Launch of The General Practice Development Programme Releasing time for care Dr Rachel Duffy and Carolyn Robertson Sustainable Improvement Team 23 rd February 2017 #Gpforwardview #GPforwardview
Welcome & introduction Catherine Blackaby #GPforwardview
3 #GPforwardview
#GPforwardview
#GPforwardview
#GPforwardview
#GPforwardview
Launch of The General Practice Development Programme Dr Rachel Duffy and Carolyn Robertson Sustainable Improvement Team 23 rd February 2017 #Gpforwardview #GPforwardview
Introductions #GPforwardview
Icebreaker • Who you are • Where you are from • Your favourite record and why • Some thing you have in common • Your biggest challenge in practice • What you are hopeful about #GPforwardview
Agenda 12:30 Arrival and lunch 13:00 Welcome and Introductions 13:10 Icebreaker 13:30 Review of the HIA and showcase event & the General Practice Development Programme 14:10 Considering your ambitions and project ideas 15:00 Refreshment Break 15:15 Using prioritisation to select your project 15.45 Making changes locally – working with the Model for Improvement 16.30 Introduction to Measurement 16.40 Actions and next steps 16.50 Evaluation 17:00 Close #GPforwardview
Session Objectives • To launch the time for care action learning programme • To create time and opportunity to think about your project areas • To introduce the Model for Improvement as a structured approach for making changes • To gain greater clarity of what you want to achieve and your project to help achieve it #GPforwardview
Activity One • On tables think about the showcase event. Consider: • What did you get out of it? The takeaways .……. • What have you done since? • What do you want to get out of today? • What would you like to know more about? #GPforwardview
Previously ………. #GPforwardview
www.nhsalliance.org/making-time-in-general-practice/ bit.ly/time4caretool1 #GPforwardview
Most burdensome areas of bureaucracy 0% 5% 10% 15% 20% 25% 30% Getting paid Processing information Keeping up to date Reporting Supporting patients www.nhsalliance.org/making-time-in-general-practice/ bit.ly/time4caretool1 #GPforwardview
Data from 5,128 consultations GPs judged 26% of their consultations Other in practice to be potentially avoidable 7% Self care/Pharmacy 6% Potentially avoidable GP Outpatients 4% 74% appointments 3% (audit by GPs) Sick notes / appeals 3% Care navigation 2% 2% Continuity/preparation Other … 18% are about how the practice manages its workload bit.ly/time4caretool1 #GPforwardview
10 high impact actions to release time for care #GPforwardview #GPforwardview
10 High Impact Actions Innovations from around England that release time for GPs to do more of what only they can do. bit.ly/gpcapacityforum #GPforwardview
10 High Impact Actions Innovations from practices throughout around England that release time and improve care. bit.ly/gpcapacityforum #GPforwardview
1 Active Reception care signposting navigation Impact The idea • Reduced GP appointments – estimated • Receptionists’ job is to connect the at 1,046 per year for a 10,000 patient patient with the most appropriate practice. (Eg West Wakefield, 930 GP service (not just book everyone with hours saved across the 6 practices a GP). (64,000 patients) in the first 10 months). • Patient benefits - faster access to the • Train receptionists to ascertain the right service (one step in the process patient’s need. Include red flags for removed). medical emergencies. • Staff satisfaction – receptionists feel • Develop a directory of services, inc they’re doing a better job for patients and services outside the practice, for making bigger contribution to the practice. patients to be directed to. Implementation tips • Explain to patients that the aim is not to deny them access but rather to improve it, as well as allowing GPs to focus on the things only they can do. • Involve GPs themselves in giving information and explanation, eg through the practice newsletter or phone system messages. Patients appreciate and respect this. • Encourage receptionists to ask lots of questions, practice asking about the patient’s need and make their own suggestions for improvement and the directory of services. • Measure closely at first, to demonstrate impact and identify areas for improvement. • Keep the directory of services updated. Include hospital outpatient booking offices, voluntary & community sector services, community pharmacy, dentists, optometrists, welfare rights, housing, etc. • Replicate the information on the practice website, for patients to find directly. bit.ly/GPcapacitynet1 #GPforwardview
10 High Impact Actions Innovations from practices throughout around England that release time and improve care. bit.ly/gpcapacityforum #GPforwardview
2 New Consultation Phone types consultations Impact The idea • 60-70% of consultations can be handled • The phone is used to consult (not just entirely on the phone, in an average of 4- triage). 6 minutes. • Where face-to-face consultation required, • Patients can be offered an GP usually decides in first 2 minutes. appointment with their usual GP or Some face-to-face consultations are then with any available GP. much shorter (eg examine rash). • Access improves, especially for carers & • Many follow-ups can be done on the people in work. phone as well as new problems. • DNAs fall up to 80%. • Interpreters usually don’t need to be prebooked for telephone consultations. Implementation tips • Measure actual demand and adjust supply of appointments as it varies during week (Monday often 40-60% busier) and year. • Provide training in clinical skills to ensure safety and productiveness of phone consultations. • When moving to a ‘demand led’ rather than ‘supply led’ approach, plan how to account for current unmet need. • Use alongside ‘active signposting’ to reduce demand. bit.ly/GPcapacitynet2 #GPforwardview
2 New Consultation Online consultations at Docklands types Medical Centre The idea Impact • Patients make the practice website • 91% patients ‘extremely satisfied’ their first point of contact. • 90% users don’t contact practice: • Options: • 60% symptom checker / self help • find out more about symptoms, a particular condition or treatment • 20% visit pharmacy • request a call back from 111 nurse • 10% request 111 nurse call back • send details of problem / query to • 10% users have ‘online consultation’ GP • 40% completed by GP remotely - • GP surgery includes “slots” for online 2.9mins ave consultations (three per typical face to face slot) • 20% GP phoned patient - 5.5mins ave Implementation tips • 40% face to face appointment – • Careful & persistent marketing. Personal recommendations from staff. 10mins ave • Don’t expect it to suit every patient • Design GPs’ sessions to provide a prompt response. Audit to spot any problems. Training & support helpful for some GPs • Use released time to offer longer face to face appointments for patients with complex needs bit.ly/GPcapacitynet2 #GPforwardview
10 High Impact Actions Innovations from practices throughout around England that release time and improve care. bit.ly/gpcapacityforum #GPforwardview
3 Reduce DNAs The ideas • Make it easy for patients to cancel. • Send appointment reminders (text/email) 10% reduction. • Patients write their own booking 18% reduction. • Patients read-back appointment details 4% reduction. • Report how many appointments were kept last month rather than DNAs 14% reduction. • Reduce 'just in case' booking by improving same day access up to 70% reduction. Implementation tips • These are additive - implement several of them for best effect. • Measure DNAs periodically to identify any needs for additional solutions. bit.ly/GPcapacitynet3 #GPforwardview 10 High Impact Actions. Quick facts 1.2
10 High Impact Actions Innovations from practices throughout around England that release time and improve care. bit.ly/gpcapacityforum #GPforwardview
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