 calls on other daysPlan for 40 each per GP per day40 x 5 mins plus 16 x 10 minsTotal 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.

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.

Average wait time to see a GP drops dramatically

All data from Clarendon, charts by PA Navigator

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

The Relief of Working Efficiently

The Patient Access Launch Programme

1. Your personal training partner

2. Key actions checklist week by week

3. Datalog paperless data capture

4. Unique Navigator analysis suite

5. Private online resources portal

6. Easy to use video tutorials & FAQs

7. Patient communication materials customised for you, video &

leaflet

8. Expert helpline and rapid response throughout the programme

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

The agenda

• Your current status - current model• Data illustrating current situation• Fear about change and your ideal• The new system and what it means to you• Any questions