Changes will improve service

We are writing on behalf of the Castle Medical Centre to discuss an important change that we are making to our appointment system.

Why change? We have had feedback that, although we perform very well in treating patients successfully, access to our GPs’ appointments has been difficult, also highlighted by NHS England through their national survey. We’ve listened to what our patients have said and, together with the approval of our patient reference group, have devised a new system. What do patients want? They want to see a doctor when they need, and they often want to see the doctor of their choice.

We are a busy practice with over 12,000 patients; Kenilworth is about to grow further. Our previous system was clogged; it was often difficult to make appointments ahead. Receptionists were finding it hard because they were often having to save ‘no’ to patients.

The only solution had seemed to be to take on more doctors, nurses and receptionists; nurse triage had helped a bit, but never really fixed the underlying problem that we couldn’t keep pace with demand. We’ve been running extra late evening and Saturday morning appointments and have also reopened Friday afternoon surgeries. But trying to meet ever rising demand was just crippling us. This isn’t a problem unique to the Castle Medical Centre, if you read the national press; it is a problem all over Britain.

So we looked at a new system that has been trialed in many practices in the UK called ‘Doctor first’.

The objectives of the new system are to deal with today’s demand today. Initial GP telephone consultations are ideally with a doctor of choice. If necessary a mutually convenient appointment will be arranged with the right length of consultation (patients bring multiple problems nowadays!) The most poorly patients will be seen first. We want to decrease the number of patients not attending appointments. We want continuity of care for patients and want to improve patient access and satisfaction.

Instead of patients having to go through the frustrating ‘fastest finger first phone lottery’ to get an appointment, sometimes days or even weeks ahead, they can now ring up at any time between 8am and 6pm and know they will get to speak to a doctor.

The system will see patients ring the surgery with their problems; the receptionist will find the most appropriate doctor for them to speak to and the doctor will aim to call them back within an hour or at a time that they find convenient. We think there will be about 30% conversion from telephone to face-to-face appointment rate. Once people recognise that the phone consultation is not a barrier, then hopefully they will find it helpful. The doctor and the patient will, now make the decision that used to be made by the receptionist and the patient.

It may not be easy to start with, and will require a huge change in approach from doctors, staff and our patients. We have spent a lot of time preparing and researching and we have been communicating with our patients through our patient representation group, our website and leaflets over the last few months.

Will it work? We are very optimistic, but at the time of writing, have only been running the new system for two days so it is hard yet to tell. It is a huge change but we hope after a few months that all our patients and the doctors and staff in our practice will see the benefits.

There will be other questions. Our staff (who have been brilliant during this time of change) have had a lot of training and are happy to explain. On the Castle Medical Centre website, there is a section about the new system with FAQs.

Dr David Rapley, GP, Mrs Kim Dodd, practice manager, On behalf of the Castle Medical Centre Kenilworth.