Optimising Access to General Practice
It is appreciated that some people struggle to book appointments and access treatment. Over the last 5 years, General Practice workload has grown in both volume and complexity, with a growing number of patients living with multimorbidity who need ongoing care.
Despite an expansion in the number of additional clinical roles within General Practice, pressure on access to appointments remain a significant challenge.
When contacting the surgery, we may refer you to a local Pharmacy, an alternative clinician, Patient Triage, LIVI, Enhanced Access or NHS 111. For more information, see the APPOINTMENT section of our website.
Making sure you eat well, exercising & doing what makes you happy are all things that can help you feel better.
While we can certainly support you when you are unwell there is so much you can do outside the practice, & there are organisations in the community that can help you keep well, many of which you can go to without seeing us.
#HelpUsHelpYou This Winter (18/11/22)
February Friends & Family Test
This is how we obtain feedback from all our patients (who we have a mobile telephone number for) after their appointment with us, although forms are also available from Reception.
In February, 93% of you said we were good or very good. Thank you so much for your kind words & confidence in us, #TeamWMC do try really hard everyday.
There were a couple of consistent points:
trying to get through on the telephone - this is difficult to fix. Our call volume has risen considerably over the past couple of years but we do not have any capacity for more staff. Our team do answer the telephone as quickly as they are able to, but will continue to spend the time needed with each caller.
telephoning at a later time, we are always busy when we first open.
email the surgery, please allow up to 7 days for a response, although we are usually a lot quicker than this - firstname.lastname@example.org
use this link to send a message - https://florey.accurx.com/p/K83055 - please allow up to 48 working hours
respond to SMS sent
As always, you can also telephone 111 for advice (or online at 111.nhs.uk), attend a pharmacy or telephone 999 in an emergency.
there is a long wait in being able to book an appointment - unfortunately demand is currently far outweighing supply & has been for a long time. We do not have a limitless supply of appointments so our Receptionists will care navigate & direct you to the most suitable clinician or service, not always a GP & not always the surgery.
We now have Enhanced Access with additional GP & Nurse appointments during the evening & LIVI, an ability for a video consultation with a GP (see the appointment section).
More urgent matters are usually dealt with over the telephone first & if a clinician feels they need to see you, they will offer a face to face appointment. I know this does not suit everyone but we have to work an appointment system where we can help as many patients as possible in a safe & timely manner. We help as many patients as we can, but when we are full, you will be directed to NHS 111 or patient triage.
Thank you again to everyone who responded & provided feedback, for helping us to improve all the time. Some responses are to the left.
We do appreciate all your kind wishes, it is wonderful to be valued so highly by so many & we will always listen to feedback to see if we can make any positive changes for our patient population.
Recent data show that UK services output grew in May 2022 with human health & social work activities growing by 2.1%, mainly because of a large rise in GP appointments, with 24 million in April 2022 jumping to 27.6 million in May 2022.
These figures are yet another example of how hard GPs & their teams are working, but also why we desperately need more resource to close the workforce gap in Primary Care. This is not a sustainable way of working & GPs desperately need more support if they are going to be able to carry on providing this level of care. There are not enough GPs, & when taking on more work, they open themselves up to more stress, burn out, & exhaustion - potentially having to reduce their hours or leave the profession altogether, creating a viscous cycle of even fewer GPs which ultimately threatens safe patient care.
Our new Health Secretary has the opportunity to put right the wrongs done to general practice, & the wider NHS, by giving it the appropriate funding & resources it so desperately needs to close the growing workforce gap & safely meet patient demand. All doctors & their team want to do is give the best care they can, but without proper support, this is becoming increasingly hard to do.
#RebuildGP #PrimaryCare #TeamWMC 💙🌈
The media rhetoric that it is ‘virtually impossible’ to see a GP needs to end, since it’s adding to the continual abuse of practice staff, the Practice Managers’ Association (PMA) has said.
Instead, PMA’s director, Ian Jones said that compassion must be shown to GPs, Practice Managers & Receptionists, who are already under enough pressure without claims about lack of access being touted.
Mr Jones said the rhetoric had been going on ‘for some time’ and had now turned into a ‘political hot potato’.
‘The more the line is pedalled out, the more people believe it and the more damage it does,’ he said.
‘GPs are seeing thousands of patients face to face – in addition to offering telephone consultations, which some people prefer.’
He added: ‘We’d hate to think the rhetoric was stopping patients picking up the phone. But the over-riding message is this – we know there are big waiting times in some areas, but GPs and practice staff are working flat out with the resources they have. Isolated incidents are being portrayed as “the norm”.’
It comes as the latest data from NHS Digital showed there were 26 million appointments in general practice in July, with over 44% of those being on the same day as they were booked.
Last month, it was revealed that ‘inaccurate and unfair’ negative media coverage of GPs in UK newspapers is contributing to workforce stress and the retention crisis.
In September, Pulse’s sister title Management in Practice spoke to one surgery that had lost eight members of staff due to high levels of abuse.
The Practice Manager at Chapelgreen practice in Sheffield, Blake Foster, cited media coverage as one of the contributing factors.
‘Generally, there is a high level of demand and expectation and an unwillingness to wait,’ he told Management in Practice.
‘People want everything now and, on their terms, and we just can’t deliver that. It tends to worsen after media coverage where a negative opinion has been shared on general practice or the NHS, perhaps by politicians. That seems to ignite the flame and make the abuse worse.’
Recently, our Reception Team have had to deal with a number of angry, aggressive, rude & insulting patients who could not get what they wanted. This is not acceptable & we will not tolerate our hard working team members being abused & bullied in this way while they are doing their jobs, & following national & local directions.
We should not have to write this post but feel it is important (again) to remind our patients that it is not the fault of the person answering the telephone if:
➡️ Your prescription has not been signed by the clinician (either because you have not given 48 working hours or there is a medical reason for not issuing it)
➡️ There is not an appointment left for the same day
➡️ That our routine appointments are 1-2 weeks away
➡️ That you are advised to see / speak to a team member other than a GP for your symptoms (we have a Nurse Practitioner, Paramedic, First Contact Physio, Clinical Pharmacist, Care Co-ordinator as well as our Nursing Team.
➡️ That we do not have capacity to undertake a non NHS service within your time scale (there are lots of other providers that can undertake things like pre employment medicals & travel vaccinations, we are not allowed to promote or direct our patients to these but they can be easily found with a Google search)
➡️ That our team signpost you to another service like a Community Pharmacy, NHS 111, DoctorLink or even A&E
We would be really grateful to our patients that are reading this if you hear people being rude about those who are patient facing at Wootton Medical Centr, or any other practice you remind them of the difficult job those people have.
We need to change the culture of ‘shooting the messenger’ for things that are not in their control, or in the control of any of the staff or Partners at Wootton Medical Centre & across General Practice
Last year The Institute of General Practice Management created this video of real reception staff telling you the kind of things that they are told on a daily basis. However frustrated you become, however worried you are, however upset & angry you feel please work with us not against us. #HelpUsHelpYou get the service you need.
Thank you 💙🌈
#BeKind #TeamWMC #HelpUsHelpYou #NotInADaysWork
GP Extended Access
We are increasing our capacity & access by working together within our PCN 🌳 to introduce GP Enhanced Access.
This means, from 1st October you can pre-book appointments with a GP or Nurse in the evenings, weekends & Bank Holidays, at a time that may suit you better.
Enhanced Access is an extension of #TeamWMC & #ParkWooDPCN 🌳. It is not a walk-in-service, appointments are bookable through Reception.
Depending on your clinical need you will be offered a face to face, telephone or video or consultation.
The service is located on the ground floor of Highfield Clinical Care Centre, Cliftonville Rd., Northampton NN1 5BD - ENTRANCE B.
#GPExtendedAccess #PrimaryCare #HereForYou 💙🌈
Sometimes it can be a challenge to get a GP appointment, which is why it is more crucial than ever to cancel any unwanted appointments.
Before covid came along, 100% of our appointments were face to face. During the pandemic we were asked to change the way we worked overnight, only seeing patients if a clinical need.
We opened up face to face appointments, for patients to book directly into in November. When we ask what appointments patients want, many still prefer a telephone call. This gives convenience for patients who want it & enables us to deliver more total appointments, when the telephone is appropriate. Currently, the share of telephone appointments is around 26% & face to face appointments around 74%.
There have been significant changes in General Practice. There are Pharmacists, Paramedics & Physiotherapists in our practice seeing patients. Reception are playing a more vital role in helping patients to find the most appropriate person for you to see. We have different types of appointments. GPs numbers are going down yet the needs of the population increase. This affects us all.
#TeamWMC cares deeply for our patients & we will continue to make the changes needed to reflect this 💙🌈
Telephone Information (25/01/22)
Some of our patients are waiting longer than we would like to get through to us. We can appreciate this frustration & wanted to explain what our patients can do to help alleviate the long waits & demands on us.
Looking at our telephone statistics over the last 12 months, some tips contacting us, & other organisations that might better help you ⬇️
➡️ Our busiest times are 0800-0930 hrs, this is consistent across all days. If you are looking for an appointment on the same day (for a matter that cannot be dealt with by a local pharmacy or should be seen at A&E) it is best to telephone ☎️ as early as you can. If your matter is not urgent, please telephone later in the day.
All on the day appointments are telephone consultation only. If a clinician needs to see you, they will offer you a face to face appointment. Routine face to face appointments are available.
➡️ Our Reception team have had training from our clinicians & are able to work with you to find the right support for your issue. This will mean that when you get through to us they may ask additional questions. This is to #HelpUsHelpYou & we ask that you are as honest as possible with them. It may mean that they direct you to another service not in the practice, for example the pharmacy, who can help.
➡️ The average call time for incoming calls is 5 minutes, we try & spend time with everyone to ensure they get the quality of service that we would like to receive, this can mean it may take us longer to get to you.
➡️ It would really help us if you have a pen & paper (or electronic diary open) when you call us to make an appointment. Some of the calls we receive are for patients checking their appointment time. You can also do this via SystmOnline or NHS App.
➡️ Your local pharmacy is the best place to go for any minor ailments such as coughs & colds, rashes, vaginal thrush, headaches, back pain or things like viruses.
Please do not be upset if you are directed to them after you have waited on the telephone to speak to us, it is not the fault of our Reception team, it is clinically the right place to go.
➡️ If you have an injury that you think might need stitches, or an xray you need to go to A&E, we cannot stitch or request urgent xrays, you are not wasting the hospitals time if you need them you must go there.
➡️ We are sorry we cannot take requests for prescriptions over the telephone. This is not because we are lazy, medication is complicated, it is so that we know exactly what you want at what dose. Requests received verbally can easily be misheard or misunderstood.
➡️ Many things that you ring us for can be done over SystmOnline (https://woottonmedicalcentre.co.uk/prescriptions) or the NHSApp (https://www.nhs.uk/nhs-app/)
You can look at your records, order your medication & find out the result of your tests. This saves you & us time.
➡️ You can also use our email address for non urgent queries 📧 email@example.com
➡️ If you are unsure if its us or the hospital or somewhere else that you need to contact you can ring 111 or use the symptom checker on line (https://111.nhs.uk/)
➡️ Finally, our call volumes have increased over the last year by 33% & nearly a 50% increase pre-covid. We are looking at our staffing levels & the way that we answer the calls. With your help doing some of the above steps, we hope to be able to improve things for our patients & staff.
What we know is key is that we must ask you #ToHelpUsHelpYou so we can continue to give you the best service when you need us. This story is sadly not just about Wootton Medical Centre, GP surgeries across the country are having the same issues with demand & staffing levels.
This message is not to deter you from contacting us should you need to, but please remember to #BeKind to our staff who are doing their best to help.
Thank you 💙🌈
#HelpUsHelpYou #BeKind #TeamWMC #TelephoneDemand
Patient Survey (18/07/22)
The latest patient survey results are now available ➡️
You can see we score positively compared to the ICS (Northamptonshire) & National Results.
We always strive to provide the highest possible quality of service & are thankful to those who responded.
The surgery has no control over who receives a survey, patients who have had an appointment over the previous 6 months are randomly selected.
Thank you 💙🌈
Wootton Medical Centre now has CCTV installed. The pupose of this installation is:
- The protection of staff, patients, visitors, and the assets of Wootton Medical Centre
- The prevention, investigation and detection of crim and disciplinary offences in accordance with the Practice disciplinary procedures
- The apprehension and prosecution of offenders (including the use of images / data as evidence in criminal / civil proceedings
- The monitoring of the security of premises
- Investigatiion into a missing or vulnerable person
The principles of our CCTV policy are that:
- Individuals' rights are respected and protected
- The installations are operated fairly and within the law
- The CCTV system is operated for the purposes for which it was set up
- The recorded material / data is adequate, relevantand not excessive for the purposes
- The recorded material / data is accurate, securely stored and not kept for longer than necessary
Just to reassure all our patients that, although we offer an array of ways to contact our practices & book appointments (AccuRx, NHSApp, SystmOnline, Email 📧) our telephone ☎️ lines are always open to those who are not able, or do not wish to, use the on-line access points.
Although lines are always busy, they remain open all day Monday to Friday, other than for planned training days & Bank Holidays.
Please do contact us if you need to.
Thank you 💙🌈
Emailing the surgery (30/10/21)
Please remember, sending an email is not an urgent form of communication. If you require an urgent response, please telephone 📞 Reception.
For general enquires, please email 📧firstname.lastname@example.org. Responses can take up to 7 days.
For prescription requests, please email 📧email@example.com, these will be actioned within 48 working hours. We do not take requests over the telephone.
Thank you 💙🌈
If you need to provide a sample, please bring this to the surgery by 12pm (midday).
This time frame is to ensure it is sent to the hospital lab the same day.
Please also ensure your sample is labelled with your full name and date of birth.
Thank you 💙🌈
Media Response (26/09/21)
Recently, primary care has faced many negative headlines enticing dissatisfaction & unhappiness against General Practice & their staff.
The GP does not work alone but with a multi-disciplinary clinical & administration team to provide & support patient care.
Not everyone needs to see a GP; they are not always the most appropriate person. Many issues can be diagnosed & managed over the telephone or remotely. Previously there were no means to submit histories & photos so a face-to-face appointment was needed but now there is this ability, why should primary care not embrace digital innovations as other areas have?
Prior to covid the workload was sustainable, just. Primary care had to quickly change & adapt to new ways of working which we did, along with our fellow GP Surgeries across the country, as advised by the Government.
Covid has not gone away, so reverting back fully is not possible. It has also provided us with an opportunity to assess if there are better ways to manage patient access so the sickest are seen promptly & appropriately.
Some patients have been asked why they did not come to see a clinician sooner, replies such as 'GPs are not seeing anyone' seemed to be a common response. When prompted further, patients advised they had not previously tried to get an appointment, citing the newspapers as their source of information.
It is appreciated that it is not always easy to book an appointment but this is a long-term problem. Primary care is underfunded. There are less doctors doing GP training than ever before (44,570 GPs in June 2019 compared to 34,354 GPs in July 2021). Why would you want to train in this current climate of constant abuse?!
Primary Care Networks (PCNs) were tasked with rolling out the Covid Vaccination Programme which started long before the mass vaccination centres started. This was run by clinicians and administration staff who are still having to do their normal jobs at the surgery.
The goalposts constantly change & now we have the upcoming covid boosters yet again heavily involving PCNs & impacting upon our staff & workloads.
We are human too & despite being in the early cohorts for vaccination many primary care staff have had covid or had to self-isolate due to a covid contact. There is no back up workforce so no staff equals no appointments & reduced patient access.
The recent representation of General Practice in the media is vitriolic & harrassment of a service already nationally on its knees. This constant trolling means that a proportion of a valuable face-to-face appointment is spent with a patient expressing unwarranted negative comments about primary care.
In 2020 there was a lot of clapping for the NHS, many of which no doubt journalists took part in & likely reported on it. Those claps now feel hollow & worthless.
So how can this situation be improved? Perhaps the media needs to spend their time raising the profile of primary care so once again it becomes an attractive area of medicine & nursing to work in. A balanced view needs to be given with the challenges presented.
For patients, we ask that you #SupportYourSurgery by not adding to these negative comments, join our virtual patient participation group to put forward your suggestions & ideas in how you can #HelpUsHelpYou, write to your local MP about your concerns & sign the petition at Support your surgery (bma.org.uk)
Thank you 💙🌈
Frequently Asked Questions (29/06/21)
The COVID pandemic over the last year has meant that all GP surgeries nationwide have had to adapt and change their systems in order to keep staff and patients safe. This has meant huge changes in how we are working and many people have been frustrated they can no longer access services in the same way that they use to.
We are proud of the fact that we have never closed our doors and have continued to provide quality care to our patients throughout the pandemic. We have been asked a number of times about when we are 'going back to normal'. The old 'normal' would not necessarily work anymore as we have seen a significant increase in demand on our appointments in the last 6-9 months.
Our focus must therefore be on ensuring the services that we provide are safe and that our patients medical needs are met by the correct person within an appropriate timeframe.
We want our patients to understand the reason behind the way that our services are currently set up and how to access medical care by working with us and have prepared these answers to questions we are commonly asked about how our access works:
I need to speak with a doctor, what are my options?
This depends on how urgently you need medical advice. GP telephone consultations are bookable up to 28 days in advance with a few 'urgent' appointments on the day. If your medical need is urgent, you may be directed to an appointment with our Prescribing Nurse or Paramedic, both deal with minor illness and minor injuries and can prescribe.
You may also be directed to complete DoctorLink, an online consultation which will assess how soon you need to speak with a clinician.
Please also remember that you can speak to a Pharmacist at your local Pharmacy, these are skilled professionals and can offer advice and give information on recommended over the counter medication.
I have been booked an appointment with someone who is not a doctor, what does this mean?
We have worked with some of our neighbouring practices to form a Primary Care Network (PCN) in order to significantly expand our clinical team. We now have appointments with GPs, Prescribing Nurse, Practice Nurse, First Contact Physio, Paramedic, Clinical Pharmacists, HCA, Phlebotomist and Social Prescriber Link Workers. Our Reception Team will care navigate to ensure you are booked with the person who has the right skills to help you.
I have been booked an appointment with someone from 'the hub', what does this mean?
We work together within our PCN and also within PML Federation. The main aim is to ensure local NHS healthcare professionals have an opportunity to provide, innovative healthcare services to deliver services in a range of NHS and surgery premises across Northamptonshire. This enables us to offer appointments outside of the core practice hours (evenings and weekends) with various different members of our extended clinical teams. This has increased our appointment availability and also flexibility of types of clinician and times.
Please be reassured that anyone contacting you from the hub has access to your medical history and letters should they need, just as if they were in the practice. They are also bound by the same strict confidentiality rules we are.
When are you going back to just being able to book a face to face appointment?
Simply put, certainly not for a while yet. COVID-19 cases are dropping in the local area but we must remain careful especially with the current Delta variant. We cannot go back to the days of the crowded GP waiting area. We need to continue cleaning each room after every patient attends and wearing PPE. Therefore, we need to continue to only bring in patients who have a need to be seen in person. For this reason, we will only give people an appointment in the surgery once we have determined this is necessary either due to the type of procedure or treatment needed or after we have assessed an examination is required following a telephone consultation with a clinician.
Why can't I just book a telephone consultation / appointment? Why do you ask me to use DoctorLink?
When our appointment system is full and we have no availability, you may be directed to use DoctorLink (we can send you a link to your phone or you can access via our website). DoctorLink can sometimes be clunky and frustrating to use but some of the questions are designed to ensure that certain conditions and problems are flagged as more urgent and patients are then advised to either contact 111 for assessment within a short time or the surgery will make contact advising an appointment within the notified time frame. Sometimes this does feel like it is overly sensitive but it has been set up that way to be safe.
At times, when demand is high and the next routine telephone appointment is not for a week or two, DoctorLink allows us to assess whether someone's clinical need is okay to wait that long or whether their problem requires a more urgent response.
Why can't I see / speak to the GP that I want to speak to?
With the currently level of appointment demand, it is not always possible to see or speak to the GP of your choice. Our GPs are not always available for telephone appointments every day. For new appointments we will always suggest the next available appropriate appointment with any GP / suitable clinician.
Why is there a long wait on the telephone?
The telephone access can be a frustration for many. This is truly due to the number of patients needing medical advice and sometimes due to other queries (COVID vaccination queries have hugely increased our incoming calls). We have successfully:
- Increased the line capacity so that outgoing calls did not tie up incoming lines
- Added a fair queuing system and information about the number of calls ahead
We regularly post updates on the COVID vaccination programme on our Facebook site (Wootton Medical Centre | Facebook) and ask that everybody check here first or put a query through email (firstname.lastname@example.org) where able.
I have been given a routine telephone appointment for 1-2 weeks time, why is there such a wait?
Simply that demand on appointments is high. This is not just an issue for us but one that we are hearing from our colleagues across the country. Our list size has increased with the growing population in Wootton. We also now have access to significant additional appointment capacity offered by our PCN. However, this additional capacity continues to be easily filled and our waiting time for non-urgent appointments is sitting at approximately 1-2 weeks, although this does fluctuate.
For this reason, we will continue to ask patients for a brief reason for an appointment so our Reception Team can care navigate to the most appropriate clinician and they may refer you to DoctorLink or NHS111 if we are unable to see you more urgently than you would like.
Summary: keeping the surgery going
We are incredibly proud of our entire surgery team for keeping going throughout the pandemic and dealing with so many challenges which have included:
- Completely overhauling the clinical structures to reduce the number of people coming into the surgery to keep our staff and patients safe
- Coping with staff sickness and staff off shielding
- Dealing with people's frustration that the systems have changed and access cannot be the same way as it used to be
- Playing an active role in the COVID-19 vaccination programme
Everyone at the surgery is working harder than ever to keep the surgery going. Be kind. Use services wisely and work with us to help you.
Sharon Bailey - Practice Manager
Collecting & Ordering Prescriptions (Updated 27/08/20)
To order a prescription, you will need to use SystmOnline (prior registration required), email (email@example.com) or letter box (on main road opposite shop).
As usual, we DO NOT take requests over the telephone.
Please allow up to 72 hours to action you request, which will be sent electronically, where possible, to your pharmacy of choice (nominated pharmacy). If you have not nominated a pharmacy, this will be sent to Wootton Pharmacy.
Remember, all NHS staff are doing this to help keep you safe. Thank you for your ongoing support and cooperation.
Booking routine non-obstetric ultrasound appointments at Northampton General Hospital (08/09/21)
Due to an increase in demand Northampton General Hospital (NGH) are currently unable to offer patients appointments 3 working days after the request being submitted & they are now arranging appointments by letter.
Until further notice, patients will receive a letter, they do not need to phone the department after 3 working days.
Currently routine general appointments should be arranged by 6 weeks but routine musculoskeletal and routine head and neck scans have slightly longer waits.
NGH are looking at ways to improve the waiting times as quickly as possible but wanted patients to be aware of the current waits for when they should expect an appointment. If they have not received an appointment after 6 weeks then they can follow up with the booking team on 01604 545636 option 4.