Getting an appointment

Getting an appointment

“We don’t make appointments over the phone” is something our patients report being told when they call the practice. ‘Well, how the heck do I get an appointment then?’ is often the response.

Nearly 18 months ago, Ashford Medical Partnership moved to what the NHS calls a Modern General Practice Access Model (MGPAM). It is the model that the NHS wants all GP practices in the UK to adopt. At its heart it means both that the 8am bun rush, waiting in a telephone queue, to try to get an appointment on a first-come-first-served basis, has been replaced with a system where every patient who wants an appointment has their need assessed. This is so those with the greatest need can be identified, and we ensure they are dealt with before their problem escalates.

We run a total triage* system now. Every request for an appointment throughout the day (not just those that would have got through on the 8am phone call) is now assessed by our GP triage team – this is two senior GPs who review every single request.

All requests are channelled through our Klinik system (this is our appointment system), so that we can ensure all the information the GPs need to triage the request is collected and passed to them. Klinik is an online system available from a link on the home page of our website every weekday between 7.30a.m and 4.30pm.

Whilst it is easier for most patients to complete the Klinik form online from their phone, computer or tablet – and that is the way most patients choose to do it – if you have no internet access, or are otherwise digitally excluded, it is still possible to complete a Klinik form by:

· Coming into any of our sites and requesting a tablet from reception to do it, or,

· Asking the care navigator at the reception desk to do it for you, or,

· Phoning the practice and asking a care navigator to complete the form for you.

Please leave these options (particularly phone lines) for those who are genuinely unable to complete the form online themselves.

However, it is the case that all requests are made by first completing the Klinik form.

Once you have completed the Klinik form it goes directly to the GP triage team, and they review it to assess your need. A good tip here is to remember when you complete the form you are sending a note to a GP, so try to put as much information in as you would if you were speaking directly to the GP. Once they GP triage team have reviewed your request, they will determine what the best solution is for you. It might be they will sign post your request to the new Pharmacy First scheme, which means going to a Pharmacy is the best solution for you on the day. If they decide you need an appointment with a GP, or associated clinical professional, they will assign you a same-day appointment or a routine appointment. They will also decide whether a face-to-face appointment is warranted, or a telephone consultation might be best.

A same-day appointment means they believe you need to be seen on the day of your request, not the next day or the day after. A routine appointment means they believe your need is not urgent and can be satisfactorily resolved with an appointment up to two weeks away.

If you have been assessed as having a routine need you will be sent a self-booking link so you can book the next available routine appointment that suits.

If you have a same-day need you will be called by a care navigator so they can slot you into an appointment on the day.

The care navigators are not able to overturn the GP’s triaged assessment of appointment need because they are not clinically trained.

We have a finite amount of capacity on any given day. This capacity is limited both by the availability of clinicians (which is sometimes impacted by sickness), and by the availability of clinical rooms. Once we have reached capacity on a day, we are full. We can’t create additional capacity.

If you have been assessed as needing to be seen on the day, but we have reached capacity for the day, we have no choice but to refer you to 111 or to an Urgent Treatment Centre or A&E. We only do this when we genuinely have no more capacity.

111 is staffed by doctors, nurses, pharmacists and paramedics. They can do almost everything that a GP can do for you including assessing your needs, referring you to an appropriate solution, send an ambulance, provide a prescription (in certain circumstances), provide advice and book an appointment at an urgent care centre.

Occasionally, 111 will refer you back to us. When your clinical needs are triaged as requiring same day treatment by our senior clinical GPs and all our same day capacity is exhausted for that day , our care navigators direct you to the most appropriate service for your clinical needs = 111. However, currently there is no mechanism to communicate this to 111 and so they are unaware you have already been triaged. We apologise if you get caught in this loop. We will continue to try to resolve the situation.

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We do understand how frustrating it is for you when we have reached capacity. We are busier than we have ever been – we are seeing more patients than ever before (including before covid). We have added significant additional capacity, including more GPs, but have no more funding or room to add any more. However, we are seeing more patients than we have ever done before.

Every month we ask a random selection of 150 patients to complete a Friends & Family Test to score their satisfaction with our service. Since we changed to the new Modern General Practice Access Model our Friends & Family test scores have improved

dramatically. Over the last six months on average 79% of patients have rated us Very Good or Good, and we have a positive Net Promoter Score of 66%.

Whilst it will never suit everyone, and whilst change is always difficult, the shift to the new model seems to be supported and appreciated by a majority of patients, who are finding it far easier to access us and get an appointment than they did when they had to join the horrible 8a.m. telephone queue.

*Triage

“The preliminary assessment of patients or casualties in order to determine the urgency of their need for treatment and the nature of treatment required.”