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How advanced access has eased our working day

Dr Stephen Banham wrote about the demands of patients on primary care (Letter, May 19) and how advanced access will stoke demand. I am a partner in a practice that has worked with advanced access for more than two years, and insatiable demand is not our experience.

Advanced access is certainly not a one-size-fits-all answer to our problems, but having taken ideas from the collaborative process co-ordinated by the National Primary Care Development Team, change is possible.

Each primary care team is able to safely test different ways of working in its own locality.

We progressed through measuring demand from patients for appointments and then shaping that by looking at the range of appointments at the busy times of the week, introducing telephone consultations as an alternative to face-to-face consultations and having a mix of pre-bookable appointments alongside those for same-day booking.

We also asked patients to see other appropriately skilled members of our team rather than always seeing a doctor, in order to maximise the usefulness of each consultation.

We had concerns about demand but our experience has been that patients soon learned that pre-booking an appointment just in case it was needed became unnecessary as appointments are available when needed.

Also I now have a 10-minute appointment time to deal with patients instead of a lot of extras on the end of a surgery. Our DNA rate fell from 200 a month to 40. The pressure upon the team is less, leading to a better working environment.

I would recommend anyone who feels the system they work in has delays and pressures within it look at the many ideas brought forward by the collaborative.

Dr Graham Hillary

Wyke

Bradford

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