Make enough appointments available
The new GP contract obliges all practices to make at least a quarter of our appointments available to book online by July. Practices are sometimes reluctant to relinquish the triaging skills of their practice staff, especially when demand is so high.
I understand those reservations and instinctively share them. Typically, on a Monday, in addition to a routine clinic, I also work an emergency session managing the telephone triage list. The list has effectively no limit and I admit that the thought of offering online booking for these sessions fills me with that snowed-under feeling. Importantly, when patients phone, our experienced reception staff can often support many without them needing to speak to a doctor. And with our diverse inner city multi-cultural population, sometimes patients simply need some signposting or clarification questions that our reception staff can help with. But the truth is that booking appointments online is the future – soon we will regard it as commonplace as using apps to transfer cash or book train tickets.
This means needing to trust – and educate – our patients to use tools enabling them to book appointments online responsibly. Practices can disable online booking ability for any patient who abuses it, so we aren’t losing control.
At my practice in Southampton, we make all routine appointments and smear tests available online. Our practice was linked up to the app last November and we have 215 patients using it so far. To date, they have used the app to book 124 appointments, cancelled 31, and ordered 195 repeat prescriptions. Small numbers for now, but they will grow as more patients download the app.
We are finding it works well and does free up some time, with less admin work to do each day and a modest reduction in phone calls. And if I was to think without that snowed-under feeling, maybe we should offer some of the triage telephone slots as online appointments – test it out slowly in a measured way, and see if our patients use them effectively.
Make appointment names clear
The effectiveness of taking this approach relies upon clear and simple appointment names. We are a long way from that now and it needs action.
Appointment names have traditionally not been patient-facing – they have been used for administrative purposes. But the lack of any standard around appointment naming means there are tens of thousands of varieties in the system, and it’s flummoxing patients.
In a recent poll of NHS App users, when we asked whether patients understood the names of appointments, more than two thirds found them confusing.
On a couple of occasions, patients even mistakenly reported thinking they were seeing someone else’s appointment, because they were looking at the first name of the clinician they were due to see. An inconvenience while the app has around 25,000 users, but potentially crippling once it has millions.
This requires action from us at the centre, and work is underway, looking at creating a standard for naming appointments. But we cannot wait for that – we need practices to do their bit now and act to ensure their appointments are named so patients booking them online or via the app can easily find what they require.
Embrace the app
We all know that we need more GPs and that our workforce is the most important part of our health service. But, at a time when there is no magic bullet, we must dip into every little efficiency gain and benefit we can achieve. At our practice, we have found taking a measured approach to rolling out the NHS App has given us another channel to work with our patients, whilst releasing staff time for other work. Patients love it and there is something satisfying about knowing that my surgery is embracing being digital! Hmmm… perhaps a few online emergency appointments isn’t such a bad idea after all…
Dr Amir Mehrkar is the new interim chief medical officer at NHS Digital and a GP in Southampton