A Blog from Amanda Gray, Managing Partner at Meon Health Practice
As we navigate the challenges of the winter season – cold, ice, snow and the pressures in the healthcare system – I want to reassure you that our top priority is providing as many appointments as possible with our GPs and extended team each week.
Reflecting on last year’s care
Looking back, we’ve seen significant growth and changes in the types of care we provide. With more patients facing complex medical conditions rising year on year, we’ve had to find additional appointments to ensure we can manage all of the follow-up care. Doing more with less is part of the way work as our base funding per patient is £109.20 annually. Diversifying staff and using digital tools to reduce admin are important strategies to help with this.
Feedback from patients overall has highlighted that whilst they are frustrated by access and would like more accessible appointments, they do appreciate the quality of their consultations which are delivered with kindness and compassion, making for a great patient experience of the actual care given.
How we use our time – a balancing act
Approximately 70% of our appointments last year were pre-booked for planned care. This includes for the conditions that we are already treating patients for with medications, regular testing and annual monitoring, annual reviews for chronic conditions like diabetes, asthma, and heart failure. This part of our service has improved due to more consistent processes, and I’m pleased to share that our recruitment, retention and development efforts have resulted in a strong, resilient clinical team.
In order to increase the numbers of appointments we can offer, we are continually developing our team to include more nurses, pharmacists and paramedics and using digital innovations to remove non-clinical work from GPs. Our patients have embraced these changes and since new technologies are developing all of the time there will be more positive change to come.
At our PPG Focus Group in November, we explored with patients how we can improve some of the administration, around our recalls in particular, ensuring there are enough appointments available when invitations are sent and improving the follow up of hospital letters/actions. We have now built this into our 2025 plans.
Once all the planned appointments are in the appointment book, each day we have an allocated amount of time that we can give to unplanned care (i.e. for the assessment and treatment of new symptoms that our patients are experiencing, and we don’t know about until they tell us). This has to be carefully balanced with the time we allocate for planned treatment of patients and of course the time we spend giving preventative care and vaccinations.
Each day we also allocate time for the clinical team to review blood results, review and sign off prescriptions and for the actions that are required to support referrals and hospital appointment follow up. We are regularly told by patients that getting these practical steps around their care right is really important and we make sure this is a priority.
On average each week, we issue nearly 10,000 prescription items, reviews thousands of test results, and read over 3,000 letters. About 15% of our GPs’ time is allocated to these critical tasks each day, which we know are essential for ensuring smooth patient care.
Whilst we appreciate that sometimes things go wrong, we only get a very small number of complaints/concerns raised about errors in relation to the large volume of tasks that are carried out.
Why it’s hard to get a GP appointment
One of the most frequent concerns we hear from our patients is about the difficulty of getting a GP appointment. As I have explained, our team have to use more of their time each week and each year to complete the planned appointments, review diagnoses, treatment plans and complete the clinical administration for prescribing and follow up.
All of this activity has to come first to maintain the wellness and treatment of the conditions we know our patients already have. The remaining 30% of appointments are made available for new consultations.
These remaining appointments have to accommodate patients who have urgent and non-urgent requests. We classify urgent medical matters as things that require quick assessment so they can be treated as swiftly as possible to stop them escalating – some examples of these are a chest infection that needs antibiotics, a mental health episode or a breast lump. When we have a large number of urgent requests, we are then unable to allocate any time to deal with new non-urgent (routine) requests and the end result is that there are no new routine GP appointments to offer patients.
Our ongoing efforts to improve access
We are working really hard all of the time to keep our number of appointments as high as possible through reducing staff absences, using triage to identify the best and quickest way to deal with requests and finding digital/automated solutions to speed the work up.
Each year we use all of our available budget to employ the maximum number of best value staff, and we continue to work to find innovative ways of working that means they can each look after more patients safely.
Looking ahead
Improving access to appointments remains a key goal for us this year. Additionally, our Patient Participation Group (PPG) has encouraged us to enhance communication with patients. This bi-monthly blog is one way we’re addressing that, and I hope you’ve found this first edition an informative read.
We welcome your feedback.
Please email our Communications team at: hiowicb-hsi.comms-meonhealthpractice@nhs.net
If you would like to join our Patient Participation Group (PPG), please click on the link: