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Workload tips: Reviewing your appointment system

Making best use of online services can help practices to manage demand, explains practice manager Fionnuala O'Donnell.

Practices are contractually required to to promote and offer patients the ability to book appointments online. They should also routinely consider whether the proportion of appointments that can be booked online needs to be increased to meet the needs of patients, and, if so, take action accordingly.

Findings from the accelerator sites involved in NHS England’s patient online programme showed that practices that offer a higher proportion of their appointments online find the systems work more effectively. 

As long as those who don’t have access to the internet can still make appointments, there is an argument for putting as many appointments as possible as bookable online. Encouraging as many patients as possible to make full use of the online services will:

  • Reduce telephone calls to reception
  • Reduce walk ins
  • Reduce requests for appointments – when patients can see their test results, their letters and the free text of their consultations this enables them to make more decisions for themselves, moving demand away from the practice.

Some useful questions to review

  • How many appointments do you offer in a typical week?
  • How many are filled?
  • How many are for GPs, nurses and HCAs?
  • How many are telephone appointments?
  • How many are booked online?

Other points to look at:

  • Check the balance of same day and book ahead slots, in particular looking for signs that patients are defaulting into the same day slots because they were unable to get a convenient appointment in a few days’ time.
  • Review how frequently the average patient has a clinical consultation with the practice in a year, the average patient visits the GP just over five times in a year. This may highlight an opportunity to deal with multiple problems in one go, or to think about how to case manage patients, is there any additional input that could help? 
  • In order to check how your population compares to the average of five consultations per year, run a search for appointments within the last year and breakdown the search by patient. Download this guide for how to do this in systmOne. Other clinical systems will have similar functionality to enable you to do this.

Online appointment booking

Include online registration in your regular registration process, so that patients are signed up to the online services as they register with the practice.

Advertise on your website and in the waiting room and ask clinicians to promote the service to patients.

Online prescriptions and EPS2

Run a search for patients on repeat medication but who don’t have a nominated pharmacy and contact these patients to see if they want to sign up for online prescriptions. This guide shows you how to do this in SystmOne.

Online record access

There is an excellent article on this in the Making time in general practice report but the key points are:

  • Ensure you have a robust system in place and that all clinical and non clinical staff are aware of it. There is more advice on how to do this in the article.
  • Test it out with patients you know well to make sure everyone is confident in the system and get initial feedback
  • Prioritise patients with long term conditions, these are the patients who will get the most out of it and who will reduce the requests for appointments the most as they are seen regularly

Fionnuala O'Donnell is a practice manager in Ealing, West London, and a CCG board member

Useful resources

This article is part of a series of workload tips which you can access here

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