As part of the General Practice Forward View, a new five year £45 million fund has been created to contribute towards the costs for practices of training reception and clerical staff to undertake enhanced roles in active signposting and management of clinical correspondence.
Benefits for patients and the practice
In the past 2-3 years, a number of practices, most notably through the GP Access Fund, have taken a more systematic approach to identifying the most impactful ways of deploying reception and clerical staff, and have developed formal approaches to processes and training.
We intend to support every practice to have the opportunity to train their staff to undertake one or both of these enhanced roles, through providing bursary funding towards training and backfill costs.
Active signposting by reception staff
This provides patients with a first point of contact which directs them to the most appropriate source of help. Web and app-based portals can provide self-help and self-management resources as well as signposting to the most appropriate professional. Receptionists acting as care navigators can ensure the patient is booked with the right person first time.
Reception staff are given training and access to a directory of information about services, in order to help them direct patients to the most appropriate source of help or advice. This may include services in the community as well as within the practice.
Benefits for practices: This innovation frees up GP time, releasing about 5 per cent of demand for GP consultations in most practices. It makes more appropriate use of each team member’s skills and increases job satisfaction for receptionists.
Benefits for patients: It is easier for patients to get an appointment with the GP when they need it, and shortens the wait to get the right help.
Correspondence management by clerical staff
A member of clerical staff in the practice is given additional training and relevant protocols in order to support the GP in clinical administration tasks. All incoming correspondence about patients from hospitals is processed by a member of the clerical team. They have received training to deal with most letters themselves. Working against standard protocols developed in-house and refined through continuous improvement, the member of the team reads the letter, enters details into the patient’s record and takes appropriate follow-on action. In some cases this involves other members of the team, or booking the patient an appointment.
Benefits for practices: Using this system, 80-90 per cent of letters can be processed without the involvement of a GP, freeing up approximately 40 minutes per day per GP. For the clerical team, job satisfaction is often increased as well.
Benefits for patients: Practices report they are often able to take speedier action on some issues. More detailed coding of clinical information in the GP record results in improved monitoring and management of certain conditions.
How will it work?
A total fund of £45 million is available over the next five years (2016/17 – 2020/21) to develop the capabilities of the practice workforce for these new ways of working. In the first year, £5 million will be available, and £10 million will be available in each of the subsequent four years.
Central funding will be allocated to clinical commissioning groups (CCGs) on a per-head-of-population basis, to allow them to disseminate it in the most appropriate way for their practices. It will also make it easier for CCGs to add their own investments in their providers’ sustainability and transformation.
Funding for 2016/17 will be transferred to CCGs in the autumn. In liaison with their practices and the local medical committees, CCGs will agree how best to distribute money for practices. Details will also be published in the autumn of the arrangements for CCGs to report how this fund is spent to ensure that all money intended for supporting general practice reaches general practice. A new directory of training providers will signpost CCGs and practices to relevant training courses. It will be available on the NHS England website. Please contact firstname.lastname@example.org to suggest training offers for inclusion in the directory.
Criteria for use of this funding
This funding is allocated solely for the purpose of supporting the training of reception and clerical staff in GP practices. The training should cover either:
- the task of active signposting for patients. As described above, this is an enhancement to normal good customer service. It requires the receptionist to be skilled and confident in sensitively ascertaining the nature of the patient’s need and exploring with them safe and appropriate options. These options will usually include sources of advice and support outside the practice as well as within, and will often be drawn from a directory of services. Training should ensure receptionists are confident in communicating available options. Ideally a training experience should include an opportunity for staff to hear from a receptionist who is already working in this way.
- task of managing clinical correspondence. As described above, this is an enhancement to typical tasks of handling correspondence, such as scanning, forwarding to GPs and filing. It requires the staff member to be skilled and confident to make decisions about how to code a letter and its contents in the patient record, how to use an approved protocol for deciding which letters need to be sent to a GP and with what level of urgency, and when to ask for help. Training should also support the practice in establishing its own internal systems including a safe and appropriate protocol to guide staff, a system of supervision (especially for the early stages of implementation) and regular audits of safety and effectiveness. Ideally a training experience should provide opportunities for practice managers, GPs and staff to hear from others who are already working in this way.
Other training needs for clerical and reception staff (for example, customer service, information governance, understanding Read or Snomed codes, safeguarding) remain the responsibility of the employer, and are not covered by this funding.
The CCG and their practices may choose any training provider they deem appropriate. The funds may be used for any of the following:
- The cost of purchasing training
- Backfill costs for practices to cover staff time spent undertaking training
- Support in kind for practices for planning this change or undertaking training