Ilkley Moor Medical Practice

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Ilkley Moor Medical Practice Advanced Access
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1.Government targets By 2004 all patients
should have access to a Health Care
professional within 24 hours and a GP within
48 hours
2.Waiting times routine Dr of choice up to 3
weeks
3.DNAs approximately 20 a week
4.Increased work loads 2 to 1
shift National Service Frameworks
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5. Rapid Access Clinic the pros and cons
6. Patient Satisfaction
7. Staff contentment
8. Doctor Stress
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Advanced Access
A way to improve patient access in General
Practice based on ensuring a balance between
DEMAND for services and the CAPACITY of the
practice to deliver them.
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FOUR PRINCIPLES

• UNDERSTANDING DEMAND

Data collection

• SHAPING THE HANDLING OF DEMAND

Offering alternatives to face to face
consultation i.e. Telephone follow ups, telephone
management of same day demand, email, proactive
self help etc

• MATCHING CAPACITY TO DEMAND

Looking at skill mix

• CONTINGENCY PLANS

For predictable (holidays, meetings etc) and
unpredictable (staff illness, flu epidemics etc)
events
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Data Collection

• The following graphs demonstrate capacity and
  demand for GPs over a 4 week period.

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Data Collection
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Data Collection
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Data Collection
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Data Collection
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Data Collection
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Data Collection
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Data Collection
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Data Collection
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Preparation
Happy to try, we can always go back to the old
system.
Itll never work!
As long as I dont have to work any harder
As long as this doesn't effect my child care
I dont like change
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Preparation - Appointments
Previously GPs spent 47 of their total time in
surgery. Rapid Access Clinic 250 5 minute appts
per week
New System
Aim at 600 10 minute appointments/week
GPs never do more than 50 time in surgery
With all GPs there this will drop to 35
50 bookable same day 30 bookable 1 week in
advance 20 bookable 3 months in advance
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Preparation
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Preparation - Shaping Demand
Telephone Consultations
Re - directing to Practice Nurses -
Contraception HRT Hypertension Travel
Advice - Developing Protocols
Triaging Visits
Self - help information - Web Site
(www.ilkleymoordoctors.co.uk) Leaflets Etc
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Preparation - Administration
Data Collection - Number of appointment
Requests/DNAs
Initial Meeting with GPs to talk through shaping
demand.
Trial of telephone consultations
Change in staff rota Change of rota for
staff so as to best cope with busiest times
Increased telephone lines
Staff Training
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Preparation - Administration
Publicity
Leaflets and posters at reception
2 public meetings
Local press release
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Preparation - The Backlog
Stopped all pre bookable appointments after
Christmas
Provided more appointments during 1st 10 days of
January
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Experience to date.
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Experience to date.
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Experience to date.
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Experience to date.
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Experience to date.
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GP Comments.
Looks like you didn't need me
Stress whats that!
I cant believe it worked!
I didnt have to work any harder
Brilliant
The surgery mix is much better
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Patient Questionnaire
Q1. Do you feel the appointment service has
improved?
Q2. Were you satisfied with the appointment
service?
Q3. Did you see the Doctor of choice?
Q4. Did you get an appointment on the same day
you rang?
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Patient Questionnaire
Q5. Did you have to ring back for an appointment?
Q6. Do you know that we provide telephone
consultations?
Q7. Do you feel that the provision of telephone
consultations is beneficial?
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Experience to date.
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Potential Problems
Popular Doctors
Continuity
Patients planning appointments around their
commitments.
Elderly patients
Patients being asked to phone back
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Why Bother To Change?
All 10 minute appts - better quality service to
patients. Improved continuity, Decreased waiting
times.
Doctors are spending less time in surgery freeing
more time for pro active as opposed to reactive
treatment. Overall improvement in their working
lives.
Staffs working lives have been improved. Less
time spent dealing with each appointment Less
patient aggravation
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Why Bother To Change?
2 appointments per surgery
4 per day
18 per week
810 per year
8100 per 10 years
1350 hrs less / 169 days / 34 weeks