As part of the General Practice Development Programme (GPDP), the NHS has launched 10 High Impact Actions to respond to the challenges of modern general practice and allow practices to ‘work smarter, not harder’.
Productive workflows – matching capability with demand, was addressed to practice managers and anyone with an interest in managing workload.
On a mission to reduce waiting times, the founder of GP Access UK (now Ask my GP) Harry Longman talked to the webinar’s attendees about a smarter way to manage workload and release the pressure within UK practices.
Did he manage to convince his public?
1. Under pressure
‘Don’t trust me, I am not a doctor’. Mr Longman’s opening sentence was not really promising. However, a few minutes in the talk, this engineer with a passion for healthcare centred a problem common to many practice managers: pressure.
For a lot of people, waiting time to get a routine appointment with a GP is of around three weeks, he said. This puts extra pressure on practice staff, who wishes to accommodate patients’ needs.
With an analogy between the pressure within a surgery and that in a pressure cooker, Mr Longman said that the problem caused by a lack of capacity.
So practices try to address it by getting a ‘bigger pressure cooker’.
Turning back into an engineer, he advised: ‘The pressure only relates to temperature, not to the volume.’
Therefore, hiring more staff is not always the solution. ‘The 5,000 extra GPs are not going to suddenly appear and our population is growing and is ageing’.
Tell that to Jeremy Hunt, please.
2. Demand is predictable
Mr Longman said: ‘We know how many people will call and what time they will call’.
About two thirds of the demand can be dealt with remotely. Instead of increasing the capacity of a practice, we should look into ways to improve the system we have in place to deal with patient queries.
Ask my GP calculates with the practice how many GPs they need each day, said Mr Longman. Demand is entirely predictable, but if it is unmet with the correct supply of workforce, it upsets the balance within the practice.
‘Don’t worry about the demand going up – it doesn’t. Do worry about GPs suddenly deciding they can take the same holidays,’ said Mr Longman.
3. Asynchronous mode on
Efficiency can be achieved when we choose a more efficient mode. This means moving away from the traditional local and synchronous face-to-face consultation while implementing a remote and asynchronous mode.
This mode is cheaper, because communication happens through the internet and does not require staff to pick up phone calls or invest too much time with patients as in when they walk in a surgery.
When patients call in, a recorded message redirects them to the practice’s website, where they can get in touch with a GP through the service provided by Ask my GP.
‘We have a simple system in place to deal with a demand that is, instead, varied,’ said Mr Longman. While this system helps dealing with communications, decision making still happens at the human level, with staff properly trained to address patient’s queries according to their needs.
4. Efficiency enhanced
This system will make you 20-30% more efficient, advised Mr Longman.
‘If you currently have 20% of unmet needs, and you increase efficiency by 20%, your workload will be the same but you will be more efficient. But you might have 15% of unmet needs and increase efficiency by 30%. That is going to reduce your workload by 15%.’
Around 30% of patients calling the surgery and hearing the recorded voice message redirecting them to the website visit the practice’s website, estimated Mr Longman.
In the practices where the system is already in place, Mr Longman’s team has seen that GPs are going home one hour earlier every night.
The benefits start immediately; it’s a journey of improvements.
5. It makes receptionists and patients happier
Medical receptionists’ role is enhanced through this service. Ask my GP provides them with training and e-learning resources that allow them to naturally slot in their modified role. They are also happier because they no longer have to turn patients away, said Mr Longman.
Patients hear back from their GP within an hour from their online query and can get an appointment only if needed.
Mission accomplished: the waiting time is eliminated!