Following a review of our urgent appointment data and reasons for attendance we decided that an alternative system to manage on the day demand was essential while still providing sufficient routine GP appointments.

 

We now have a range of clinicians including 4 paramedics who all rotate to provide an Urgent on the Day clinic.

 

We introduced the new clinic in January 2017, with an Urgent Care Team comprising 2 GPs and 2 Paramedics.  This team would be responsible for managing on the day demand and would undertake all of the urgent visits, telephone calls (which were dramatically scaled back) and urgent face to face appointments.

 

The day now comprises a single list on Front Desk (our appointment system) on which all requests for home visits, urgent telephone calls, urgent messages and appointments are shown.  The team then decide amongst themselves who is the most appropriate clinician to carry out each home visit.  At 10.00am they all return to the Surgery to see the patients who have been booked in – appointments are booked by the receptionists in such a way that they are grouped in batches of 10 patients every half an hour from 10.00-12 noon (often the later appointments are not needed).  The patients have been told that they may well have to wait as the clinicians will call them in based on priority – not first-come-first-served.

 

A similar session is booked for the afternoons.  However, it is rare that we get more than 10 patients in the afternoon, leaving the GPs to get on with their paperwork, prescriptions, etc.

 

The Paramedics are rapidly developing their skills, fully supported by the GPs covering UCD.  

 

The reception team are invaluable as the ‘gate-keepers’ and have been trained and supported in how to signpost the patients to the correct clinician.  They all do a great job and we are now developing a culture whereby the GP is the last in the queue when booking.