Case study summary
Brant Road and Springcliffe Surgeries in Lincoln have four GPs (3 part time partners and one salaried GP) and approximately 10,000 registered patients serviced over the two practices. The volume of correspondence GPs were receiving each day was overwhelming, leading one GP to do something about it. To get some help and direction on how to address the issue the GP participated in the General Practice Improvement Leaders programme, which is part of the support available through the General Practice Forward View.
The GP chose ‘document management’ as the live project she wanted to work on during the programme. Working with her practice team she took the lead in helping redesign a new process that was more efficient and reduced workload for GPs.
Identifying the problem
Each GP across the practices was receiving up to 70 letters a day, for the senior partner this was more, signalling an uneven distribution of workload. It was felt that most of this correspondence did not need to go to a GP and could be dealt with by other members of the team.
The GP first set out an aim for the project, which was to reduce the volume of inappropriate correspondence going to GPs, to ultimately help reduce their workload. This followed with the GP facilitating a process mapping session where the team mapped out the steps involved in how clinical correspondence was currently being dealt with. The team included GPs, practice managers, receptionists and administrators. Some of the issues identified were as follows.
- Some correspondence was on paper and other electronic, and was passed on to the GP who it was addressed to, even if it was not appropriate for them to see.
- The GPs dealt with correspondence in different ways.
- The complexity and inconsistency of the process posed a risk. For example, a GP receiving paper correspondence meant it was not visible on the records until after they had seen it and it had been scanned on.
Redesigning a more effective process
With the issues identified, the GP led the team to design a new process that was more efficient. The practice team discussed and agreed what the new process should look like, who should be involved at the different stages, and what was required to implement the new process. For example, staff training would support the new way of working.
The redesigned process ensured that all correspondence was first scanned before distribution. It relied less on GPs as the majority of correspondence could be dealt with by other members of the team. For example, DNAs could now go direct to secretaries and the coding team. Correspondence that requires clinical action such as prescribing changes, interpretation of test results, would continue to go to GPs.
- The volume of correspondence received by GPs has reduced by 70 per cent, from up to 70 pieces of correspondence to less than 20 per GP each day.
- Each GP has released at least one hour per day, which would equate to 20 GP hours released a week over the two practices. Between them, the four GPs were working around 130 hours per week therefore this equates to a 15 per cent reduction in total hours. Releasing this time has helped GPs feel less overwhelmed about their workload and reduced the need to work late, or even take work home.
- Due to filtering correspondence, actions are taken more swiftly, resulting in fewer delays for patients and quicker response to patient requests.
If you would like to find out more about participating in the General Practice Improvement Leaders programme, along with details on how to apply, visit our web page.