Regal Chambers Appointment System Newsletter

Posted on September 1st, 2023

Patient Communication – Appointment System

Background

Following recent queries that we received and responded to from patients, we thought it would be helpful to provide an update on how the appointment system at Regal Chambers Surgery is operated.

We implemented a telephone assessment/triage appointment system in May 2019. A triage system involves qualified clinicians making a preliminary assessment of patients in order to determine the urgency of their need. This need may be investigation, treatment or face to face further assessment. This system was implemented well in advance of the pandemic that hit in 2020 and put us in an excellent position to manage patient requests during that difficult period.

Duty Team

Every day, from Monday to Friday, a Duty Team comprising two duty doctors, nurse practitioners and clinical pharmacists, work together to manage requests for appointments.  We allow for over 125 patients per day to be booked into these slots.  If we have reached capacity, extra patients are always assessed, if the Duty Doctor deems that the symptoms are medically urgent.  There are occasions when symptoms are not appropriate to be managed by general practice and patients will be signposted to other providers e.g.  to community pharmacy, dentist or to the Emergency Department/Urgent Care Centre.

Booking Appointments

Patients can book an appointment by calling the surgery or by submitting an online consultation via our website.  We use an online triage tool called AccuRx

All requests for appointments, however they are made, are placed on the same triage list.

When a patient phones, a member of the reception team will ask them to describe their symptoms; this is to help the triaging clinician to assess the priority of the call. All receptionists have received confidentiality training and have signed a confidentiality form. The receptionists have also received training in care navigation and guidance on potentially urgent symptoms that need to be highlighted to the Duty Doctor.

Appointments on the triage list

The triage list is for any patient who is seeking advice about a new symptom that has developed or an existing condition that has worsened.  Contact will generally be made between 9.00 a.m. and 6.30 p.m.  Reception is not able to provide a precise time for the phone call as patients are not contacted in order of booking but in clinical priority order.

If a patient is only able to take a call at a certain time due to working or other constraints, then this can be discussed with the receptionist and a note will be made in the appointment request.  The clinician will make every attempt to honour this request.

The triaging clinician may further assess the patient’s needs on the telephone or send an AccuRx text message.   The clinician will then decide what the urgency is, if the symptoms can be managed remotely, or if and when a patient needs to be brought in for a face-to-face appointment.  Patients may have a preference about which clinician they see or speak to.  This can generally be accommodated; however, the patient does need to speak to the triaging clinician in the first instance.

The triaging clinician will attempt to contact the patient twice.  If there is no answer on the second attempt a message will be left asking the patient to call the surgery and the appointment will be marked as a “DNA”.  The patient will be advised to make another triage appointment on an alternative day.

What happens when the appointments are full

Once we have reached capacity, a message is activated on our telephone system to inform patients that we do not have any appointments left for that day.  Patients are advised to stay on the line if they think their query is urgent or to call 111.  If patients are looking to book an appointment with the practice nurse/healthcare assistant or request a prescription, they can stay on the line and speak to reception.

To ensure equal access for all patients and to avoid excluding those who do not have digital access, we will also turn off the requests for appointments via the online consultation.  Patients are still able to make admin or prescription requests via the online consultation tool.

We must limit the number of appointments that are available on a daily basis for patient safety reasons.  The British Medical Association (BMA) have recommended a safe level of 25 patient contacts per day for a GP to deliver safe.  We consistently provide over and above this.

What next?

We understand that the way in which we operate our appointment system may not suit all patients, however, feedback that we have received to date from patients and results from the recent GP patient survey, indicate that the vast majority are in favour.

We have no plans to change the system significantly as we feel that this enables us to work safely and to manage demand effectively.  We do, however, constantly review the system and make minor adjustments accordingly.

If you’d like to download this document in full please click the link below

Patient communication re appointment system