Developing a New Web Based Tool
This initiative has developed out of the report we prepared for the Department of Health in May 2009, supported by the RCGP and the BMA and circulated to all practices and PCTs across the Country. Although the report was well received, many general practices have struggled to translate what needs to be done into practical steps to make it happen in their own practice.
Developing the tool and what it does
We worked with a number of pilot sites across England in 2010 & 2011 to understand more about how we could best support the way practices manage access, capacity and their response to urgent care. We developed a web based tool so that there is a simple way for all practices to assess how easily patients can access care, the match between demand and availability for appointments and how staff respond to urgent demand for care. A practice enters data covering a week in the practice and a largely automated report is produced. Reports enable practices to compare how effectively they manage these areas compared with other practices across their locality of CCG, as well as against others across the Country.
What information do we collect?
There are basically three different types of information collected through the survey.
How you work in your practice. The first section of the survey has 14 multiple choice questions providing an important description of the practice that, combined with other data, helps us suggest areas that the practice may be able to address to improve the way they manage access and urgent care.
Data for a sample week. The second part covers ‘Opening Hours’, ‘Telephony’, ‘Walk In Appointments’, ‘Consultations’ and ‘Additional Information’. These each require the practice to enter data about one week that they select as a reasonably normal week for the practice.
The Reception Quiz. This third part designed as a support tool for everyone who carries out reception duties in the practice, either taking calls or speaking to patients who walk in to the surgery. It looks at levels of confidence to manage urgent cases before asking how they would deal with 13 different scenarios of patients presenting with potentially urgent problems. This is not a clinical quiz but it does check on whether there is a consistent response. The quiz is intended to be the basis for a follow up session in the practice for reception staff, preferably with the practice manager and a GP.
What do results show so far?
Results so far suggest that practices are far more likely to change if reports are based on their own data with practical suggestions for how to make improvements. There are potentially significant gains if practices in each area manage urgent care effectively as we have seen reductions in acute admissions in some cases that are estimated as between 20 and 40% as a result of good management of urgent care in general practice. Although this benefit will not be achievable in every case the aim of the work is to fill the gap in capability of practices to undertake regular and ongoing capacity planning to ensure their response to urgent care is as effective as possible.
A case study from a practice that has already been involved in an early pilot is included below. More case studies will be available soon providing other examples of how practices have used this information to improve care and reduce costs in the wider healthcare system.