Richmond Road Medical Centre, recognised for its achievements at last year’s GP Awards, has transformed the services it offers to patients in Hackney
In 2016, the team at Richmond Road Medical Centre in Hackney, East London, knew that without ‘drastic change’, their practice risked going under.
A small practice of 3,500 patients, the surgery had seen an influx of young adults with new health care needs and access demands. At the time, there was already a one to two week wait for an appointment with the GP.
‘The patients joining our practice wanted to see a doctor here and now, but also wanted to see a doctor in different ways,’ says partner Dr Gopal Mehta.
‘We realised if we didn’t make a change then it could be quite catastrophic.’
Two years later and the team have overhauled the practice’s access system and introduced a range of innovative services, resulting in their patient list growing by 57% in just 18 months. Their work was recognised at the 2017 GP Awards, where they received the accolade for GP Team of the Year.
Dr Mehta says the team decided to focus on four key areas in their improvement journey. The first – and biggest priority – was health outcomes, he says, because ‘that’s obviously all about the health of your patients’.
The senior management team decided to set up a new ownership model, whereby all staff, including those working on reception, are educated about the importance of patients managing long-term conditions like diabetes.
This means that the administrative team now manage patients alongside a ‘clinical buddy’, who is a doctor, ensuring that reviews are set up on time and any issues are picked up ‘right from the time someone picks up the phone’.
‘It’s become a collaborative team effort and that model for ownership and accountability has now been launched all over Hackney,’ says Dr Mehta.
The second task – and the practice’s greatest achievement, Dr Mehta says – has been to implement a new access system for booking appointments.
‘We absolutely had to change our access system around to remain fit for purpose, so we created our own model, known as Patient First,’ he says.
The model guarantees that everyone is seen within 48 hours of making contact with the surgery, as long as they call between 8 and 10am or book in online. A turnaround time like that ‘just doesn’t happen in London’, Dr Mehta says, and it has ‘absolutely revolutionised’ the experience for patients.
The model has also helped the practice achieve an impressive bunch of statistics, Dr Mehta adds. In a 12 month period, A&E attendances reduced by 21%, admissions by 31% and the did not attend rate for appointments dropped from 18% to just 0.8%. At the same time, the patient list has grown from 3,770 to 5,952, which is ‘significant’ for a small practice.
‘That’s all because of access – addressing the access problem means it’s easier to get appointments, people can see the GP of their choice and so patients are happier and they tell other people to register,’ Dr Mehta says.
‘The other day we had a group of 26 people walk in who had all been told to join Richmond Road – that was quite heartwarming really.’
Alongside getting patients signed up with online access, the team have also embraced wider digital technology, focusing in particular on electronic prescribing services (eps) to enable patients to request prescriptions online.
Dr Mehta says that apart from the controlled drugs that can’t be sent electronically, 97% of Richmond Road’s patients will now use the service, which ‘makes things much more efficient and safer for them’.
‘I had a patient recently who contacted me to say they were going on holiday, flying from Manchester Airport, but had a urinary tract infection,’ he adds.
‘Within literally 20 minutes, I’d spoken to her and sent a prescription to the pharmacist at the airport, which meant she had it to take away with her.’
The fourth and final area the team decided to focus on was ‘innovative services’, after realising that patients wanted more than just a GP appointment and the practice itself need to create new, engaging services.
Because the surgery was seeing an increase in patients with complex mental health issues, the team decided to focus on this area of healthcare first of all. These patients didn’t just want counselling and medication, Dr Mehta says, and after an extensive search, the team settled on in-house yoga classes.
‘Those patients I used to see every week for a catch up about their mood, I now just see at yoga – it’s amazing how it’s transformed their experience.
‘Everyone comes to yoga, has a chat, and they’ve become a really good network – we’re now looking to start our second class on Thursday mornings.’
It’s been a good two years for Richmond Road. The practice’s access model is now being trademarked and launched across Hackney, and there’s a visit from the director of NHS England on the horizon. Dr Mehta says it’s taken a lot of time, energy, but it has been a massive, collaborative effort.
‘I’m very passionate about all of this work, but I couldn’t do it without the most amazing team, who are just as dedicated to the cause as I am,’ he adds.
‘At Richmond Road we’ve instilled that culture of “we’re all in this together” and that’s why the GP Team of the Year award felt so fitting, really.’