Improving access for patients and supporting general practice: Our experience to date

NHS England and DHSC recently published plans aiming to improve access for patients to Primary Care. As it has always done, primary care will be clear about the challenges in our sector but will also show the enterprise and leadership needed to grasp opportunities and deliver for our patients.

The latest measures, including ￡250 million via the Winter Access Fund, come at a critical moment for primary care providers. It is vital this funding is used to improve access for patients and support the frontline, whilst allowing providers to deploy digital tools, use the full range of consultation types, and employ a diversified workforce.

At Operose Health and AT Medics we have been exploring this challenge for several years. Nobody has all the answers, but we have developed practical solutions to help ordinary practices with real world problems. What’s more, we have done this in those parts of the country which suffer from some of the most severe health inequalities. The introduction of digital tools, a diversified workforce, extensive patient engagement, and effective ongoing evaluation have helped us grapple with the current challenges while maintaining face-to-face appointments for patients who need them. Whilst funding and workforce need more backing to keep pace with demand, there are step changes which can be made through better use of what we have. They include:

Digitally enabled access: We introduced our digital front door, Dr. iQ in 2019 and currently, 60% of our adult population are registered and actively using it, with high satisfaction rates. ?Dr. iQ enables a streamlined workflow reducing pressure on individual practices. Our ‘digital-hubs’ consolidate expertise and allow admin and clinical tasks to be processed remotely on behalf of one or multiple practices. Our range of high-impact online consultations and bi-directional messaging via the app reduce call volumes to practices ensuring those who do call can get through more easily. Effective triage ensures the right professional can meet patients’ needs first time, increasing the availability of appointments and effective utilisation of the multi-professional team.

Workflow optimisation: Introducing digital workflow tools, supported by training, increases the availability of appointments without simply piling more pressure on our people. Instead, our EZ Nav and EZ Doc web-based tools ensure all members of staff are used more effectively. EZ Nav, for example, allows reception staff to systematically navigate patients to the right place/person, promote social-prescribing, self-care, and online services and has been proven to free-up c.25% of appointments. EZ Doc enables GP surgeries to develop an efficient, safe and standardised method of managing clinical correspondence reducing GP admin time by up to 60%.

Diversified workforce: NHS England’s new plan describes a workforce model that is becoming the new norm. We have seen how it gives clinicians more time to care and is appreciated by patients. ?Across our practices, GPs are supported by the full range of clinical professionals to ensure patients can see the right person for their needs. This is enhanced through a suite of RCGP accredited training modules, made bespoke for each staffing group and developed by front-line GPs who are also experts in education.

Monitoring and evaluation: It is necessary to monitor and evaluate the impact of new approaches. Our business intelligence platform EZ Analytics provides real-time data on appointment types, waiting times, and online consultation outcomes (including the number of face-to-face appointments and A&E attendances avoided). This is balanced against patient feedback and satisfaction. ?This has also allowed us to take targeted action for specific groups - in a recent BMJ article we discuss how we focused on high-utilisers of Dr. iQ (https://bmjopenquality.bmj.com/content/10/2/e001310).

A bit about us

Operose Health and AT Medics have had 15 years’ first-hand experience developing tech-enabled, data-driven practices that deliver high-quality patient-centred care. We are the largest provider of NHS primary care, serving 570,000 patients across 67 practices, and employing 1,500 health care professionals, including 350 GPs.

Our solutions can be scaled to offer the same support to practices outside of our Group. These can be delivered individually or collectively to practices across the country to reallocate workload that can be completed by our digital hubs, freeing up practitioner time and easing up access for face-to-face patient appointments.??

If you would like to hear more about our work or how you can partner with us, please contact us: [email protected]??