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Hugh Reeve is a GP in Grange-Over-Sands in Cumbria. The practice wanted to improve the way they met patient demand and initially began to look at introducing an online consultation system. They soon concluded that this could not be simply about introducing a “bolt on” digital system and it quickly became a process that forced them to radically reconsider all aspects of their patient flow. In this episode Hugh explains how they went about transforming their practice, how the new system now works for GPs and patients with the resultant outcomes including the fact that only 40% of patient contacts are now face-to-face.
Why introduce an online consultation system? (0:59)
Improving continuity of care (1:49)
Researching the options (2:57)
The kind of system they didn’t want (4:00)
A much bigger task than choosing a system (4:44)
Improving the “flow” of patients (5:21)
How the system works for GPs (6:13)
Changing the way they work rather than “bolting on” a system (7:16)
Radically rethinking “flow” (8:03)
Only 40% of contacts are face-to-face (9:33)
Not just introducing online (10:05)
Establishing what capacity is needed (10:45)
Introducing the new system (11:19)
Patients using the system (12:07)
Not about workforce challenges (13:15)
A typical day for a GP in the practice (14:13)
The reaction of patients (18:45)
Pilot site for the Health Foundation Programme on Continuity of Care (19:39)
Hugh’s advice for others (22:03)
You can email Hugh at hugh.reeve@gp-a82053.nhs.uk
The askmyGP website is available here
1 Comment
Very interesting and compelling. (though we find any changes we have made over the years creates a win…for a while….and then patients find other ways around the system). We have always matched supply to the varying weekly pattern of demand on an ‘advanced access’ basis, have a duty dr to mop up any on the day demand and 50:50 prebooked/on the day. We are nearly 16,000 and I wonder how scalable this system would be in terms of control and safety, and for the larger number of people with busy commuting lives who need to diarise prebooked appts. I love your realistic appraisal that it does not reduce workload (which is what is ctouted) but reshapes the work to be more flexible and giving you a feel of control and I sense, calm? We do a lot of phones consultations and small numbers of e-consult but this one entry system for everything is attractive. I particularly like the flexibility for individual working preference.
One tiny thing – you started mentioning difficulty phoning patients about results- as an EMIS user do you not have AccuRx for texting your patients? Simply the best, simplest and most effective patient communication tool we have.
We’ve seen the AskMyGP material and videos but your more considered view has made for very interesting listening and I shall now share with my partners