National Review of Access to General Practice Services in England: Patient and public participation event Tuesday 20 August 2019 Slides and feedback NHS England and NHS Improvement
Welcome and introductions Alison Dickinson, Programme Lead, Improving Access to General Practice Liz Vickerstaff, Programme Lead, Improving Access to General Practice Olivia Butterworth, Head of Public Participation 2 2 | | National Access Review to General Practice Services in England
Agenda 10.00am Registration and networking Welcome, purpose of day and introductions Alison Dickinson, Programme Lead, Improving Access to General Practice, Liz Vickerstaff, Programme Lead, 10.30am Improving Access to General Practice, and Olivia Butterworth, Head of Public Participation, NHS England and NHS Improvement Current experiences of accessing general practice services 10.50am Open discussion Access to general practice – what does good look like for you? 11.20am Open discussion 12.15pm Lunch Who else/what else can support good access to general practice? 1.15pm Facilitated table discussions Continuity of care – what does this mean to you? 1.45pm Facilitated table discussions What’s the review about and reflections so far 2.15pm Dr Raj Patel, Deputy Medical Director for Primary Care, NHS England and NHS Improvement Followed by panel discussion and Q&A 2.45pm Break 3.00pm Final thoughts: top 5 recommendations 3.45pm Next steps and close 4.00pm Close 3 3 | | National Access Review to General Practice Services in England
National Review of access to General Practice services in England Liz Vickerstaff, Programme Lead - Improving Access to General Practice 4 4 | | National Access Review to General Practice Services in England
Why are we looking at access to general practice? • Patients views and needs are changing • Level of investment in general practice not increased • Morale and job satisfaction at its lowest since 2001 • General practice and primary care needed to change • So, what are we trying to do…. 5 5 | | National Access Review to General Practice Services in England
Current experiences of accessing general practice services 6 6 | | National Review of Access to General Practice Services in England
How satisfied are you with General Practice? Voting Results. 1.Very satisfied 1.Very satisfied 14% 2.Satisfied 2.Satisfied 29% 3.Somewhat satisfied 3.Somewhat satisfied 38% 4.Not satisfied 4.Not satisfied 17% 5.Not at all satisfied 5.Not at all satisfied 3% 7 | National Review of Access to General Practice Services in England
Current experience of accessing general practice – discussion 1. How do you access general practice services? 2. What do you do if you can’t get an appointment - what other health services or groups do you use? 8 8 | | National Review of Access to General Practice Services in England
How do you access general practice? Responses (themes) #1 • Patient • In person • Telephone – triage system / ring on day • Online • Wait to see own GP • Email • Queue at door • Patient and carer • Book online • Go to surgery in person • Telephone 9 9 | | National Review of Access to General Practice Services in England
How do you access general practice? Responses (themes) #2 • Patient and health and care professional • Online booking • Telephone (triage system) • Drop-in (in person) • Ring for emergency appointment • Queue outside practice • Practice contacts me (long term condition) • Something else • Ring for same day appointment / triage • Sit and wait • E-consultation or telephone consultation • Use online booking • Telephone • In person (sit and wait) 10 10 | | National Review of Access to General Practice Services in England
How do you access general practice services? Voting Results. 53% 1.Phone 2.Sit and wait/queue 15% 3.On-line appointments/prescriptions 30% 4.Call 111 (to access a GP) 0% 5.Do nothing 3% 11 | National Review of Access to General Practice Services in England
What do you do if you can’t get an appointment? Responses (themes) #1 • Patient • Go to community pharmacy • See pharmacist at practice • Call 111 • Complain • Wait for an emergency appointment / ring on the day • Use a health apps • Visit surgery to get an appointment • See a private doctor • Self-care • Go to urgent treatment centre • Go to A&E • Don’t go • Patient and carer • Go to Urgent Care Centre • Self care (use rescue medicines) • Ring 999 (if urgent) • Ring 111 12 12 | | National Review of Access to General Practice Services in England
What do you do if you can’t get an appointment? Responses (themes) #2 • Patient and health and care professional • Go to GP hub or walk-in centre • Self-refer e.g. to physio • Go to out of hours service • Ring and keep ringing at 8am • Something else • Ring 111 • Self-care • Go to GP hub • Go to local pharmacy • Go to A&E • Change my GP • Use out of hours GP services • Put up with it • Complain • Go to private GP 13 13 | | National Review of Access to General Practice Services in England
What do you do if you can’t get an appointment? Voting Results. 8% 1.See the pharmacist 9% 2.Use health app/go online for information 3.Ring 111 15% 4.Go to A&E 8% 5.Self-care 16% 6.Go to urgent care centre/walk in centre 19% 7.Do something else 25% 14 | National Review of Access to General Practice Services in England
What would improve access? Responses (themes) • (More) information about what different professionals do. • Educate patients about which service or professional to see. • Easily / consistently available interpretation services. • Being treated as soon as possible. • Supportive / helpful receptionists. • Accessible surgeries. • Not having to queue. • Having more appointments available. 15 15 | | National Review of Access to General Practice Services in England
What is the most important thing for you regarding access? Voting Results. 1.Can get an appointment when I ‘phone 37% 2.Effectiveness/appropriateness of triage 18% 3.Not having to queue 11% 4.Seeing a doctor / GP 23% 5.Seeing someone on the same day 9% 6.Being able to sit and wait 3% 16 | National Review of Access to General Practice Services in England
Access to general practice – what does good look like for you? 17 17 | | National Review of Access to General Practice Services in England
Access to general practice – what does good look like for you? Discussion 1. What are the barriers or challenges to accessing general practice? 2. Who do you expect to see? 3. How quickly do you expect to be seen? 4. What is the outcome you want? 5. How do you make decisions about when, how, who you see? 6. Is the type of access – ‘phone, video, face to face, online – important? 18 18 | | National Review of Access to General Practice Services in England
What does good look like? Responses (themes) #1 • More use of pharmacists. • (Re-)direction of patients to appropriate services (including from A&E). • Timely access to appropriate professional. • Self-referral e.g. to physiotherapist. • Additional / more diverse practice workforce. • Education of receptionists. • Education of patients / public (including about different options). • Improved IT skills (professionals and patients). • More volunteers in General Practice. • Communication. • Access to own medical records and online booking / prescriptions. • Home visits when needed. • Easy to get urgent GP appointment. 19 19 | | National Review of Access to General Practice Services in England
What does good look like? Responses (themes) #2 • Good triage system. • Good services available locally. • Choice of doctor / healthcare professionals. • Choice of different type of appointment (face-to-face / ‘phone / online). • Better online services. • Recognition of people who aren’t online / support. • Having a Patient Participation Group (PPG). • Right ratio of GP to patients. • Continuity – especially for long term conditions. • Support for carers – priority access to appointments. • Addressing barriers to registration with a GP practice. • Accessible information and communication. • Access to interpreters. National Review of Access to General Practice Services in England 20 20 | |
What does good look like? Responses (themes) #3 • Flexible appointment length. • Access to same-day appointments (where appropriate). • Appropriate referrals. • Able to get appointment with ‘own’ GP / same professional. • Annual reviews. • Being able to see an appropriate expert e.g. asthma nurse. • Person-centred / personalised care. • Address transport issues. • Additional diagnostics available at GP Practice. • Sufficient appointments to meet demand (day / evening / weekends). • Being able to see a doctor within 2/3 days. 21 21 | | National Review of Access to General Practice Services in England
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