Over the last 12 months there have been considerable changes to Wallingbrook Health Group. We have looked at the way we provide services, added another location to our portfolio and reorganised the administrative staff. All of which are designed to invest in the future of rural healthcare in what is a very unsettling period of time for the NHS as we know it today.
The NHS, along with many public organisations, has not escaped the economic downturn in the country and whilst a level of funding has been maintained by the Government there is a huge deficit in the “pot” which needs to be reduced. To this end everyone involved in healthcare has been tasked to look at how they work to see if things can be done more efficiently. GP’s are contracted to the NHS to provide a healthcare service to their population but their practices are their businesses with limited funds to pay for premises, staff and all the equipment and maintenance.
In the next few years some of the smaller, rural surgeries may find that they are no longer viable, which could result in a vital community service being lost. The Partners at Wallingbrook Health Group are committed to preserving a high standard of health care in rural areas and is because of this reputation we were asked to take over the contract for the provision of Health Care in North Tawton in September last year following the retirement of Dr Downie.
Usual GP System – Towards the end of 2010 it was very apparent to the Partners at Wallingbrook that our appointment system, which had been running for a number of years, was not providing the service required by our patients. Routine appointments with a GP had at least a two week wait; care was delivered to individuals by a number of GP’s making it cumbersome for all and the Reception staff were getting increasingly frustrated with the inability to be able to provide satisfactory solutions for the patients we serve. We therefore introduced a “Usual GP” system whereby patients who visited the surgery regularly were allocated to the Doctor who saw them the most or knew them best. Patients who visited less frequently were allocated a GP who would undertake to manage their care therefore ensuring an even distribution of patients among the GP’s. This has been very successful in providing continuity of care. However, the GP’s appreciate that the access to a usual GP must be satisfactory and, therefore, since January, a new rota has been put in place whereby no GP will work at any more than 2 sites. Patients at North Tawton have also now been allocated a GP. We appreciate that some patients have been allocated to a GP they have never seen but we would urge people to persevere with this, unless they have any strong objections, and attempt to build up a rapport with the GP allocated to maintain an even spread of patients and avoid one GP being more overloaded than another. Should patients not be satisfied with the GP chosen they are able to switch to another one, please let the reception staff know. We still provide same day appointments with either our Nurse Practitioner or Duty Doctor for urgent matters.
Patients based at Wallingbrook and Okement will be acutely aware that we trialled a triage telephone appointment system during the last six months. Whilst this proved popular for some patients it was disliked by many and was hard to maintain with GP’s working at different locations. The GP’s have now reverted back to the more traditional system of a combination of appointments and telephone calls. In some instances, because of the usual GP system, the relationship between the GP and patient is so good that there is no need for the patient to visit the surgery. Matters can be dealt with over the telephone thus saving a journey. It is not about becoming more remote from the patients but trying to offer more options. Patients are also able to see or contact their doctor at any of the sites, which increases flexibility.
Since 3rd January 2012 the GP’s are working at the sites below:
We continue to be supported by our GP Assistant Dr Liz Wilson Smith who works across all the locations providing cover as and when required.
Linking the clinical computer system to all sites has proved invaluable. Not only does it allow Clinicians to keep in contact with their patients at whatever site they are working, it also gives patients the opportunity to be seen at a location of their choice at any given time. The administrative function provided by the office staff can be efficiently managed at one location by a highly trained, productive team.
The introduction of the telephone system means that, like the clinical computer system, all the sites can communicate easily with each other and are networked together as extensions. In centralising the calls to Chulmleigh it means that the telephones can be answered by a dedicated, highly trained team who are able to direct callers to the right person for their particular situation. However we acknowledge that we have been ill advised by the Telephone Company regarding the call charges. In order to address this issue we now have an additional number, 01769 580295, which runs alongside the 0844 number. This will drop into the menu system in the same way, the only difference being when all the lines are busy you will not be held in a queue but will get the engaged tone. Patients will need to seek advice from their call provider as to which number will be the cheapest for them to use.
We have also recently taken on another member of staff to assist with the answering of the telephones and are monitoring the volume of calls coming through and how long people are kept waiting in order to ensure that we have the correct number of staff answering the phones at the right time of day.
In listening to feedback we have also reduced the number of menu options and changed the voice from female. We are required to inform you that, should your situation require immediate medical attention, you must dial 999 and that all calls are recorded.
The networking of the telephone also means that patients can order their repeat medication via our dedicated repeat prescription answer phone. This service is only made possible by having trained dispensers at Chulmleigh listen to the messages (British Medical Association regulations); the prescriptions are then printed off at the relevant site ready for the GP to sign.
The linking of all sites via telephones and computer networks also means we have changed the function of the reception team. Previously the receptionists working at all locations have been required to perform a wide range of duties and, with the changes in the appointment system taking place, it has become increasingly difficult for them to deal with the varying requests from patients with confidence, in some instances leading to unsatisfactory conclusions for all parties.
However since the beginning of December 2011 the reception role has been split into two areas:
In recognising the individual strengths of the receptionists we have been able to allocate staff to the role particularly suited to them. Over the coming months we will be embarking on a period of intensive training to ensure that all staff members feel confident in their job role and patient trust can be developed. The GP’s will also play a crucial role in this training. Patients will start to see a significant change, especially when visiting the surgeries, as staff dealing with face to face enquiries will not be constantly interrupted by the telephone.
We will also need assistance from you, the patients, particularly when phoning the surgery, in giving a clear indication of the reason for your call. The more information the Patient Services Coordinator can gather the more satisfactory the outcome. On many occasions the GP’s appointments get blocked with matters other members of the team could have dealt with more efficiently had they had the correct information. Freeing this time up will allow more time for seeing patients. We follow strict codes of confidentiality and all staff receive comprehensive training around information governance and the data protection act, signing a code of confidentiality on an annual basis.
Wallingbrook Health Group is pleased to announce that we are embarking on an innovative approach of delivering healthcare services in rural communities by working more closely with our Pharmacy Colleague. In order to facilitate the new service, we are keen to invest and develop the premises in North Tawton to house the Pharmacy and upgrade the space to ensure it is fit to function as a modern medical centre. We are in early stages of development at present but will provide further information as and when it is available.
Medical records for 16 year olds: One of the common problems we come across is parents wishing to access records for their child who has now turned 16. It is very frustrating for both parties but, unfortunately unless your 16 year old has supplied written permission, Mum or Dad can no longer have access to their medical record. This forms part of the Access to Health records legislation and the Data Protection Act.
Messages on answer phones/the use of SMS texts or e-mails: Again, in complying with the Data Protection Act, we are unable to leave specific messages on an answer phone unless we have received consent from a patient that it is ok to do so. We are also exploring the use of text or e-mail as a way of communicating with patients but again, we will need explicit written consent, as we have to be sure that the message being delivered is being received by the person for whom it was intended.
Online services: We are looking to extend the options for online services, the first of which is the repeat prescription ordering. Please contact the dispensary at Wallingbrook or visit the website www.wallingbrook.co.uk for more information. Once we are confident this is working well we will be looking to expand into offering online appointment booking, cancellation services and online registrations.
Month of Birth recall system: We invite all patients on regular medication for a yearly review of their medical conditions during the month of their birthday. By doing this we aim to avoid the inconvenience of receiving several invitations during the year. Patients receive a request in the post a month before their birthday asking them to make an appointment, thus choosing a time most convenient to them. The Patient Services Coordinator will know what appointments are required for the review and will book the appointments accordingly with the relevant clinician. Any patient not on regular medication but who would like a check up can book an appointment for a ‘well person check’ with one of our Health Care Assistants.
Role of the Nurse Practitioner. Often confused with a Practice Nurse, the Nurse Practitioner can see patients for many minor illnesses and injuries. Our Nurse Practitioner may also prescribe in these areas when necessary. Examples of problems with which the Nurse Practitioner can help: coughs colds and chest infections; skin and wound infections; stomach pain; some female problems (it is recommended that you speak with the Nurse Practitioner beforehand to assess if she can help). She may also be able to give advice in certain circumstances over the telephone for: eye infections; head injury; diarrhoea and vomiting; simple cough and cold advice; sore throat; women’s health e.g. thrush, delaying of period; female urine infections. If the presenting condition is something she is unable to attend to the Nurse Practitioner will refer the patient back to their usual GP or Duty Doctor, depending on the severity.
This group has recently been formalised with the appointment of a chair and adoption of aims. Most representatives are drawn from Parish Councils from villages within the Group area.
The aims of the group are:
Maggie Samuel has been elected Chair. She is anxious to develop a dialogue with the community by helping the Practice publish a Newsletter and by creating a virtual group prepared to provide email feedback.
We are currently looking for a volunteer from North Tawton (and Okement). Meetings are monthly. If you are interested in either of the above or wish to contact the Group please contact the Practice by phoning 08443 87 80 78.
We hope this newsletter has helped to explain the changes taking place within Wallingbrook Health Group. As with all changes there will be a settling down period but we are confident that this is the way forward to building Wallingbrook Health Group into an organisation to which both patients and staff will value. As always we welcome your feedback and thank you for your continued support.