to all our patients who completed the recent Appointments Survey.
The purpose of the survey was to enable us to gauge levels of satisfaction and to
gain knowledge of our patients’ understanding of certain aspect of our appointments
systems.
The results of the survey will help us with our future planning. We will also more
prominently advertise information to ensure that patients have a better
understanding of what to expect from the surgery.
The 3 things we would like patients to be more aware of are:
An appointment is 10 minutes long.
The GP deals with 1 item in this time
Repeat Prescriptions have a 2 working day turnaround
period.
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Convenience of our Same Day Triage:
The majority of our participants in the survey rated this as satisfactory with only 20%
finding it inconvenient.
40% of patients surveyed felt that the current system of calling between 8:30 and
10:30 to register for a telephone triage call the same day. As could be expected a
further 42% would prefer an all day service. No patients indicated they would prefer
and afternoon service.
We are currently looking at ways to provide more pre-bookable and online
appointments but without causing detriment to our same day service.
Seeking Alternative Advice
Surprisingly 52% of patients surveyed did not seek advice elsewhere before
contacting the GP. Less than half the respondents had visited our website. Of those
who did visit the website over 80% found it useful.
Appointments
Whilst three quarters of the respondents were aware that a standard GP
appointment is 10 minutes more than 50%, mistakenly, thought a GP could deal with
2 or more items in this time.
Prescriptions
Most were aware that the turnaround for a repeat prescription is 2 working days
although around a quarter a patients thought it was less than this.
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Telephone Triage
Whilst many of the patients surveyed felt our telephone triage system
worked well for them some others questioned why we use it.
The fact is that we receive far more requests for appointments than we
can possibly see. Triaging helps effectively manage these requests. By
doing this we will generally ensure that the right patient is seen at the
right time by the right clinician in the right location.
Our reception team is absolutely key to this system. They have a huge amount of
knowledge and understanding around what is considered as urgent and which
members of our team are the most appropriate for the conditions being explained to
them. Whilst we understand there may be trepidation in providing information to a
receptionist we would assure you that they are all extremely aware of their
responsibilities around confidentiality and undertake regular information governance
training. We would therefore encourage patients to provide information to the
receptionists as it will help improve the overall service they receive.
Triage: Definition
the assignment of degrees of urgency to wounds or
illnesses to decide the order of treatment of a large
number of patients or casualties:
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Number of Doctors
Some patients questioned why we don’t employ
more doctors. The shortage of GPs in the UK is the
subject of many a media article and this is something
we have become very aware of when trying to
recruit. To enable us to continue providing a high
quality service we have looked at alternatives to the
traditional and possibly outdated models of providing care in general practice.
We therefore now employ Advanced Nurse Practitioners and a Clinical Pharmacist to
assist the GPs in dealing with the increases in demand. Both these roles operate
within their competences.
The Advanced Nurse Practitioner (ANP) is an experienced and autonomous
registered nurse who has developed and extended
their practice and skills beyond their previous
professional boundaries. An ANP is able to use the
expert knowledge and complex decision-making skills,
guided by The Code* in unpredictable situations. This
may include managing patients with undiagnosed health care problems and is
shaped by the context of their clinical practice. The advanced level is underpinned
by the essence of nursing, and the values of caring. It applies the principle of
knowledge of the patient as a distinct person and individual whilst respecting and
working with their culture and diversity. More information is available at :
http://www.rcgp.org.uk/membership/practice-teamresources/~/media/16411E76AC5B4E818547E331F9D3CA97.ashx
*The Code: Professional standards of practice and behaviour for nurses and midwives
https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
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Appointments
Many patients indicated they thought a GP could deal with multiple issues in a
standard 10 minute appointment.
The GP consultation can
often be a complex affair
with each patient having
very individual symptoms.
In addition to the
consultation they also need
to update the medical
records and make any arrangements, such as referrals, that result from the
appointment. It is therefore important that the GP is able to spend the appointment
time concentrating on the most pressing issue. Our GPs will endeavor to assist
patients with more than one issue provided time allows. You should, however,
expect to be asked to make a further appointment for additional issues. If you advise
the receptionist or triaging GP that you have multiple things you wish to discuss they
will consider allocating an extended appointment.
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Clinical Pharmacists in GP surgeries resolve day-to-day medicine issues and
consult with and treat patients directly. This includes providing help to manage longterm conditions, advising those taking
multiple medicines (polypharmacy) and
delivering clinical advice about
treatments. They also assist with
communication across a patient’s care
pathway and manage medicines
shortages by suggesting suitable
alternatives where appropriate. More
information is available at
http://www.rpharms.com/our-campaigns/pharmacists-and-gp-surgeries.asp
Electronic Communications
Several people suggested that we should have a facility
where they can email the practice with queries etc. The
issue here is that whilst the NHS email system is
considered secure we cannot have this assurance when
emailing external addresses and therefore we would not
be able to keep a patient’s clinical information secure. In addition to this a clinician
will pick up on nuances on the telephone and in face to face consultations that
simply would not be apparent in an email.
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Self-Care
Our survey indicated that very few people
seek advice elsewhere before contacting
the GP surgery.
Many minor ailments can be adequately
treated without need for the intervention of a
GP surgery. Our website provides links to
fact sheets about several minor ailments.
In today’s modern society there are a vast number of places where people can seek
advice We would, however, recommend that you only use NHS websites such as
NHS Choices.
In answer to the question why should you use self-care when you have access to a
GP we would refer to the section of the Self Care Forum on “Why is self care good
for people?”
Empowering people with the confidence and information to look after
themselves when they can, and visit the GP when they need to, gives people
greater control of their own health and encourages healthy behaviours that
help prevent ill health in the long-term. In many cases people can take care of
their minor ailments, reducing the number of GP consultations and enabling
GPs to focus on caring for higher risk patients, such as those with
comorbidities, the very young and elderly, managing long-term conditions and
providing new services.
More cost-effective use of stretched NHS resources allows money to be spent
where it’s most needed and improve health outcomes. Furthermore,
increased personal responsibility around healthcare helps improve people’s
health and wellbeing and better manage long-term conditions when they do
develop. This will ultimately ensure the long-term sustainability of the NHS.
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Opening Times
In addition to our core opening hours we have been operating an early and late clinic
one day a week for the last 18 months. These clinics have been held primarily for
patients who are working and find it difficult to come to the surgery in normal working
hours. During these extended hours we only provide limited services i.e. the
Dispensary and appointment booking are not available.
It is evident from some of the comments that many patients are not aware we
provide this additional service.
In addition to our GPs seeing patients they regularly work late into the evenings and
weekends dealing with the non-face to face aspect of their work. This includes
dealing with correspondence to and from hospitals and specialists, reviewing test
results, dealing with incoming queries, authorising repeat prescriptions and keeping
their knowledge up to date.
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