Our systems explained

Posted by: philheiden - Posted on:

Dear Patients,


COVID has forced us all to change, and we at the Practice have had to respond to this. We think our current system keeps you safe while COVID is still at large, but we believe it also has real benefits for life beyond COVID as set out below.

A question we hear often on national and local media channels is, Why can’t I have a GP face to face appointment?

Please be reassured that we have been seeing patients all throughout the pandemic where necessary or where requested but only after being appropriately screened first to ensure safety. This is called a ‘triage first’ system. 

The adoption of our current system, which has been in place for the past 18 months, was a Practice decision, with government and professional (BMA/ RCGP) supporting guidelines helping us to set our safe processes.

We regularly receive feedback via different sources that the majority of our patients feel we offer an excellent service which is reassuring. Further details on our current system and FAQs can be read below.

Our Reception and Clinical teams have unfortunately seen an increase in demanding and abusive patient contacts recently. Note our Receptionists must work from a consistent set of Practice rules on what they can and can’t offer. Please respect this. We will be stepping up our Zero Tolerance policy. Going forward we will be recording all telephone calls and will write to those patients that overstep the line. If there are multiple instances this could result to a de-registration from our Practice list. If you have any frustrations, these are not to be directed at our staff but instead written or verbally communicated to our Managing Partner, Philip Heiden.   

Our Systems

eConsult
Our preferred initial contact is using eConsult, available via our website. This provides a lot of detail for the GPs who may be able to solve your issue virtually by replying to you via the eConsult email or a text message. They may need further information, or feel that another consultation type is more appropriate, such as a telephone or face to face appointment. They will let you know if this is the case. 

All clinical eConsults will be responded to by 6.30pm of the next working day at the latest. Often the turnaround is the same day. 

Self selecting the correct healthcare provider with guidance

Not all medical problems are best dealt with by your GP. There are many NHS specialist community services that patients are unaware of. We ask that you use our ‘Who do I See’ signposting information advice on our website before making contact https://www.adelaidemedicalcentre.co.uk/health-information/right-clinician-right-time-right-place-who-do-i-see/

Telephone appointment
If you cannot use eConsult then please call reception, but please note these requests are not responded to any quicker than an eConsult. The Receptionist will ask you some basic questions about your problem to ensure the surgery is the best place to help. If so, they will ensure you are booked in with the right member of the clinical team.  

We operate a named GP system so you will be booked with your registered GP wherever possible. We believe this is important for good continuity of care and building a relationship with your GP which has been shown to improve the quality of care and satisfaction. If you wish to speak to a different member of the team then you may request this with Reception.

If your problem is clinically urgent for that day and cannot wait for the next appointment with your registered GP, then one of the duty team will call you.

Our clinical team can conduct a thorough assessment over the phone, and may ask you to send in photographs, or convert to a video consultation. Some things, however, do require an in person appointment and therefore you will be asked to attend the surgery. 

Frequently Asked Questions

Why can’t I book directly with a GP face to face?  

  1. Infection control measures. Pre pandemic we would have 20-30 unscreened patients sitting next to each other in our small waiting room with little information of their risk factors known, we may have had a possible measles patient sat next to a pregnant woman. COVID has opened the NHS eyes as to how poor our infectious diseases control measures were. Going forward we wish to clinically screen all patients prior to an onsite appointment to keep everyone safe.
  2. Right patient, Right time, Right Place. Pre pandemic our routine waiting time for a GP appointment was 3 weeks and patients would self-select who they saw and when with very little clinical input or signposting upfront. On the day of the appointment, it was sometimes apparent that the patient should have either been seen earlier due to their symptoms or in fact seen by another clinician who has greater experience in their problem field. Triage via eConsult or telephone call provides safer care and care navigation provides less wastage of appointments as patients are directed to the right clinician first time.  
  3. Make every contact count. Pre pandemic we used to operate on 10 minute appointments and tried to focus on just one medical problem per appointment. Patients and clinicians felt rushed by this set 10 minute consultation timing and conscious they were keeping others waiting who are being delayed past their appointment time. With our new way of working there is more flexibility in spending longer with some patients to complete all their needs/concerns in one appointment and all feel less rushed.
  4. Better use of Did Not Attend time. Pre pandemic when we were purely face to face appointments, if a patient DNA’d then our clinicians time would be wasted. This could be occasionally up to an hour per day per clinician. Now that we are telephone triage based, time is not lost as we can move onto the next patient.  
  5. Patient convenience. Pre pandemic we use to operate on a timed appointment model. Often clinicians would run late due to unexpected emergencies within their clinics. This caused patient delays. Being telephone based you can continue to carry out your day as you normally would, until we phone.

Why when I want to speak to a GP am I offered another clinician type?

  1. Right patient, Right time, Right Place. Pre pandemic our routine waiting time for a GP appointment was 10 working days and patients would self-select who they saw and when with very little clinical input or signposting upfront. On the day of the appointment, it was sometimes apparent that the patient should have either been seen earlier due to their symptoms or in fact seen by another clinician who has greater experience in their problem field. Triage via eConsult or a clinician within 48 hours provides safer care and care navigation provides less wastage of appointments as patients are directed to the right clinician first time.  
  2. GP stands for General Practitioner. By its title they are generalist of all clinical fields but not specialists in them. An MSK first contact practitioner physio is upskilled to know more in depth about musculoskeletal problems and a Pharmacist about medication side effects, etc. It should be seen as a positive offer to see a specialist rather than a diversion away from your GP request.  
  3. The Primary Care team over the past few years has significantly grown in terms of specialities and this is a vision of the government also (more community-based specialist care). In Primary Care we now employ –

Advanced Practice Nurses – prescribers dealing with acute conditions and minor illness
MSK first contact practitioner physios –Musculoskeletal conditions
Clinical Pharmacists – Medication queries and reviews
Health and Wellbeing – Mental Health conditions

Why can’t I be given a time when you will call me?

Make every contact count. Pre pandemic we used to operate on 10-minute appointments and tried to focus on just one medical problem per appointment. Patients and clinicians felt rushed by this set 10-minute consultation timing and conscious they were keeping others waiting who are being delayed past their appointment time. With our new way of working there is more flexibility in spending longer with some patients to complete all their needs/concerns in one appointment and all feel less rushed.

Local delivery system support – reducing bed occupancy. Clinicians will triage in order of urgency determined by the problem and symptoms known to them passed on by eConsult or Receptionists. It is sometimes obvious that a patient may require hospital treatment and the earlier we send them in the more chance they have of getting home the same day. If sent in later they have to stay in overnight which is distressing for the patient and their family but also impactful of struggling hospitals and costly for the NHS.

Your Health is important We believe your health needs should be prioritised. If you have contacted us and wish for NHS advice and treatment then we ask that you keep your phone on you, on loud and be prepared for a call throughout the day. We encourage all employers, where possible, to be flexible around health appointments and telephone calls. If you have preferred times throughout the day that suit better, please make our receptionist aware of this when booking and we will try out best to call within said period.    

Recent Patient reviews/ engagement

Although we wish to please all our patients, all the time, it’s inevitable that our processes won’t be for everyone and unfortunately, we can’t have a different process for all. We vow to listen to and regularly engage with our patients to source the majority view. The NHSE anonymous patient survey carried out in COVID published in Aug 2021 is available to view here. Practice Overview (gp-patient.co.uk)

Philip Heiden

Managing Partner @ AMC