Earlier this month the Scottish government announced £2.5m worth of funding for the training of GP staff. The big news here is that, rather than focusing on GPs, decision makers at Holyrood are recognising the role clerical staff play in delivering effective primary care – and how integral they are to the practice team.

The move is part of plans to develop the skills of the whole practice team, making it easier for patients to access the right person at the right time, and is part of the additional £71.6m in direct support of general practice that was announced by Health Secretary Shona Robison in March.

Receptionists and practice managers will be able to access training on signposting patients to the most appropriate source of help or advice. This could be a service available in the practice or elsewhere in the community, such as a local pharmacist or optician. Staff will also be up-skilled to allow them to take on more of the administrative tasks currently carried out by GPs.

Robison said: “We want to reinvigorate general practice and attract more people into the profession. We also want to shift the balance of care into the community, and general practice clearly has a significant role to play.

“By investing in the training of practice staff we can make the whole system more efficient, freeing up time for doctors to spend on their consultations. We can also increase the skills of those practice staff and improve their job satisfaction.”

Training examples

So what could the money be used for? If NHS England’s General Practice Forward View is anything to go by, when a £45m fund was created to contribute towards the costs of training reception and clerical staff, work will revolve around active signposting and management of clinical correspondence.

Signposting is a topic we’ve covered before on the Practice Index Blog – most recently here – but what about clinical correspondence? How can that benefit practices?

Correspondence management

One example published by NHS England revolves around a practice where a member of clerical staff was given additional training and made aware of relevant protocols in order to support the GP in clinical administration tasks.

Now, all incoming correspondence about patients from hospitals is processed by a member of the clerical team, who has received training to deal with most letters themselves. Working to standard protocols developed in-house and refined through continuous improvement, the member of the team reads the letter, enters details into the patient’s record and takes appropriate follow-on action. In some cases this involves other members of the team, or booking the patient an appointment.

Practice benefits: Using this system, 80–90 per cent of letters can be processed without the involvement of a GP, freeing up approximately 40 minutes per day per GP. For the clerical team, job satisfaction is often increased as well.

Patient benefits: Practices report they are often able to take speedier action on some issues. More detailed coding of clinical information in the GP record results in improved monitoring and management of certain conditions.

Ideas in practice

In a case study published by NHS Networks, Wincanton Health Centre in Somerset decided the long working hours and administrative demands for GPs had to be addressed.

The practice’s GPs were receiving about 200 pieces of paperwork every day. With each GP holding a list size of more than 2,000 patients and demands increasing throughout the day, the paperwork was being pushed to the end of the day. As a result, the practice handed over more administrative duties to admin staff and provided training to help them take over more of the procedural tasks previously handled by the GPs. As new processes were implemented, practice GPs found they could hand over an increasing number of duties to their clerical colleagues.

GP Dr Fox says: “We started by identifying letters that we felt we never needed to see, such as ‘did not attend’ letters and diabetic retinopathy screening notifications. We put in place systems to make sure these were dealt with appropriately by a member of the admin staff. This was a small help but didn’t make a sufficient dent in the workload so we pushed the envelope further.

“We then trained one of the admin staff to code diagnoses, procedures and values in the letters and set the computer system so that on viewing the letters, the GPs could deal with actions that were required but not have to go to the trouble of doing the coding. This was another improvement but still not enough.

“Finally we took the plunge and decided that a lot of the work being done by the GPs could be done equally well and possibly better by a member of the admin staff. A senior member of the admin team would then go through the post and weed out the letters that needed to be seen by the GPs but send the remainder to the admin team for task completion, coding or simply for scanning if no action was required. The initial letter reading was checked by a second senior staff member to ensure there were checks in the system. The general rule of thumb is if there is any doubt then the letter should be presented to the GP.”

As a result of this training and implementation, the number of letters being sent to GPs has dropped to about 10–20% of what was previously being received. GPs are now feeling more in control of their workload and working hours have been reduced – something that will be attractive whenever the practice next needs to go to GP recruitment.

Dr Fox concludes by saying: “It has been a great process for us, although it may not work for all as it does require an amount of trust being placed in the senior staff on behalf of the GPs. I am aware of GPs even in my area who feel uncomfortable with that but I would strongly encourage them to consider how certain processes within their practice can be handled differently.”

Important steps

This is just one example of how clerical staff training can benefit practices. What’s more, anecdotal evidence from talking to practices suggests that training and the subsequent allocation of important tasks can boost morale and empower staff.

The latest announcement of funding by the Scottish government is good news for general practice, if used correctly. And best of all, it’s refreshing to see the work of all practice staff being recognised.

——-

Topics trending in the forum:

PM vs PA…
Are breaks compulsory
Assistant PM salary suggestion (NEW REPLIES)