Key patient messaging
- General practice is open, but due to the coronavirus outbreak, the way you contact your GP surgery is different. For all contacts other than urgent cases or emergencies patients are encouraged to use the AccuRx service to contact the Health Centre by following the link https://florey.accurx.com/p/N81077.
- Face-to-face appointments are available to all patients where there is a clinical need. You will be asked to first discuss your conditions using the AccuRx online service or on the phone with a member of the healthcare team to assess what would be most appropriate for you and which practice member would best provide it.
- Most GP practices are also offering online consultations and video consultations, as well as telephone consultations. These can be convenient and flexible ways to receive healthcare. Where patients need to be seen by a health professional face-to-face, this will be arranged.
- General practice continues to offer care based on clinical need.
- General practice continues to offer cervical smears and childhood immunisations.
The Restoration of GP Services - Triaging and Patient Access
As we emerge from lockdown and return to a degree of normality practices are facing an increase in demand. Having spent the past 12 months living with all the restrictions of COVID-19 it is not surprising that patients are now seeking access to healthcare again, the practices are also are being 'encouraged' by the government and NHS England to return to business as usual. Unfortunately, it is clear that COVID-19 is not over, and we all have to live with this infection for some time to come. All of us have been affected by the pandemic, including the way we work. This includes general practice.
The government is calling on practices to return to face to face consultations. The practice at Holmes Chapel has never stopped seeing patient’s face to face. We adapted to work differently and safer during the pandemic, and this has involved moving away from face to face consultations as the first patient contact. Triage has kept patients and practices safe, by remotely assessing symptoms and concerns, without unnecessary exposure to risk. Anyone who when assessed was felt to have worrying symptoms has been seen face to face, or where appropriate, referred directly to hospital. We have made every effort to ensure patients report new symptoms that could indicate significant disease, including cancer. Triaging all calls has allowed us to work more efficiently, freeing up staff for the vaccination programme whilst providing primary healthcare in the village. Total triage has been used for years in many practices, and at Holmes Chapel we have been gradually moving in this direction. The pandemic brought together a need for remote consultation and technological advances that accelerated the process, and having achieved a safe and efficient service it would appear to be a retrograde step to revert to the previous way of working.
General practice is all about people, and nobody wants to see our work become a remote service. The practice will therefore continue to offer face to face appointments as we have throughout the pandemic, but this will run alongside the newly expanded use of video, online and telephone consultations, as long as these are helpful for patients. There are still restrictions in place and whilst social distancing is with us we have to consider the capacity of our waiting room. We cannot support a return to queuing at the reception desk to book appointments, whilst these are available to book over the telephone and online. The practice plans to expand its use of triage by following the example of practice in the use of online consultations. This has been available for several years as our e-consult service, but the uptake of this has been low, and the system is cumbersome to use for the practice. Consequently we are moving to using the AccuRx software that has been used very successfully to help our texting service. From Saturday 5th June patients will be encouraged to use this to communicate with the practice, whether to book an appointment, enquire about results or sick notes, or the status of a referral. Reception staff will help patients who struggle with or do not have access to texting, so that eventually this will become the default means to contact the patient. The practice will respond to all contacts within two working hours (i.e. messages sent on Saturday and Sunday will be accessed within two days from the time they are read on Monday morning), though usually much sooner. This should be quicker and easier for patients, and enable staff to prioritise workload so that patients can be contacted and an appointment given with their usual GP if possible in an appropriate time frame. It will also free up the phone system for staff and make it easier for patients requiring urgent attention to speak to someone with a minimum delay. For patients wishing to contact the practice for less urgent problems this service will remove the need for long waits or frustration of an engaged tone that we recognise has become an increasing problem as demand increases.
You can use the AccuRx service to contact the Health Centre by clicking https://florey.accurx.com/p/N81077.
The practice continues to engage with our Patient Panel and has their support with the use of new software as we move forward.
The government, through NHS England, has made the following recommendations:
- Patients and clinicians have a choice of consultation mode. Patients’ input into this choice should be sought and practices should respect preferences for face to face care unless there are good clinical reasons to the contrary, for example the presence of COVID symptoms. If proceeding remotely, the clinician should be confident that it will not have a negative impact on their ability to carry out the consultation effectively.
- All practice receptions should be open to patients, adhering to social distancing and IPC guidance. This is important for ensuring that patients who do not have easy access to phones or other devices are not disadvantaged in their ability to access care. Receptions will not yet feel like they did pre- pandemic – for example where space is very constrained patients may be asked to queue outside. Individuals with COVID-19 symptoms or who meet criteria for self-isolation should continue to follow public health guidance.
- Patients should be treated consistently regardless of mode of access. Ideally, a patient attending the practice reception should be triaged on the same basis as they would be via phone or via an online consultation system.
- Practices should continue to engage with their practice population regarding access models and should actively adapt their processes as appropriate in response to feedback.
Practices need support not condemnation
Following the UK LMC Conference held early in May the BMA has responded to the statement from NHS England:
'General practice has been through a hard and difficult time that has left many physically exhausted and mentally drained. It’s tested every GP team and individual like never before. But it has shown the profession at its best. We have been there for our patients. We have not let them down. We have responded to this unprecedented situation and we have risen to and met the challenge. The hard work and dedication of so many people in general practice has saved countless lives and the nation owes you all a huge debt of gratitude.'
'Recent media headlines and the subsequent letter from NHS England has understandably left many GPs and practice teams demoralised, angry and feeling that the immense workload pressures that practices are currently experiencing is not recognised or appreciated. Practices need help and support not condemnation and criticism.'
'Instead of knee-jerk responses to press headlines there needs to be proper acknowledgement from the Government and NHS Executive that practices are under huge pressure at the moment, that we are doing the right thing by working in line with national infection protection and control guidance as set out by the Chief Medical Officer and that we have been using telephone and online consultations appropriately to both keep patients and staff safe.'
'None of us trained to be call-centre GPs and we all want to get back to a time when we have the freedom to see more patients face to face but we need to do that in a way that matches capacity and safety within each practice. As covid-19 prevalence falls and, through the incredible efforts of general practice, vaccination levels rise practices are rightly and wisely adapting the arrangements they have had during the height of the pandemic. However, at present we know there is no spare capacity, there is no surplus workforce waiting to come and assist and the impact of the wider NHS backlog is having a massive impact on every practice. We know that Practices have been, and will continue to offer face to face appointments for those patients who need them as well as trying to protect our patients and colleagues from becoming infected in our surgeries.'