Customer stories
Building resilience and improving patient access
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The revised GP Contract has brought about a focus on empowering patients and implementing modern general practice access, with practices now required to provide an assessment of need and appropriate care at point of contact.
Dr Westgate has recently seen meaningful change at Carlisle Healthcare since harmonising online and telephone access within the practice.
The journey
Carlisle Healthcare was formed from a practice merger in 2016 and functions across three sites, currently serving the needs of 38,000 patients from a broad and varied demographic background. It operates as a single practice Primary Care Network due to this size, which in turn keeps things simple in terms of management and communication.
They introduced online consultations in 2018 in response to Care Quality Commission comments about improving patient access and reducing telephone waiting times. During the pandemic online consultations played a bigger part in safeguarding and reducing footfall. At the same time, the team adopted a process in which they actively managed the appointment book based on a clinically assessed need, whilst creating opportunities for clinicians to work flexibly and remotely.
Over the years I think we have tried every permutation possible in terms of improving access and delivering the best service we can. It's all about being flexible and adapting within the limits of your working practices.
The challenge
Post-pandemic the practice continued to operate with both telephone triage access and online access running as separate work streams. However, they had to limit the availability of online consultations, due to clinical capacity issues, and the telephone system still encouraged an 8am rush and resulted in frustration for patients and staff.
Despite putting large amounts of clinical resource into telephone triage, patients were still not getting a good experience and clinicians were also conducting multiple consultations with individuals, which was certainly not the best use of their time.
Our challenge was to deliver a clinically appropriate response for patients, in a safe timeframe, whilst recognising our finite and limited clinical capacity.
The solution
The turning point was the decision to designate online contact as the preferred method of contact for all patients where possible. The team then started to use eConsult to fully capture the details of each patient and their specific needs, then flowing this information into the triage system and integrating with Local Services.
With a common route for all patients coming into the system, the queue can now be managed better with trained care navigators, who assess the urgency of the request and direct to an appropriate clinician or service in-house or outside of the practice itself. Once the decision has been made, this will then be communicated back to the patient, closing off the feedback loop.
We have begun the process of turning our triage system upside down, with the majority of our clinical templates now made up of consultations rather than triage slots.
Carlisle Healthcare’s new modern access approach is still in its infancy, having only soft launched in June 2023. However, the team have already observed lower telephone call volumes and shorter telephone congestion periods at the start of the day.
In conclusion
The reality is that capacity may still provide some challenges going forward, but the Carlisle Healthcare team are certainly on the right track with their proactive approach to access.
Overall they have proven that the building blocks to an efficient process are:
- Improving access for all patients
- Being efficient with clinical resource
- Optimising technology for good information flow
- Using the wider team, care navigators and resources
- Signposting and communication for an enhanced patient experience