Many practices struggle with receiving more calls from their patients than they can handle. There are simply not enough slots available, and the appointments that are available quickly disappear after 8am. The receptionists then spend their time trying to assuage frustrated and angry patients. Physical queues of patients start forming outside the practice before the doors have even opened as, out of desperation, patients try turning up in person to secure one of the available slots.
The whole situation is frustrating and demoralising for everyone. Surely there must be a better way?
Well, the good news is that there is! On this month’s Practice Index podcast I am joined by practice manager and IGPM Director, Jo Wadey, and Dr David Stokes from St Lawrence Surgery in Worthing who share their experience of starting with exactly the situation described above and completely turning it around. In the episode, they share how they did this so successfully that their patient satisfaction rating improved by 10% (at the same time as it fell by 10% nationally) and they were able to secure an outstanding rating from the CQC.
So what exactly did they do?
They looked at the data, in particular the number of times each patient was calling the practice and the number of different clinicians each patient was seeing. They spoke to the staff, both clinical and administrative, about just what their day-to-day experience was like. Everyone agreed that something needed to change.
They have introduced a system whereby the patient services team takes a short history from the patient when they call. They then discuss this with a dedicated clinician who is physically there with the patient services team, who will review the notes and decide who is the best person for the patient to see (if they need to see anyone at all). They do this live (i.e., while the patient is still on the phone) and the patient is booked in there and then.
This does mean that each call takes longer than it used to but the beauty of the system is that each patient only has to call once. The practice put messages onto the call system explaining what is happening and patients are happy to wait knowing that they will be properly dealt with and not have to call again. Very quickly reducing the total number of calls meant that there was a net gain, even with the increased length of the calls.
The same principle applied to the clinical time. Most practices respond by saying that they cannot free up the clinician needed to support such a system but, by ensuring only those who need an appointment are given one, and that appropriate use is made of all the roles who now work as part of the practice team, the net impact is that more clinical appointments are ‘saved’ than have to be sacrificed.
In the episode, Jo and David share how they introduced the new system and explain how they overcame concerns from clinicians and from the patient services team, the worries that overall demand would go up and that patients would not want to share their information, as well as much more detail about how the system works. Find out more by listening in to what they had to say here
March 3, 2023 at 8:41 am
Interesting concept and thought provoking. This is an issue facing all practices I would hazard a guess.
March 3, 2023 at 8:55 am
Sorry to be negative, but how many calls were dealt with before in the first hour and then after? What is the capitation as well ta? We deal with about 200 calls in that first hour for 12500 pt list, so need to understand the clinician to phone calls ratio to see if worth trialling at our practice.
March 3, 2023 at 9:00 am
Interesting read – and great to see what positive outcomes can be achieved.
We have improved our telephone access at the surgery over the past 6 months by:
1) employing more staff to take calls
2) reviewing telephone stats – incoming calls, call waiting times
3) setting some clear targets for our team and patients to expect – 95% of calls answered first time, with an average wait of less than 3 mins.
4) in-day monitoring of a live call-stats wallboard.
5) proactive sharing of phone stats on social media (twitter @grangemedical)
6) Tracking of monthly average stats and reporting of the same – to show progress over a longer timeframe.
Our positive outcomes are:
1) Improved telephone access – backed up by raw, undeniable data
2) Increased number of positive reviews on nhs reviews, google etc.
3) Reduced frequency of patient agression and frustration
4) Improved staff morale – having clear targets has supported that
5) Reduced footfall to the reception.
All round positive project – now we’re striving for “perfection” and aiming to hit our 95% answer and under 3 min wait consistently for 1 whole calendar month.
March 6, 2023 at 10:55 am
For those of you who fear this why not simply have a nurse triage in the mornings. Our team, and many others, take the patient history and sign post where appropriate, patients are then either given a routine appointment on put on to that mornings triage is deemed urgent. Triage ANP then deals with the triage list away from main reception. Simple and effective
March 6, 2023 at 11:13 am
We have been running an on the day triage for years now, and still don’t find that this changes anything in terms of telephone contacts as much as AccuRx does. However, we are not finding any of these approaches helping with abuse, because there is still a cut off point at which we have reached capacity for the day and we still have to tell patients – call back another day as we can’t offer you anything. We don’t book non-urgents in ahead of time, unless routine with nurses, because we have the staff to deal with them, but it doesn’t matter how many more members of staff we get we can’t ever meet demand, so we still have to say no to patients each day and offer them appointments elsewhere – this isn’t a problem with this practice, it’s a problem with the way in which the NHS is being used/abused and until there is a complete re-design or re-education of use and expectation then this won’t change.