Deben Health Group, made up of seven rural Suffolk practice, decided to look into care navigation when confronted with the difficulty of hiring GPs.
After receiving guidance from NHS England though the Time for Care programme, they jointly wrote guidance to enable their receptionists to better navigate patients to the appropriate care.
Since the protocol was adopted in October 2017, the practices have saved around 37 hours of GP time across all sites.
Management in Practice’s reporter Valeria Fiore talked to business manager at Wickham Market Medical Centre Jane Wallace and practice manager at The Penisula Practice Linda Deabill to find out how they have done it.
The problem
‘Our receptionists were not booking appointments appropriately. They did not know which questions they should have asked to patients and were just booking them with a GP, who would be overloaded with work.
‘We identified that the majority of appointments were being booked with the GPs when there were other clinical or non clinical staff who could best deal with patients healthcare needs.
‘We needed to find a way to support the reception staff to sign post the patients to the most appropriate person or service to support their needs.’
The solution
‘We got in touch with NHS England, and decided to work on care navigation and signposting.
”A suitable training company was identified and we held a two-day course, during which we trained all our 60 plus receptionists working across the seven practices. At the same time, we held four seminar sessions with NHS England, which involved reception staff from each site.
‘While we had seminars with NHS England, we kept in touch with our patient participation group (PPG). They joined the last seminar with NHS England and had a look at our protocols.
‘Their input was invaluable. They produced leaflets to inform patients on how care navigators could help them and they simplified anything that might have sounded too technical to patients.
‘We later implemented a protocol using process mapping to find out how we were signposting patients, after which we decided to write a protocol for all of our receptionists to follow across the seven sites starting from October 2017.’
The challenges
‘The main challenge was to get the buy in from receptionists and GPs to all use the same process across all sites. However, we had previously been working collaboratively with upskilling our HCA and Nursing staff, so staff were use to networking and sharing best practice.
”The reception staff enjoyed being involved in writing the protocol and that they had the chance to meet each other to network.’
The benefits
‘The programme gave receptionists techniques to ask patients specific questions, which allowed them to offer better assistance and book appropriate appointments with the right person.
‘We did an audit when we launched the protocol to make sure the people GPs were seeing were those who most needed their care. We ran the same audit again in December last year to see how it was working and we found out that we had saved 36% of inappropriate appointments booked with a GP.
‘Apart from the protocol, receptionists can refer to a laminated information sheet on their desk with all the appropriate clinical and non-clinical contact details for all the different organisations that patients could be signposted to.
‘Working collaboratively has also freed up practice manager time, as we share the project work according to each managers strength thereby freeing up manager time to concentrate on other areas within their own practice or on behalf of the Deben Health Group.
‘Since implementing the protocol, we managed to collectively release 227 appointments, which equates to around 37 hours of GP time.’
Comments
‘I would not hesitate in recommending care navigation or working as a group of practices. You can share workload and best practice’ (Jane Wallace, business manager at Wickham Market Medical Centre)
‘It is also good for patients. When they ring a practice, we all live in a local area. All practices give the same information and there is no confusion. It’s good standardised care.’ (Linda Deabill, practice manager at The Penisula Practice)
Business manager Jane Wallace and practice manager Linda Deabill are part of a group of eight GP practices, called Deben Health Group. These include: Church Farm Surgery, Aldeburgh; Framfield House, Woodbridge; Framlingham Surgery; Little St John’s Street Surgery, Woodbridge; Saxmundham Health; The Peninsula Practice, Alderton; Wickham Market Medical Centre
Picture credit: Sarah Lucy Brown
