Case study summary
Beacon Medical Group introduced ‘ten high impact actions’ to benefit patients and staff.
Beacon Medical Group became aware, after partaking in the NHS Productive GP Programme that 50% of demand at their largest site was “On the Day Demand.”
The problem was how to meet this demand and ensure that the right care could be given by the right person at the right time working in a financially sustainable model with the workforce available in the locality. Concern was that eventually the group would hit levels that were not safe to continue unless appropriate action was taken.
The group felt that by adapting the way they offer on-the-day access they could not only provide a prompt service for patients but also cope with demand using a broader skillset. The group also worked with NHS Productive GP to look at every aspect of the practice and see if there was scope to improve the provision of care or administrative processes to release capacity.
Introduced ten high impact actions to benefit patients and staff:
- Active signposting: ‘No Waiting Room’ campaign which introduced the concept of the Urgent Care Team. This recognises that some patients might find it hard to adapt to seeing other clinicians when they are unwell.
- New consultation types: Group consultations with patients who suffer with dementia and their carers; and also patients who suffer having had a stroke and stroke awareness.
- Reducing nonattendance: Offering a technical facility to remind patients of their appointment and also provide the opportunity to cancel.
- Develop the team: Recruited an Advanced Extended Scope Paramedic, an Advanced Nurse Practitioner and a Clinical Pharmacist to work within a team with the duty GP being the leader of the team.
- Productive work-flow: Engaged with the NHS Productive General Practice Programme to ensure that time was well spent and not wasted.
- Personal productivity: Provided extra training to build confidence of use with the IT system, produced templates and auto-consultations to improve efficiency.
- Partnership working: Combined with Livewell Southwest to develop a Care Home Project. This involves a pharmacist and a GP proactively visiting care homes, thus reducing unnecessary prescribing, drug interactions, polypharmacy and hospital admissions. Beacon worked with their community pharmacy in a coordinated and collaborative way to deliver the NHS Flu Programme locally.
- Social prescribing: Looking to employ Health Care Activators in the practice as members of the team to utilise community resources as social prescribing.
- Supporting self care: Launched the WebGP as an addition to the website to provide ease of access to self care with nationally agreed protocol.
- Develop quality improvement expertise: Welcomed other local practices giving the opportunity to see how work is carried out.
All patients who call into the urgent care system, have their call triaged promptly and acted on with the majority of calls being dealt with within the hour. This means that a decision can be made by an experienced practitioner promptly, enabling timely actions to be taken – this may involve a review at the surgery, a home visit, telephone advice or medications issued.
- Creating a safer pathway for patients with calls being proactively addressed.
- Responsibility for making a decision on how urgent a patient’s health needs now sit with the most experienced and qualified members of the receptionists and telephonists team.
- Providing a second duty GP on Mondays (the busiest day) gives the system some resilience, still having more of our most experienced resource triaging the calls promptly.
- The Advanced Paramedic Practitioner has the capacity to undertake home visits as necessary without losing GP cover from site.
- Regular assessment of the team’s performance, also looking at patient numbers, capacity and satisfaction, reporting findings at our regular practice meetings.
Tips for adoption
- Do not be afraid to try new ways of working – there is great fear with change but investment can reap rewards.
- Involve the staff in developing a new service to not only gain buy in but also to gain other views on how services could be delivered.
- Communicate changes with patients – involve patient participation groups early to promote changes.
- Strike a balance between routine and urgent provision that meets the demands on service and provides a positive patient experience.
- Regularly review and revise each new service as necessary.
- On-going support and training for team members must be available.
- Engage with new technology to provide increased access for patients but also to reduce DNAs.
Dr Jonathan Cope GP said: “At Beacon we recognise that our core role is to provide the best possible service for our patients. We aren’t afraid to work with others and to use new approaches in finding ways to improve our services. We feel it’s our duty to find sustainable ways of working, use our resources wisely and to look for improvements at every opportunity.”
For more information please contact Dr Jonathan Cope
GP Plympton Health Centre
Managing Partner Beacon Medical Group
Tel: 01752 346634