23rd July 2021
This last year and a half have seen significant change to how we have delivered services for our patients. Some of these changes were needed in light of responding to the covid situation and keeping patients and staff safe, some of these changes were future plans in line with national changes from NHS England.
Although lockdown measures have eased as of Monday 19th July 2021, we still have ongoing concerns for staff and patient safety as positive cases and variants are still prevalent in the Chelford area. While many patients may feel well of health and consider them selves protected following the vaccination process, we still have a large population of vulnerable patients in our area.
Considering this, we still feel it is important to continue with ensuring we deliver services in a safe way. The processes needed to ensure this include:
- Continuing with asking patients to wear face masks within the building.
- Continuing with distancing and keeping numbers in the building (including reception) to a safe level.
- Continuing with telephone/online appointments as a first contact with the clinician
- Face to face appointments arranged by clinicians on clinical need to keep footfall into the practice to a controlled and safe level.
- Encouraging use of online ordering and online consultations to reduce numbers of patients visiting the surgery where other routes may be as effective.
Online and telephone triage services
Online triage was always part of NHS England’s long-term plan to provide more accessibility for appointments and will continue to be one of the services we continue to encourage patients to use. It continues to have advantages in not needing to wait to speak to a receptionist as well as providing information on self-care and self -referral routes if appropriate. The process is easy to use, and patients can submit as much or as little information as needed. Entries are clinically reviewed and can help clinicians focus the conversation to needs in a better way.
Covid necessitated the need to move to a telephone triage first system. While this may have felt like a barrier to patients it is so important to stress that as a result of this the doctors and nurses have been making more contact with patients to discuss clinical matters then we did with Pre-Covid systems. Despite this, we have still been seeing patients where clinically indicated further adding to the increased demand.
We have seen some benefit in using the online system, such as:
- Patients have been able to put good detail into online consultations allowing for a more focussed consultation when contacted. Where patients don’t feel they can put more information in we will still contact to discuss the matter further.
- Patients have found benefit in being able to submit online consultations at times when it may have been difficult to come to the surgery or take a phone call initially.
- It has allowed us to differentiate between urgent and non-urgent problems, letting us deal more with urgent problems on the day and non-urgent problems by the next working day.
- Entries are clinically reviewed and can help clinicians focus the conversation to needs in a better way.
- We have been able to use other team members more to deal with non-clinical matters.
As a result, we would like to consider using the online triage tool (Klinik) and potentially plan to incorporate this at the front desk when patients contact reception. This would help us to get patients in touch sooner with the clinician or staff member best placed to provide help with their query.
Another plan from NHS England, which was in place before COVID, was to put in place additional roles in General practice. This was in recognition of the ever-increasing demand on services as well as some difficulties in recruiting new GPs. These additional roles will have their own areas of expertise and utilising this will allow GPs to focus on other clinical areas or more urgent problems.
These roles will continue to remain in place and expand over coming years. Examples of some of the roles include:
- Clinical Pharmacists – Pharmacists trained to provide clinical advice around medication queries as well as carry out routine medication reviews. Some pharmacists will also be able to prescribe medication whereas others will pass information back to the GPs before medication changes are put in place.
This role is already in place and patients may be asked to book an appointment with the clinical pharmacist
- First Contact Physios – The team of physiotherapists can use their knowledge of musculoskeletal (MSK) problems to carry out triage conversations for patients with (MSK) symptoms. Following consultations, they may offer physiotherapy advice, arrange a face-to-face appointment with their team, arrange further investigations or arrange for more formal physiotherapy treatment.
This role is already in place and patients may be directed to the team by reception or by one of the doctors or nurses.
- Social prescribers – Staff from varying backgrounds that can help with support with more social problems or general healthy living.
- Mental Health Practitioner – Teams with a background in mental health that can help to assess severity of mental health problems and help patients get in touch with services that will help with improving their mental wellbeing.
While patients may prefer to speak to a GP we would ask them to consider using these teams’ expertise when felt appropriate. This will further allow us to focus on the more urgent care for other clinical matters.
We appreciate the unease around some of these changes to the previous way of accessing services. It is hoped that these measures in the long-term help to improve patient care and accessibility and we would ask for your continued support and patience as we all get used to the new ways of working.
We will continue to keep patients updated with changes at Chelford Surgery as they develop.
Our aim is always to provide safe and effective care while dealing with challenges now and in the future.