Access to Appointments - Frequently Asked Questions
The COVID pandemic over the last year has meant that all GP surgeries nationwide have had to adapt and change their systems in order to keep staff and patients safe. This has meant huge changes in how we are working and some people have been frustrated that they can no longer access services in the same way that they used to.
We are proud of the fact that we have never closed our doors and have continued to provide quality care to our patients throughout the pandemic time. We have been asked a number of times about when we are ‘going back to normal’. The old ‘normal’ would not necessarily work anymore as we have seen a significant increase in demand on our appointments in the last 6-9 months.
Our focus must therefore be on ensuring the services that we provide are safe and that our patients medical needs are met by the correct person within an appropriate timeframe.
We want our patients to understand the reason behind the way that our services are currently set up and how to access medical care by working with us.
We have prepared these answers to questions that we are commonly asked about how our access works:
I need to speak with a doctor, what are my options?
This depends on how urgently you need medical advice. Our econsult system should be the main method for contacting us. Every econsult received is looked at by a GP within 2 working days of being submitted (often same day). Some econsults are dealt with at the time by a phone call or message back to you and others will be booked appropriate appointments (telephone or face to face).
For medical problems that are urgent for that day, we ask you to contact reception who will add you to the duty list for the day. All requests for urgent assessment will be contacted by phone in the first instance by the duty GP or duty Nurse Practitioner.
I have been booked an appointment with someone who is not a doctor, what does this
We have worked with some of our neighbouring practices to form a Network (Eastleigh Southern Parishes Network) in order to significantly expand our clinical team. We now have appointments available with GPs, Nurse Practitioners, Practice Nurses, Physiotherapists, Mental Health Practitioners and Pharmacists. By using the econsult tool, we can ensure that you are booked with the person who has the right skills to help you.
I have been booked an appointment with someone from ‘the hub’. What does this mean?
We work together with our Network to offer appointments outside of the core practice hours (evenings and weekends) with various different members of the clinical teams. This has increased our appointment availability and also flexibility of types of clinician and times. Please be reassured that anyone contacting you from the hub has access to all your medical history and letters, just as if they were in the practice. If you are asked to attend a face to face appointment eg Practice Nurse appointment or blood test, the hub is located at Botley Surgery, Mortimer Road, Botley, SO32 2UG
When are you going back to just being able to book a face to face appointment?
Simply put, certainly not for a while yet. COVID-19 cases are really dropping in the local area but we must remain careful. We cannot go back to the days of the crowded GP waiting room and we need to continue cleaning each room down after every patient attends and wearing masks. Therefore, we need to continue to only bring in people who have a need to be seen in person. For this reason, we will only give people an appointment in the surgery once we have determined that this is necessary either due to the type of procedure or treatment that they need or after we have assessed that an examination is required following an econsult or phone call.
Why can’t I just book a phone call appointment? Why are you asking me to use econsult?
We have decided that we want to stick with an appointment system instead of ‘first come, first served’ on the day only GP access. This is to try to spread the workload throughout the week, ensure that patients who need follow up appointments are offered them and also ensure that patients are seen by the most appropriate member of the clinical team (eg it is often most efficient for someone with new knee pain to be assessed first by our Physiotherapist rather than a GP and then a Physio).
The econsult system is the safety net built into that system. We agree that it can sometimes be clunky and frustrating to use but some of the questions are designed to ensure that certain conditions and problems are flagged as more urgent and patients are then asked to contact the surgery or 111 for same day assessment. Sometimes this does feel like it is overly sensitive but it has been set that way to be safe.
At times when demand is high and the next routine appointment isn’t for a few weeks, the econsult system allows us to assess whether someone’s clinical need is ok to wait that long or whether their problem requires a more urgent response. It also allows us to respond to queries where an appointment doesn’t actually need to be used and simple advice can be given.
We do have routes of access reserved for patients who are unable to use econsult but ask that these pathways are kept only for this group to ensure that we are able to offer them timely appointments.
I’ve been sent an appointment time or date. What if it is inconvenient?
To try to keep our receptionists free to answer phone queries, if we have determined that you need an appointment, we will offer you the next available suitable appointment (phone or face to face). If you are unable to make this appointment, please do call the surgery and we can rebook it for you.
Why can’t I see/speak to the GP that I want to speak to?
With the current level of appointment demand, it is just not possible to always see or speak to the GP of your choice. Our GPs are not always available for phone appointments every day as we share out who is responsible for being the duty doctor and who is reviewing all the econsults on each day. We all prefer to follow up patients that we have begun seeing about a problem and can book follow up appointments ourselves where appropriate or else request an appointment with a particular GP when reviewing econsult. For new problems, we will usually suggest the next available appropriate appointment with any GP.
Why is there such a long wait on the phones?
The phone access has been a continual frustration for us for over a year now with multiple problems. None of this is an excuse for the times when the phone access has been our failure and we are aware that on some occasions the wait times have been unacceptably long. Sometimes this is truly due to the number of patients needing medical advice and sometimes due to other queries (COVID vaccination queries have hugely increased our incoming calls). There have also been a number of issues with the system itself that we have had to work with our phone provider to overcome in the last year. We have successfully:
● Fixed an issue where patient calls had a risk of being sent into a continual loop
● Increased the line capacity so that outgoing calls did not tie up incoming lines
● Added a fair queuing system and information about the number of calls ahead
● Fixed a problem where patients were being randomly cut off at call position 1
● Adapted the reception rota to ensure enough cover over periods of staff sickness and some shielding staff.
The things we currently have in place to try to improve phone access:
1) We have just switched our phone provider and are hoping that our system will be more stable.
2) We have not had any access to statistics about call waiting times and volume for over 6 months throughout the building works and since moving into the new reception area. This is something that our new provider will be putting in shortly and will allow us to look again at trying to ensure calls are dealt with in a timely and efficient manner by the most appropriate person.
3) We regularly post updates on the COVID vaccination program (run by our network, Eastleigh Southern Parishes Ltd) on our Facebook site and ask that everybody check here first or put a query through econsult where able.
4) We encourage use of the econsult system where appropriate to keep the phone lines accessible for the urgent on-the-day medical problems and people who are unable to use econsult.
I’ve been given a routine appointment for 3 weeks time, why is there such a wait?
Simply that demand on appointments is high. This is not just an issue for us but one that we are hearing from our colleagues across the country. Our list size has increased with the growing population in West End and to adapt to this, over the last couple of years, we have increased the amount of GP time in the surgery over and above this amount. We also now have access to significant additional appointment capacity offered by our network. However, this additional capacity continues to be easily filled and our waiting time for non-urgent appointments is sitting at approximately 3 weeks currently.
There are many reasons for this which include but are not limited to:
● The additional mental health difficulties that people are experiencing due to the pandemic situation
● Frail elderly patients struggling with reduced mobility and increased isolation due to lockdown
● People waiting much longer for hospital appointments and therefore requiring more support in the meantime,
● Other services that would normally support our patients are not available or have much longer wait times
● Patients being discharged from hospital much earlier in their recovery and requiring more of our input.
For this reason, we will continue to ask for patients to use the econsult system as a way of ensuring the appropriateness of the clinical response.
Summary: Keeping the surgery going
We are incredibly proud of our entire surgery team for keeping going throughout the pandemic and dealing with so many challenges which have included:
● The building works and the disruption that this has caused with cramped room space, noise and constant changing of working spaces. We now have a much more open surgery with enough room capacity for our clinical team, appropriate storage facilities and one that meets current infection control standards.
● Completely overhauling the clinical structures to reduce the number of people coming into the surgery to keep our staff and patients safe.
● Coping with staff sickness and staff off shielding.
● Dealing with people’s frustration that the systems have changed and access cannot be the same way as it used to be.
● Playing an active role in the COVID-19 vaccination program
Everyone at the surgery is working harder than ever to keep the surgery going. Be Kind. Use services wisely and work with us to help you.
Dr Susan Smallwood
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