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Focus on Mondays to start assessing patient demand, practices advised

by Rima Evans
24 June 2024

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Measuring demand for appointments or services on a Monday – the busiest day of the week – is a good starting point for practices wanting to tackle capacity issues, guidance from NHS England has said.

The document, How to align capacity with demand in general practice, published earlier this month, has suggested seven areas that surgeries can focus on to kickstart the process of better balancing workload and resourcing with patient requests.

The tips are focused on how to measure demand and capacity. One is to review demand data on a Monday to ‘help decide how much routine work to reassign to other times of the week and help to free up capacity to meet demand’.

‘Improving the management of demand at the beginning of the week will often positively impact on days later in the week’, it adds.

Other suggestions on how to measure demand and capacity include trying to make more use of telephony data to identify peaks in call demand and looking at the practice’s ‘pain points’, such as the on-call list or ‘extras added into the day’ (see also box below).

‘Starting to measure your demand and capacity can feel overwhelming but practices who have started to measure demand and capacity find it gives them back a sense of control’, the guidance says.

The 37-page document explains that a key benefit of understanding demand and capacity is having the data to support practice decision-making on allocating resources, managing workload and the appointment book.

And it can help practices resolve problems such as running out of appointments during the day, facing overwhelming demand on GP appointments and a rising ‘queue’ of non-urgent appointments.

‘Measuring and understanding demand and capacity is not a solution in itself, but it does help clearly demonstrate the nature of the current workload in a practice, and the challenges it presents,’ it says.

The guide is split into three sections: getting started; moving to the modern general practice model; and a quality improvement approach to demand and capacity.

It is one of four NHS England ‘how to ‘ guides that have been published to help practices and PCNs make the move to the modern general practice model, as set out in the 2023’s recovery plan.

The other documents are how to improve care navigation in general practice; how to improve telephone journeys in general practice; and how to improve care related processes in general practice.

Measuring demand and capacity – where should practices start?

  1. Use your telephony data. This can  allow administrative capacity to be altered through the day, for example reassigning staff from other duties such as document scanning at times of peak demand.
  2. Look at your Mondays. This is often the busiest day of the week. Reviewing demand data on a Monday can help to decide how much routine work to reassign to other times of the week and help to free up capacity to meet demand.
  3.  Measure unmet demand.Measuring the number of patients directed elsewhere or added on as ‘urgent extras’ on top of the anticipated activity can help give an understanding of the scale of demand that is not being met, which can help it feel more manageable.
  4. Review care navigation processes. Carrying out an audit of potentially avoidable appointments can help identify where improvements can be made to the care navigation process to support patients in other ways, both inside and outside of the practice.
  5. Review non-clinical activity. Look at when business meetings and training take place and consider moving them to days or times when acute demand is lower. 
  6. Look at your GP appointments data (GPAD). If it is of sufficient quality, this will give you a level of activity rather than your full demand but can help pinpoint places you want to start with. For example, it can help identify variations in appointment length and allow appointments to be planned to the length of the task.
  7. Start with your ‘pain points’.  Look at a specific area of demand that is causing most impact on staff or patients, for example, the on-call list or the extras added into the day.

Source: NHS England