“The 8am rush for appointments isn’t fair, is stressful for our patients and a bit of a lottery,” says Dr Devin Gray, GP at Putneymead Group Medical Practice in Wandsworth.
Ending this scramble is a priority for the NHS and projects to transform technology are happening in practices across the country, with patients already seeing the benefits.
As well as being a local GP, Devin leads on digital transformation in Wandsworth and supports surgeries across south west London in this area. She explained how a move to triage and online consultation forms at her practice is making a huge difference.
“In Wandsworth more than half of practices are using a ‘total triage’ approach, which means every request for an appointment is checked before one is given.
if a parent fills in a form to say, ‘my child is unwell’, and the practice calls them five minutes later with an appointment, they tell us ‘wow what an amazing system’.”
“We encourage anyone who can use the form to complete it online. If you do phone in, we’ll usually first ask you to fill the form out online. But if you can’t, the reception will complete it for you. The completed forms go into an inbox which is constantly monitored by a GP who is reviewing every single request and making a judgement, so you’ll get a response quickly.
“That’s a real culture change for patients, but if a parent fills in a form to say, ‘my child is unwell’, and the practice calls them five minutes later with an appointment, they tell us ‘wow what an amazing system’.”
As Devin explains: “GP practices can only offer that kind of responsiveness by triaging appointment requests. This system allows GPs to prioritise those with the clinical need, while more minor things can be seen by other, very well-qualified clinicians either in the practice or in the community, such as a pharmacist.”
This includes the Pharmacy First scheme. Launched in January, it means people can go straight to a pharmacy to get treatment for many common conditions including sore throats and urine infections.
The system also works well for routine admin tasks. “When people need a fit note or a referral we can turn it round quickly. Before, they might have waited a couple of weeks for an appointment to ask for that referral, so it’s now much more efficient.”
Currently, around 50 south west London practices have adopted the total triage approach, with many more offering access to an online consultation form.
“When people need a fit note or a referral we can turn it round quickly. Before, they might have waited a couple of weeks for an appointment to ask for that referral, so it’s now much more efficient.”
Devin acknowledges that some patients don’t understand why changes have been made and might not think that access has improved.
“There’s a persistent misconception that having the option to contact your practice online means those who can’t use a computer are being excluded. I really want residents to understand it is an option. We want those who can use it to do so because it takes pressure off the phones, so those who can’t use digital can get through more easily.”
To help people understand this Devin is working with community organisations like Wandsworth’s Healthwatch, Age UK and Power 2 Connect. But gaps do exist, which practices are plugging with modern solutions.
The other element of designing a modern GP service is an overhaul of telephone systems, thanks to a national funding programme to help practices install digital systems that allow patients to queue.
Says Devin: “Before we installed this, we could only have a certain number of patients on the call queue – you couldn’t even join the queue if we were busy. Now you can join or choose a call back function.
“We also have a very neat system where we identify our most vulnerable patients to allow them to go to the front of the telephone queue. You can create rules to divert patients to a specific member of staff, if they speak a certain language, for example.”