GP Social Enterprise led Call Handling & Nurse Triage Project Powys Teaching Health Board

Summary of the Project This Project aims to develop a sustainable model of patient streaming and nurse assessment and treatment, deployed at GP Practice level, in order to: Improve access for patients Improve effectiveness through ensuring appropriate care interventions Improve efficiency through reducing inappropriate assessment and/or intervention Improve Practice sustainability through shared resource and costs This will change the flow through primary care by providing appropriate alternatives to GP assessment and intervention

Primary and Community Care Why was it chosen? 95% of all care is accessed in Primary and Community Care. A 1% change in P&CC results in a 20% change in Secondary Care Primary and Community Care Interface Secondary care Inaccessible P&CC services lead to avoidable pressure in other parts of the care system An increasingly unsustainable workload for GPs leads to an increasingly unacceptable delay in accessing services

Outcomes Effectiveness Access Efficiency Nurse Triage (for urgent GP appointment requests only): 17,000 encounters. 61% redirected to services other than GP (17.4% received advice only). Total Triage (for all GP appointment requests): 5,000 encounters. 43% redirected to services other than GP. Access Routine GP appointment time wait reduced from 14 days to 3 days Efficiency All GP appointment slots increased from 10 minutes to 15 minutes Reduced DNA rates Improved staff morale (GPs and Nurses) Improved continuity of care

Lessons Learned Reduces avoidable demand and improves access Can be applied to urgent and routine requests Can be delivered by one Practice for other Practices Need to train more Advanced Nurse Practitioners to avoid “robbing Peter to pay Paul), and training them takes time Upskilled Triage Nurses become more marketable GPs need to build trust in the Triage Nurses for the team to work effectively Empowers nurses and improves continuity of care for patients Practices, and individual GPs need to be ready to embrace it before implementation