Healthcare
Creating Patient-Centred Access Systems
Creating Patient-Centred Access Systems
A Nottingham-based general practice with significant patient access challenges engaged our team to deliver transformation through the NHS England General Practice Improvement Programme (GPIP). The practice sought to address high DNA rates, fragmented triage processes, and reception staff confidence issues whilst developing an approach that would guarantee consistent patient experience regardless of access route.
Results
- 4 hours 30 minutes per week saved through reduced DNAs (Did Not Attend appointments)
- 2 hours 1 minute per day saved through implementation of timed consultation slots
- Over 7 hours 31 minutes total weekly time savings across the practice
- 100% patient satisfaction with timed telephone appointments
- Reduced variation in patient handling through standardised protocols
- Enhanced staff morale through collaborative workflow redesign
- Improved digital access through optimised AskMyGP utilisation
- Streamlined signposting protocols with clear RAG rating system
Approach
- Diagnostic activity to highlight areas for improvement
- Significant opportunities were identified within:
> Understanding and measuring demand across multiple access channels
> Reducing variation in patient handling and appointment booking
> Improving digital engagement through AskMyGP platform
> Addressing high DNA rates to maximise available capacity
> Enhancing reception staff skills in effective signposting
> Boosting staff morale and improving workload management
> Standardising processes to improve patient experience
- Comprehensive process mapping of the triage model to identify inefficiencies and variation
- Development of detailed on-call and end-of-day protocols to standardise clinical workflow
- Creation of structured RAG rating system for reception staff to prioritise patient needs appropriately
- Review of telephone system data and subsequent contract changes to improve management information
- Detailed staff workload analysis to identify capacity constraints and resource requirements
- Implementation of timed appointment slots with rigorous patient satisfaction monitoring
Solution
- A thorough understanding of current processes and challenges was gained through comprehensive engagement with clinical and administrative teams
- Developed and implemented structured triage model that provided clear guidance for handling patient contacts across all channels (telephone, AskMyGP, email, walk-in, letters)
- Created comprehensive signposting document with RAG rating system to upskill reception staff in appropriate patient routing, reducing demand on clinical time
- Designed protocols to enable advance booking within the NHS England two-week window, enhancing continuity of care and reducing ‘call back tomorrow’ instances
- Optimised AskMyGP platform to handle specific query types (cancellations, sick notes, blood test bookings, dispensary queries) without reception intervention
- Enhanced prescription medication review process through AskMyGP to include pre-appointment blood tests and comprehensive template completion, streamlining clinical pharmacy team workflow
- Implemented timed consultation slots to reduce DNA rates and eliminate multiple call attempts by clinicians
- Changed telephone system contract to provide more valuable management data from December 2024
- Conducted comprehensive reception workload analysis leading to allocation of additional 50 hours of staffing to accommodate holidays, training and sickness absence
- Introduced regular team ‘pop-up’ meetings with structured feedback mechanism to clinical meetings
- Adjusted patient communication based on timed slot survey findings to improve appointment satisfaction
