Here at Gurn HQ we have received a press release from the Health Care Group. We also posted an article earlier today (you can see it below this one) reporting what Provost Liz said at the River CC meeting. Here is the Health Care Group press release responding to recent criticisims:
“Over the last 13 weeks NHG has changed the way patients access our GP service, moving from a ‘book in advance’ system to one where the patient initially speaks to a GP about their problem, and then the GP and patient decide on the appropriate course of action.
The reasons for this change were in response to the patients of the practice having to wait 3 - 6 weeks to see a named GP; concerns around continuity of care; and appointments that were made but not attended. Our intention was not to raise any barrier to patients seeing their doctor, as some perceive. Most weeks there were 45 appointments or 3 surgeries worth of consulting time wasted. We are constantly striving for a safer and more responsive service, so with the new service over the last 13 weeks, the patient phones the practice and then the GP and patient decide together on the best course of action. We have taken 18,500 calls in that time and had 5,325 appointments. These have been the full range of GP problems from dementia, cancer, heart and lung problems to rashes, coughs, sore throats and urine infections. Of the 5,325 appointments, 3,090 were seen on the day that the patient called, 750 were seen the following day and a total of 5,060 were see within 7 days of phoning, generally because this suited the patient. The other patients were seen by nursing staff, given telephone advice by the GP or directed to other services, for example, physiotherapy, occupational therapy, social services and the voluntary sector.
The new process has dramatically reduced the numbers of patients who do not keep their appointments, from 3 surgeries a week to 1 patient a day. This has made the doctors more available for their patients. Patients with special needs, for example those with carers, dementia, learning disabilities, visual, language and hearing problems, or any other group of patient who might find receiving a telephone call a problem, will be able to directly book an appointment with their GP. We are listening to the concerns raised and will be working on improving continuity, reducing the time to call back and how we contact people who are at work. The patient access approach, although not popular amongst some of the local population in its present form, has actually got elements in it of what we have done for some time. We have always phoned patients back at their request to improve an aspect of their care. We have regularly adjusted the balance of appointments and phone contacts to respond best to demand.
The helpful feedback doctors get when they explain the system to patients during individual contacts, and indeed when patients experience the journey through it, we are striving to build on, and we will welcome all constructive feedback to mould it to suit Nairn and Ardersier patients.
Our early patient survey after 13 weeks has shown that 46% of patients prefer the new system to the old, 27% feel it is the same, and 27% feel that it is worse. When asked whether they were satisfied with the practice, 72% state that they are very satisfied or satisfied, 16% were neutral, and 12% were either unsatisfied or very unsatisfied. Surveys from other practices that have used this system for a period of time show that satisfaction levels are much higher when patients receive a quicker call back from their GP, and we are striving to improve our waiting times for call backs in response to patient feedback.
In the last 3 months the practice has advertised nationally for GPs to come and work in Nairn and Ardersier. We are delighted to have recruited 3 GPs to come and work with us. Modern GP training programmes mean that doctors in training do far less Out of Hours work during their GP training. We hope our patients appreciate that it is rare these days for their own GPs to look after their needs both in and Out of Hours, so it is particularly heartening to appoint 3 experienced, committed GPs that share our own vision. “
The reasons for this change were in response to the patients of the practice having to wait 3 - 6 weeks to see a named GP; concerns around continuity of care; and appointments that were made but not attended. Our intention was not to raise any barrier to patients seeing their doctor, as some perceive. Most weeks there were 45 appointments or 3 surgeries worth of consulting time wasted. We are constantly striving for a safer and more responsive service, so with the new service over the last 13 weeks, the patient phones the practice and then the GP and patient decide together on the best course of action. We have taken 18,500 calls in that time and had 5,325 appointments. These have been the full range of GP problems from dementia, cancer, heart and lung problems to rashes, coughs, sore throats and urine infections. Of the 5,325 appointments, 3,090 were seen on the day that the patient called, 750 were seen the following day and a total of 5,060 were see within 7 days of phoning, generally because this suited the patient. The other patients were seen by nursing staff, given telephone advice by the GP or directed to other services, for example, physiotherapy, occupational therapy, social services and the voluntary sector.
The new process has dramatically reduced the numbers of patients who do not keep their appointments, from 3 surgeries a week to 1 patient a day. This has made the doctors more available for their patients. Patients with special needs, for example those with carers, dementia, learning disabilities, visual, language and hearing problems, or any other group of patient who might find receiving a telephone call a problem, will be able to directly book an appointment with their GP. We are listening to the concerns raised and will be working on improving continuity, reducing the time to call back and how we contact people who are at work. The patient access approach, although not popular amongst some of the local population in its present form, has actually got elements in it of what we have done for some time. We have always phoned patients back at their request to improve an aspect of their care. We have regularly adjusted the balance of appointments and phone contacts to respond best to demand.
The helpful feedback doctors get when they explain the system to patients during individual contacts, and indeed when patients experience the journey through it, we are striving to build on, and we will welcome all constructive feedback to mould it to suit Nairn and Ardersier patients.
Our early patient survey after 13 weeks has shown that 46% of patients prefer the new system to the old, 27% feel it is the same, and 27% feel that it is worse. When asked whether they were satisfied with the practice, 72% state that they are very satisfied or satisfied, 16% were neutral, and 12% were either unsatisfied or very unsatisfied. Surveys from other practices that have used this system for a period of time show that satisfaction levels are much higher when patients receive a quicker call back from their GP, and we are striving to improve our waiting times for call backs in response to patient feedback.
In the last 3 months the practice has advertised nationally for GPs to come and work in Nairn and Ardersier. We are delighted to have recruited 3 GPs to come and work with us. Modern GP training programmes mean that doctors in training do far less Out of Hours work during their GP training. We hope our patients appreciate that it is rare these days for their own GPs to look after their needs both in and Out of Hours, so it is particularly heartening to appoint 3 experienced, committed GPs that share our own vision. “
So there are figures that could be used for monitoring; that is a good thing.
ReplyDeleteThey also state that they are taking on board and building on constructive feedback. They seem to be addressing issues such as 'call back time' and contacting people at work.
It is not clear though from the statement whether the patient surveys will be repeated and how often. 13 weeks seems to suggest quarterly?
It would be interesting to see what happens to the 27% worse number over the next 13 weeks.
I wonder what the reasons are for patients 'missing appointments' at Hospital Clinics and GP surgeries; anyone know?
What about the old man I know about that does not have a telephone and had problems booking an appointment. The person at the front gets moaned at for telling people to go home and phone. So why not use some common sense and allow people to book when they are at desk. Not very joined up thinking from people who put in this system. No wonder I think this country has too much admin when more common sense can be used.
ReplyDeleteIt dosent matter what you do, people will always complain. I thinks its a great idea to weed out the malingerers and time wasters so that those who NEED to see a doctor can do so in a more timely period.
ReplyDeleteIn the interests of saving money and giving patients an even worse experience I wonder if the practice has thought about outsourcing calls to less well paid overseas doctors? You would still need a couple of doctors in Nairn case be a patient actually needed to be seen rather than phone fixed, but the savings would be enormous as the practice wouldn't need such large premises. Another possibility is to just have a couple of video confessing links set up at the surgery, again overseas doctors could handle these calls with a nurse on hand to aid examination
ReplyDeleteThat's it for me, I'm going to the vet in future you don't even have to speak there and they can tell what's wrong with you. Just the job when your feelings ruf!
ReplyDelete