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Enhancing Patient Access at Prospect Road Surgery: A Journey to Advanced Access Care

Prospect Road Surgery has transformed its appointment system to improve patient access amidst growing demand. With a practice population of 7,288 and limited GP resources, the need for Advanced Access became critical. By analyzing capacity and demand, implementing telephone consultations, and reshaping appointment practices, the surgery ultimately reduced waiting times for GP appointments from 14 days to just 0.42 days. This strategic change has led to increased patient satisfaction, happier staff, and a more efficient care environment.

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Enhancing Patient Access at Prospect Road Surgery: A Journey to Advanced Access Care

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  1. Prospect Road SurgeryAdvanced Access HOW YOU COULD GET HERE !! Chris Nicholls chris.nicholls@wakeha.nhs.uk 01924 274 123

  2. Prospect Road Surgery • Practice Population = 7,288 • 3.5 WTE GPs • 1.75 WTE Nurses • 5 Receptionists – all part time • GMS Practice • Large population increase over the last two years

  3. Why Advanced Access? • GP 3rd Available Appointment 14 days! • Nurse 3rd Available Appointment 16 days! • Stress, Stress, Stress • Unhappy Patients = Unhappy Staff • Senior Partner Retiring (October 2002) • How would we cope with no extra capacity? • Advanced Access????

  4. What Happened Next? • Presentation by Access Facilitator • Committed to working with the Collaborative • Capacity Demand Measuring (two weeks August 2002)

  5. August2002 • Total GP Demand 540 appointments per week (Follow Ups 15%) • Total Nurse Demand 165 appointments per week (Follow Ups 32%) • GP Backlog 1512 Appointments • Nurse Backlog 462 Appointments • GP DNAs – 64 per month • Nurse DNAs – 55 per month • Shortfall in GP appointments only 3 per week • Shortfall was going to jump to 100 per week in October

  6. Practice Wide Data

  7. Where did we start? • Plan to clear the backlog when Senior Partner replaced • Changed Monday Working • Mondays booked on the day only (except 1st hour) • No follow up appointments on a Monday • After two weeks extended to Fridays • GP 3rd available appointment dropped from 14 days to 3.9 days • Nurse 3rd available appointment dropped from 16 days to 1.2 days

  8. Gloomy October • Dr. Brad Retired • Mid - week wait went back up to 14 days • Practice became disillusioned • Had anything changed? • Ray of Light……………. • Dr. G’s Telephone Consultations • Potential to save 10 appointments per week per GP

  9. Telephone Consultations • 14, 5 minute appointments per week (7 on Mondays, 7 on Fridays) • Mainly for discussion of labs/ X-ray results/ hospital letters • Very clear guidelines for reception about who is suitable • Telephone consultations taking 5 minutes as opposed to 10 • Only 1 in 20 is resulting in a face to face consultation as well • The patients like them!

  10. Clearing the Backlog • No replacement for retired partner to be found • Locums difficult to find • Appointments booked on the day only over Christmas • Started the New Year with a clean slate

  11. New Year New Start • Mondays booked on the day only (except 1st 1/2 hour) • Follow up appointments kept to the middle of the week • Patients educated to ring the day they want to be seen • Patients educated to ring after 10.30am for anything other than an appointment • Roughly 40% appointments can be pre - booked • Introduced GP led Clinics • Extending telephone consultations to other GPs • New appointment slips • Contingency Planning

  12. Problems • Selling it to the rest of the Practice • Gaining the patients trust in the new system • Clarifying the system to Reception • Getting Reception to use it! • Change is scary - what if it doesn’t work!

  13. Success • GP 3rd available appointment 0.42 days (from 14) • Nurse 3rd available appointment 3.13 days (from 16) • Happy Patients • Happy Staff • Happier GPs - well you can’t please everyone! • FREE APPOINTMENTS!

  14. Where Now • Practice nurse starting minor illness training April 03 • Receptionist training to be Health Care Assistant April 03 • Out of Hours usage reduced • DNA’s reduced • Practice moved to all 10 minute appointments • Staff and patient questionnaire to assess impact of work April 03 • Identified need to increase the amount of pre-booking

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