In 2013 we decided to review our appointment system and make changes so that it would better meet our patients’ needs. The drivers for change were:
- Poor feedback on NHS choices
- Waiting time for an appointment was well over a week, reaching a two week wait at times
- Despite adding additional sessions, we were never able to meet demand and reduce the waiting time
- A significant number of complaints could be traced back to patients’ waiting time for an appointment
- A large number of ‘did not attends’
The implementation of ‘same day’
We changed our appointment system to ‘same day’ in September 2013. The principles of ‘same day’ are:
- Booked appointments are still available.
- Same day appointments are available. If a patient comes into LSMP and requests a same day appointment they are offered the next available appointment, it is their choice whether to sit and wait, or return at a later time for their appointment.
- Appointment length for all clinicians was extended from 10 to 15 minutes.
- Appointments are tightly managed, planned and recorded.
- Same day appointments are available Monday–Friday, 8.30am–3pm.
- On average, 250 same day appointments are available each day.
- Some appointments are ‘embargoed’ to enable clinicians to book follow up appointments with patients.
- If demand for appointments exceeds the number available before 3pm on that particular day, the patient can either return the next day or they are added to our ‘telephone list’. They are then telephoned by a doctor who manages their care accordingly.
- After 3pm, same day access is for emergencies only and these patients are triaged by a nurse.
An ‘access group’ was established to implement and monitor ‘same day’. The access group have continued to meet weekly to review the previous week and plan the following weeks, taking action if required.
Through the Student Health Association, we had contacts with Brownlow Health, Liverpool. Brownlow Health had implemented a new appointment system, which we were keen to learn more about. We took elements from their system and created one that suited our needs. We are very grateful for the help we received.
Where we are now
We are now receiving positive feedback on NHS Choices and our patient reference group. The CQC also made positive comments about our appointment system and our annual patient survey shows that ‘same day’ has been very well received.
We have much calmer, happier staff. Reception is no longer a call centre and staff have appointments to offer to patients. Clinicians prefer the longer consultations.
We are ‘proactively’ managing appointments, rather than being reactive.We know ‘same day’ doesn’t suit everyone on our patient list, but it seems to suit the majority of our patients.
- Vanessa Hampshire is practice manager of Leeds Student Medical Practice
Leeds Student Medical Practice was one of the finalists in the Outstanding Practice Team category of the GP Enterprise Awards 2014 for this initiative. For more information about the awards click here.