Portishead Medical Group Patient Information Evening Mon 2nd Oct 2017 Cardiovascular disease Cerebrovascular disease Hot topic-GP appointments

Contributors Mary Adams (North Somerset CCG) Tracey Taynton (Advanced Nurse Practitioner) Simon Lynes (GP Registrar) Max Howes (GP) Gerwyn Owen (GP)

Appointments in General Practice Gerwyn Owen 2/10/17

National Context King’s Fund Research Public satisfaction with general practice remains high and people are more satisfied with GPs than with any other NHS service. However, there are signs that patients are becoming less satisfied with their ability to get GP appointments. The GP patient survey shows that satisfaction with their experience of making an appointment has steadily declined from 79 per cent in 2012 to 73 per cent in 2016, while NatCen’s 2016 British Social Attitudes survey found that the proportion of people who thought GP appointment systems were ‘very good’ or ‘satisfactory’ declined from 57 per cent in 2010 to 37 per cent in 2016.

Although there is a lack of national data about activity in general practice, it is clear that pressure on GPs has increased. Last year, The King’s Fund undertook the most comprehensive analysis to date of demand and activity in general practice. This found that GP workload had grown both in volume and complexity, with our sample showing a 15 per cent increase in the number of consultations between 2010/11 and 2014/15. There are many reasons for this, including the growing number of patients with complex conditions; new services and clinical advances; and changing relationships with other parts of the health and care system. Over the same period the proportion of NHS funding spent on general practice declined by 0.4 per cent.

In recognition of the growing pressures in general practice, NHS England published the General practice forward view in 2016 which committed additional funding and outlined measures to help with recruiting and retaining GPs. NHS England is also encouraging GPs to come together in larger groups, whether through mergers, federations or other models, so that they are better able to deliver services. Also greater involvement of nursing staff, pharmacists, paramedics and physician’s assistants in General Practice

The King’s Fund view The workload in general practice has grown significantly in recent years but this has not been matched by growth in funding or workforce. This has left the profession facing a crisis. NHS England has recognised this by publishing the General practice forward view and primary care is one of four national service improvement priorities identified in the Next steps on the NHS five year forward view. National level data is now essential to understand changes in demand and activity in general practice and direct resources accordingly. There is considerable scope for GP practices to improve efficiency and effectiveness, for example by coming together at scale, using data more effectively to understand patient demand, and implementing new ways of working such as telephone triage. However, with workload continuing to grow, GPs will continue to be over-stretched, especially as the pledge to recruit 5,000 more GPs by 2020/21 looks very challenging.

Introduction Our attempts at dealing with this Ways of contacting the surgery Range of appointments on offer When you might be seen

Ways of Contacting the Surgery Telephone Via internet booking system In person at the front desk Out of hours service (18.30-08.00 Mon to Friday, and all day on Sat and Sun) is available via the 111 telephone number

Appointments on Offer GP face to face consultation GP telephone consultation Nurse appointments (Treatment room, Practice Nurses, Specialist Nurse Clinics, Advanced Nurse Practitioners) Urgent Surgery-1 doctor each day who sees all those who need to be seen on the day. Also backed up by a doctor who is performing home visits all day.

When? 50% of GP appointments are bookable in advance-exceptions will be days after bank holidays 50% of GP appointments become available only on the day Urgent surgery all appointments available on the day not bookable in advance Nurse appointments are pre bookable but not via the internet. The Advance Nurse Practitioner bookings are mostly on the day

When? GP appointments are usually 18 face to face appointments in the morning and 16 in the afternoon. 6 pre bookable telephone consultations each day. Some days and for some doctors this is adjusted. Evening surgeries on Tues and Weds 18.30-20.30 Saturday morning surgeries for the locality GP hours of availability see website

Requests from us Cancel your appointment if you don’t need it If you have a mobile phone leave us your number and make use of our text reminder service Do you really need to see a doctor or nurse or would a pharmacist be able to help? Remember Minor Injuries Unit in Clevedon Visit our website for more information and help with managing your health http://www.pmg.org.uk

Questions?