Warden Lodge What is it like to be a patient? Harry Longman

The system reveals its secrets… Patient wants the doctor –When do I have to call? –What happens? –How soon will I be seen? –My regular doctor?

What do patients think of our service? Receptionists’ view –Not enough appointments available –Difficult to get through on the phone –Grumble, can’t see doctor of their choice –Patients happy/not happy – different views Doctors, nurse, admin view –Like the doctors they see, pleased with clinical service –Want more continuity, shorter waits, to see & in surgery –Often patients have to redial, feel reception are unhelpful –Telephone access can be difficult, and GP of choice

My daily work here Reception view –Frustrated patients cause frustration to staff –Phone constantly ringing, trying to do other tasks –Patients claim emergency “cough”, impatience Nurse –Pts great but frustrated at often having nurse appt instead of Dr’s, not in my remit. But wait too long for GP, causes stress to patient and myself GP –Heavy and worsening demand, seeing the worried well, inappropriate use of appts –Pressure of demand but misgivings over care for less demanding? –Never seem to be enough appts, up to 30 phone messages daily –Demoralising after 11+ hours Admin –Day always involves firefighting, never manage to get through plans.

As a patient, I'll wait an average of 4 to 6 days to see a GP.

Though in truth I have a 45% chance to be seen on the day, if not it will be more like 10 days.

But to get in on the day I’ll have to phone on the dot of 8am and hang on with everyone else.

When I get there, a lot of cars are in the car park and people in reception (total hours waited/wk).

Consultations are about 11 mins, on the phone variable 6-8 mins.

The mix seems almost all face to face at present, just over 6% of list per week, normal range.

The small number of phone calls from the GP are returned some time, generally a couple of hours.

Chance of seeing my own doctor is 58%, not too bad, but I’d really like that to be all the time.

Summary Traditional system, pre-booked face to face Pressure to see the GP same day Rush at 8am, take any appointment going If nothing today, wait several days Continuity comes at a cost of waiting Access at a cost of getting in early and hanging on hopefully

My ideal work Receptionists –Being able to give patients what they want –Having more on the day appts –Separate phones from front desk –Get a lot of job satisfaction from this GPs/nurse/admin –Seeing patients with a real need –Continuity of care, save covering old ground –Help patients be more self reliant –Shorter days, less interruptions, reasonable break –Leave earlier in the evening

Your data capture: patients ring to see the GP

More demand on Mondays, fluctuates through the week

Most patients ask to see the GP today

17% of patients dealt with by phone consultation

Of the phone consultations, 71% don’t have to come in

Continuity important for 39% of patients

Of that 39%, continuity is achieved 94% of the time.

How would the new system change things? Reception takes call GP phones patient Problem solved Come and see me Admin question Come and see the nurse 10% 20% 10% 30% 60% PA Navigator measures the flows, which vary by GP & practice. 70%