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GPs go forth

Information for patients

Dr John Couch continues our series by looking at what is required to earn points from information for patients

Points achieved with complete ease

Information 1 The practice has a system to allow patients to contact the out-of-hours service by making no more than two telephone calls

Value 0.5 points

Most practices will already have this system, the practice telephone number providing the number of the out-of-hours service. Check your system daily.

Information 2 If an answering system is used out-of-hours, the message is clear and the contact number is given at least twice

Value 0.5 points.

Review the text of your message to ensure compliance. The message should be checked at the end of every weekday to ensure clarity and function. Speak slowly and ensure no background noise. Renew tapes and old machines (these are inexpensive) if and when necessary. Print the exact message out and display by the answer machines to allow accurate re-recording. Ensure there is an efficient back-up if one machine fails.

Information 3 The practice has arrangements for patients to speak to GPs and nurses on the telephone during the working day

Value one point

Most practices should already comply. It is more efficient to timetable defined times for phoning patients back except where urgent. Make full use of computer appointment screens to enter requests. It is pointless to refuse to call back mobile phones, go with the flow. Ensure good GP and nurse training on handling telephone calls. Ensure all calls are entered in medical records, even if the patient did not answer or a recorded message was left.

Information 5 The practice supports smokers in stopping by having a strategy, including providing literature and offering appropriate therapy

Value two points

Draw up a protocol for all staff to follow. Make full use of posters and leaflets. Off-the-shelf leaflets may not explain local services so it may be worthwhile drawing up your own to include nurse, chemist and local stop-smoking clinic details. Make your policy on NRT/Zyban clear. Make time for face-to-face discussion.

Information 6 Information is available to patients on the roles of the GP, community midwife, health visitor, and hospital clinics in the provision of antenatal and

postnatal care

Value 0.5 points

An antenatal pack containing all of this information should be handed to all newly pregnant women with added face-to-face discussion. Use named professionals where possible. All staff should be trained to advise patients requesting contact details for any of the relevant professionals.

Information 7 Patients are able to access a receptionist via telephone and face-to-face in the practice, for

at least 45 hours over five days, Monday to Friday except where agreed with the PCO

Value 1.5 points.

Although this represents an average nine hours a day, the spread can be negotiated via the PCO. Get any agreement in writing. If, by agreement, you do not offer nine hours access every day, ensure urgent calls can be directed appropriately (as for information 1 or 8) and that callers are aware when normal service will be resumed.

Information 8 The practice has a system to allow patients to contact the out-of-hours service by making no more than one telephone call

Value one point

Some practices already achieve this by virtue of calls routed through NHS Direct. This is supposedly being rolled out nationwide over the next two years. Many other practices can get calls transferred directly to their out-of-hours provider via telephone technology but there is a cost implication here that should be weighed against the value of the single point. Practices in areas where this technology does not exist should apply for exemption via their PCO.

Points achieved with good planning

Information 4 If a patient is removed from a practice's list, the practice provides an explanation of the reasons in writing to the patient and information on how to find a new practice, unless it is perceived such an action would result in a violent response by the patient

Value one point

Practices must decide for themselves whether to comply with this indicator. The 'violent response' get-out will not wash if used too often. Discuss this as a practice now. Most often removal is due to breakdown of the doctor/patient relationship. However, for practices without serious recruitment problems, removal of patients should be relatively infrequent. Record any attempts to ameliorate difficulties with patients before

removal. Use of any local PCO conciliation services can also help. Removal letters to patients should be carefully and individually worded.

Points achieved with real striving

There are no indicators in this category

John Couch is a GP in Ashford, Middlesex

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