Recent developments have seen a renewed focus on targets in general practice to achieve speed of patient access. However, with many practices already operating at capacity with limited appointments and available GP hours, just as vital will be a continued focus on ensuring patients receive the right care appropriate to their needs.
‘Right care, right time’ may be an overused phrase in healthcare. Yet, with increasing pressure across the health system, it’s a goal that’s more important than it’s ever been for its future sustainability. The key to achieving it will be facilitating optimal access and triage, and here we identify some possible enablers that could assist on the journey ahead.
Enabler 1: Additional support for staff
It’s well known that over the past few years patient interactions with primary care have changed significantly. Use of care navigation and clinical triage have increased. At the same time, patient needs are becoming increasingly more complex. For those responsible with triage, identifying patients with urgent needs is a daily challenge.
It is essential that staff get more support and resource to help with the assessment of patients. A recent workshop for the Remote by Default 2 study revealed a need to equip teams with “sufficient skills in inquiry, negotiation and communication,” while the Nuffield Trust has advocated for extended training programmes similar to the Netherlands and Germany to address current gaps in programmes described as “patchy at best.” This will support patient triage and help to reduce patient frustration. They note:
“Ultimately, patients’ trust in triage and appointment booking will only emerge through positive experiences in which either their expectations are met or the reasons for not being able to meet them are adequately explained. Without trust in these arrangements, frustrated patients will find other routes into care – too often through already overcrowded A&E departments.”
Enabler 2: Optimised websites
NHS England has rightly identified GP surgery websites as a key focus area within its winter proposals. Helping patients to find services they need easily and making websites more accessible and understandable to all is essential to ensuring care takes place in appropriate settings.
Recent research has revealed that when visiting a website, patients are focused on completing a small number of simple tasks. Whether it’s making, cancelling an appointment, ordering a prescription or finding practice information. Often patients will quickly scan for certain terms, and if they cannot locate a specific phrase quickly, will abandon the task. This can lead to increased pressure on practice lines and triage of needs that could possibly be dealt with online.
Thankfully, small changes can make a difference and enhanced surgery websites can be a real quick-win for practices. When built to NHS Digital Service Manual standards and templates, GP practice websites are an invaluable tool that can help practices drive effective online engagement and reduce demand.
Enabler 3: Greater awareness
The first Remote by Default study highlighted tensions that have emerged from a mismatch between current levels of demand and available capacity. There is a need for a greater understanding of the challenges general practice faces today.
Indeed, there have been calls from Nuffield Trust for a public campaign “about new ways of consulting in general practice and the skills of multi-professional teams working with GPs to reduce the chance of patients who are disappointed with the appointment they are offered attending a different service.”
Welcomingly, it has recently been announced that NHS England is looking into such a communications campaign “to educate patients on key changes such as the use of additional roles staff.”
Communications should focus on the range of appointments available, how to book as well as clinician types and the issues they can deal with. Additionally, any initiative should also highlight general pratice’s role within the larger healthcare picture in the UK.
Enabler 4: Flexibility of access
With demand spikes in primary care, having a wide range of appointments that can be deployed at speed can free face-to-face resource for those who need it most.
Making best use of the skills of a multidisciplinary team is also all-important. We’ve designed our Livi Practice model, to accommodate these needs and can deliver digital provision of GP, ACP and nurse appointments across telephone, text and video. We also provide mental health support.
Many of the practices we work with opt for a mix of clinician types which can increase patient access without exceeding practice budgets. Integration is seamless too with clinicians working from a specially built appointment book that works within a practice’s clinical system and provides full visibility, working as an extension of the practice team. Livi clinicians can also prescribe, refer and provide sick notes where required.
Want to learn more?
Livi can assist with digital clinical capacity, GP practice technology and surgery websites. To find out more, contact partnerships@livi.co.uk
