This site is intended for health professionals only
Wednesday 23 May 2012
Facebook Twiter Linkedin

GPs trialling Patient Access model save £300,000

By Craig Kenny | 17 Jan 2012

A practice trialling a pioneering access model under which GPs triage patients and book their appointments has saved hundreds of thousands of pounds in locum and salaried GP costs.

The three-partner practice in Leicester introduced the system last summer and immediately saw its average time from booking to appointment fall from 5.5 days to just over one day.

Under the Patient Access method, patients telephone their practice and GPs then call them back as soon as possible, with an emphasis on dealing with the problem the same day.

Dr Kam Singh said his ‘under-funded' practice had been running at peak capacity with a ballooning list size, and was on the point of taking on another salaried GP. Instead it switched to the Patient Access model and as a result has saved around £80,000 by not hiring a salaried GP, and cut its locum bills from £250,000 in one year to less than £2,000 the next.

Dr Singh said: ‘Appointments are our fundamental resource, so why give them to the least senior person – the receptionist? There's a bit of a game played by salaried doctors to book yourself easy stuff like a blood pressure. That game has stopped because the partners manage all the appointments, so a blood pressure would go to the healthcare assistant.'

Harry Longman, a spokesperson for Patient Access, a social enterprise set up by GPs, said 43 UK practices were signed up.

READERS' COMMENTS

Simon Gilbert, Salaried GP,
18 Jan 2012
I'd be interested to know what the baseline patient and reception behaviour was prior to the changes. Do receptionists ask what the appointments are for and book accordingly or had patients been turning up for anything they perceive needs a GP?
Average (0Votes)
Top
Anonymous, Practice Manager,
18 Jan 2012
This sounds good. Worth investigating further. And the comment about giving the job of allocating to the least qualified person definitely gives food for thought.
Average (0Votes)
Top
Anonymous, PCT,
18 Jan 2012
It would be useful to know what proportion of patients are diverted from needing to attend surgery due to GP advice on the phone, and also the proportion allocated to non-GP health professionals.

Fundamentally this work shows that a significant proportion of demand for appointments is 'failure demand' ie demand that arises because the practice hasn't done the right thing for the patient at first point of contact. Provide expertise at the first point of contact and the whole system becomes more effective and, counterintuitively, cost-effective.
Average (2Votes)
Top
Harry Longman, Work for third sector,
18 Jan 2012
Let's just set expectations. Patient Access is about responding precisely to patient needs, using the professional skills of the doctor. Saving money is a happy result by the by, and though our evidence shows most practices will save, some of them substantial amounts, this is not the driving ethos.
This is new thinking and an evidence based method, not a "product" offered to GPs to sign up to. It was invented at least 18 times independently over the last 12 years. I had the privilege of discovering these practices and saying, this is important, we should make it known. New ones are now coming on board.
Please see our website for more evidence on how it is reducing A&E demand as well as giving GPs control over their workload.
Average (0Votes)
Top
Harry Longman, Work for third sector,
18 Jan 2012
The evidence from a survey of 32 of these practices is that about 1 in 3 patients needs to come in to see the GP, and another 10-15% to see a different health professional, usually a practice nurse. Yes, it is counterintuitive and yes it does reduce rework, hence the time and cost saving for practices. Full survey result and case studies are on the website.
Average (0Votes)
Top
Anonymous, Practice Manager,
18 Jan 2012
This sounds like a version of our appointment system we use called Doctor First. We started it over 12 months ago and have had great results in terms of doctor and patient satisfaction.
It is a totally different way of working, but luckily we had help from productive primary care who used their profile tool to show us how to set our system up. We would never go back to our old system!
Average (0Votes)
Top
Anonymous, Practice Manager,
18 Jan 2012
Can I ask what the 43 practices are signed up to? And have you worked with them all to help them?
Average (0Votes)
Top
Harry Longman, Work for third sector,
19 Jan 2012
"Signed up" is not the right phrase. The model has been invented at least 18 times independently, the earliest forms we know of from 2000 or so at Carepoint in London, Stour in Christchurch and Quorn near Leicester. It has been known as Intelligent Access, Total Telephone Triage, Dr First and Stour Access System, possibly others, but they were unknown to each other until last year. We adopted the name Patient Access as a community in order to share experience, evidence and research and offer the benefits of the method to the NHS nationally. I have interviewed all of them in depth, run and published a survey, visited 31 and helped some make the change from the start.
Enquiries are coming not just from practices but from CCGs and PCTs: we are here to help, that is why we've put so much evidence in the public domain.
So come on, dear "anonymous" friends, don't be shy, we have nothing to hide.
Average (0Votes)
Top
Anonymous, Practice Manager,
23 Jan 2012
If signed up is not the right phrase, then why did you use it in the article in the first place? These are your words not mine.
Average (0Votes)
Top

ADD YOUR COMMENTS

Please note You must be a registered user of PulseToday and logged in to add comments. Opinions expressed below are those of the writers and do not necessarily reflect those of PulseToday. Comments are considered in the public domain and may be used in future Pulse coverage. We accept no responsibility, legal or otherwise, for the accuracy or the content of member comments.

Comment*

You must be logged in to add a comment.Clickhere to login.

SIGN UP FOR EMAIL NEWSLETTERS

Keep up-to-date with the latest changes to the NHS, CPD and clinical guidelines. Sign up below or find out more.

POLL

Is self-care the answer to the NHS efficiency drive? Read the full story here