1. Sustainability of Primary Care
19th July 2017

5. Knowing what to do?
Step 1: Need to understand demand and challenges

6. LLV patient demand audit
Received over 10,000 questionnaires in a 2 week period (73% of total patients seen ……….. this could equate to 1 in 7 people living in the locality had a F2F appointment with their General Practice in that 2 week period)
Captured data on 21,576 contacts occurred between patients and receptionists / telephonists over the two-week period.
For context we printed out 14 ½ thousand pt questionnaires = 58 reams of paper (12 boxes which stacked up on top of each other is c high of a bus!)
Printed out c 3000 admin tally charts

7. Results
Clinical
79% of patients did not seek self-help or advice for their current condition
62% of consultations would be happy to see an alternative clinician (if appropriately skilled) …… 18% indicating NOT happy
24% consultation activity within a practice could be managed in an alternative pathway ……. ¾ could have been skill mixed to other practice based member of staff (saving c33,000 GP appts / year)
Only 5% clinical consultations undertaken by phone……. survey indicated potential to increase to 12%
GP Practice capacity
5 of 8 practices offering more than 80 GP appts / 1000 weighted patients per week (national benchmark 72)
Split of reception time was 50:50 between appointment related demand and non-appointment related demand
GP Practice On-the-Day demand
On average 56% of requests for a consultation were requesting a consultation on the day the request was made, 68% of those requested were met and a further 20% booked for another day…… c35,000 additional reception / telephone contacts are made by patients per year, seeking to book an appointment because one was not booked on first patient contact
….. some practices having 10 contacts per year per patient

8. Results
Clinical
79% of patients did not seek self-help or advice for their current condition
62% of patients would be happy to see an alternative clinician (if appropriately skilled) …… 18% indicating NOT happy
24% consultation activity within a practice could be managed in an alternative pathway ……. ¾ could have been skill mixed to other practice based member of staff (saving c33,000 GP appts / year)
Only 5% clinical consultations undertaken by phone……. survey indicated potential to increase to 12%
GP Practice capacity
5 of 8 practices offering more than 80 GP appts / 1000 weighted patients per week (national benchmark 72)
Split of reception time was 50:50 between appointment related demand and non-appointment related demand
GP Practice On-the-Day demand
On average 56% of requests for a consultation were requesting a consultation on the day the request was made, 68% of those requested were met and a further 20% booked for another day…… c35,000 additional reception / telephone contacts are made by patients per year, seeking to book an appointment because one was not booked on first patient contact
….. some practices having 10 contacts per year per patient

9. Results
Clinical
79% of patients did not seek self-help or advice for their current condition
62% of consultations would be happy to see an alternative clinician (if appropriately skilled) …… 18% indicating NOT happy
24% consultation activity within a practice could be managed in an alternative pathway ……. ¾ could have been skill mixed to other practice based member of staff (saving c33,000 GP appts / year)
Only 5% clinical consultations undertaken by phone……. survey indicated potential to increase to 12%
GP Practice capacity
5 of 8 practices offering more than 80 GP appts / 1000 weighted patients per week (national benchmark 72)
Split of reception time was 50:50 between appointment related demand and non-appointment related demand
GP Practice On-the-Day demand
On average 56% of requests for a consultation were requesting a consultation on the day the request was made, 68% of those requested were met and a further 20% booked for another day…… c35,000 additional reception / telephone contacts are made by patients per year, seeking to book an appointment because one was not booked on first patient contact
….. some practices having 10 contacts per year per patient

10. Plan for the future
The survey identified many areas where the locality has the opportunity to redesign the current service to improve and standardise patient care, make efficiencies and save costs
Development plan categorised into:
Access
Capacity
Workforce

11. Access
50% people accessing the surgery is for none appointment related need.
Clinicians said 9% consultations could be managed virtually….+ further 12% via telephone

12. Ask Dr / Nurse Q online

13. LLV Primary Care workforce

14. 1 in 4 GP appts could be managed in different pathway
62% of patients would be happy to see any appropriate clinician (20% don’t know…..only 18% patients actually said NO)

15. But what about everyone else?

17. Integrated Community Services
R – operational delivery and development / implementation of transformation
A – accountable to LLV co-commissioning board
C – clinical leads + operational managers
I - LLV Co-Commissioning board + stakeholder organisations
EEAST
PPG
HUC
HCT
MIU
Integrated Community Services
Delivery Board
HPFT
Primary Care
HCS
Voluntary sector
Pharmacy
RFH

18. Or ……… plan B

19. THANKS