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Using a call centre to improve GP access

Patients can now book appointments via a call centre, writes Dr Nigel Higson.

Using a call centre is something smaller practices could consider for quieter periods, such as lunchtimes, half-days and evenings (Photograph: Istock)
Using a call centre is something smaller practices could consider for quieter periods, such as lunchtimes, half-days and evenings (Photograph: Istock)

I am not sure if ours is the only practice that currently makes use of a call centre in booking appointments for our patients, but there cannot be many others.

While at present our usage here at the Goodwood Court Medical Centre in Hove, East Sussex, is limited to overnight callers, the recent heavy snowfalls made me consider whether we should consider extending the hours when calls to the surgery are routed to the centre.

Access initiative
Fortunately the majority of our receptionists were able to make it into the surgery, but if that had not been the case, our call centre could have easily taken over the task of making and cancelling appointments.

As part of an access initiative, we audited calls to the practice and found that a number of patients attempted to telephone between 7am and 8am when our reception was not staffed. Presumably this was to try to contact us before they left for work.

While our patients have 24-hour access to booking appointments via the practice website, it seems not everyone felt there was time to boot up their computer before catching the train to London. To staff reception in the early hours of the day would have cost the practice around £320 per additional opening hour per month.

Using a call centre, which is already staffed 24 hours a day, has cost us approximately £180 per month. Hence while this is a cost we have borne to cater for a very small number of patients, it has given the practice a reputation for good access.

Monthly retainer
The call centre bill is based on a monthly retainer and a cost per minute in answering calls, so a higher number of calls would result in a higher monthly charge. While this may not be cost-effective for peak daytime periods, it is certainly something that smaller practices could consider to cover quieter periods - lunchtimes, half days, evenings - in order to maintain access for their patients.

Enabling call centre staff to access our appointment lists is made easy by our appointment software which allows patients internet access to the appointment system.

By allocating to the call centre a fictitious patient ID and password, it can make appointments in the name of 'Mr Call Centre' entering the true name and date of birth of the patient. It can also enter any other relevant information as a comment.

The call centre also notifies the practice of any appointments it has booked by email the next morning. While we do not encourage message-taking at present, the call centre is of course able to take messages and relay them to our staff by email.

We have found it necessary to limit appointment booking via the website to doctors' appointments only, as appointments of variable lengths are required with our practice nurses.

However with appropriate rules and training, I am sure that it would be easy to extend the call centre facility to nursing or other practitioner appointments.


Dr Nigel Higson: 'Call centres need not detract from individual practices having a cohort of regular staff'

Human resources
In any medical practice, human resources is a major issue - one which perhaps causes more stress and headaches for the practice management than any other single area of the business.

GP practices have tended to run as small businesses with perhaps fewer than a dozen employees.

So attempting to properly organise appropriate career training, career development and professional staff management for such a small workforce is beyond the capacity of most practices.

Sharing human resource management by the centralisation of staff employment - perhaps PCTwide - would create a more professional and more efficient business model. We could have centralised payroll and a support structure capable of cross-cover and skills sharing.


CALL CENTRE COSTS

Retainer: £75 per month

Calls per minute: £0.60

Typical bill for overnight coverage for a practice with 11,000 patients: £162 per month

This need not detract from individual practices having a cohort of regular staff but would allow specialist staff to be moved from practice to practice as needs arise - for audit work or for GPSI support, for example.

The use of call centres serving a local or regional population is a natural extension of this function.

It would not remove functionality or skills from primary care centres, but would be supporting practices by only removing from their staff those calls from patients wanting to make an appointment by telephone.

I endorse and encourage such models for the future. They are proven to work well in many other industries and while total reliance on call centres for all 'customer service' would be inappropriate, their usage alongside a new model of reception/administration at local level enhances care and decreases stress within the practice.

THE FUTURE PRACTICE
  • Is not responsible for employing admin staff.
  • Human resource management is at local/regional level.
  • Routine telephone access for appointments is handled by regional/national call centre.
  • Staff have the benefit of career structure, professional management, training and development.
  • Practices have the benefit of specialist staff available for various occasional practice activities.
  • There are support mechanisms in place in case of business disruption.
  • Dr Nigel Higson is a GP in Hove, East Sussex

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