New Appointments System - UPDATE from 16th October 2017

​Dear Patients of Audley Mills Surgery
Our new appointment system has running since June and we are reviewing what we have learned:
  • Telephone appointments have been very effective at meeting the needs for a large number of patients.   Where a telephone appointment IS possible, it is a great deal more convenient for patients (rather than taking time off work to attend for example) and quicker for the doctors.
  • This time-saving has meant we have increased the total number of appointments we can offer from an average of 1616 per week to 2098 – a 30% increase in appointments!
  • This is great, but the doctors are certainly feeling the effects of this increased workload and we need to ensure we avoid burnout.   Working 10-12 hour days is not ideal for anyone, especially if you consider the intensity of the workload and the importance of the decisions being made each day.
  • Some patients have not liked the fact that they can’t book to see a doctor face to face straight-away.   If a problem ‘obviously’ needs a face to face appointment then this is clearly an unnecessary hurdle which must be overcome and this can add to frustrations.
  • The extra telephone lines and staff to answer phones have certainly helped, but we still hear stories of people waiting a long time to get through on the phones.
  • The objective of ‘doing today’s work today’ is a good one; dealing with patients the same day that they contact us has greatly reduced the number of appointments that used to be wasted because patients Did Not Attend (DNAs) when appointments were booked up to 4 weeks in advance.
  • We have retained flexibility in allowing doctors to book some patients in for follow-up appointments in the future, but these are the exception rather than the rule.
In view of these findings we have decided to tweak the system in the following way
  • From now on when you contact the surgery you may select whether you wish for a telephone appointment or a face to face appointment.
  • If you request a face to face appointment this will be booked directly without an initial phone call from a doctor
  • Some of these appointments will be made available to book online through SystmOnline, but others will be kept for patients who do not have online access to be booked by phone or in person at the reception desk.
  • If you are unsure, then a phone-back appointment is probably a good starting point – sometimes we arrange tests after a phone consultation and then a face to face appointment to review the results. This is more efficient than brining you in 3 times for the same problem.
  • We will still aim to deal with the vast majority of problems ON THE DAY that you contact us.  Please do not try to book appointments in advance, this will only lead to disappointment and clogs up the phone lines with problems that aren’t being resolved today.
  • We will aim to continue to supply a minimum of 2000 appointments per week, but if we run out of appointments then the on-call doctor will still be available to deal with GENUINE emergencies that cannot wait until the following day.   We would kindly ask that these emergency appointments are respected for those that really need them.
​Finally - a plea!  We have all heard from lots of patients who have been very positive about their experience of the new system.   Many of you have told us how speedily your problem has been dealt with and what a relief it is not to have to wait 2 weeks for an appointment.   However, this is not reflected in the feedback we have received on the NHS Choices website.   We understand that it is human nature to highlight negative experiences over positive ones, but if you have had a good experience, would you consider sharing this on NHS Choices, or elsewhere?  We believe that we are working harder than ever to deliver a service that we can be proud of, but we need your help to establish and maintain a reputation for excellence.
Thank-you!
Audley Mills Surgery

Appointments System from 12th June 2017

New GP appointment system
From 12th June 2017, our appointment system is led by GPs. Your request for a GP consultation will result in a GP telephoning you to discuss your problem.

Our aims are:
  • To improve ways for you to see or speak to your own GP
  • To improve access to appointments either by telephone or face-to-face
  • To try to offer you a chosen time convenient to suit your daily schedule
Please remember to ensure that we have your up to date phone number on our records at all times (and email if you wish).

How it will work:
 
There are two ways to book a telephone consultation
  1. By phone (new lines have been installed)
  2. Online via SystmOnline

1. How to book by phone:
  • You call the surgery to book an appointment.
  • The receptionist will take your name, date of birth, and the best telephone number to contact you on.  If you are happy to share the reason for your call, this will also be noted to help us to provide the right care, first time.
  • The receptionist will put your name on your doctor’s ‘call back’ list.
  • A GP will call you back as close as is possible to a guide time you are given.
  • GP discusses your medical condition; he/she will provide advice over the phone and/or a face-to-face appointment where necessary.
Please note, on exceptionally busy days we may only be able to accommodate medically urgent appointments if the demand is higher than usual.
 
2.  Online:
  • If you have already registered with SystmOnline, you can visit www.audleymills.co.uk to book a telephone consultation with a GP of your choice. (Please remember to add the phone number you wish to be used when the GP calls you back in the box called “Reason”.)
  • Your chosen GP will call you back as close as is possible to the guide time you have booked.
  • They will  discuss your medical condition; he/she will provide advice over the phone and/or a face-to-face appointment where necessary.
Please note, on exceptionally busy days we may only be able to accommodate medically urgent appointments if the demand is higher than usual.
 
Further information
Why are we introducing this new service?
As patients have chosen to join us, our practice list size has grown from approximately 18,000 to over 21,000 in the last four years. Whilst this is a wonderful vote of confidence in us, funding restrictions prevent us from growing our staff size to match this increase in our patient population.
 
We need to try new ways of working so that we can optimize the use of our GP’s time (and other staff in the practice) to better meet the needs of the patients.
​
This system is used in other parts of the country and works well.  We believe it will provide a much better service for patients as the majority of patients will be dealt with by doctors on the same day (even if some patients are asked to come back later).
 
We know that often patients want reassurance that they are doing the right thing and want to know if there is anything else they can do. They often wish to talk to the doctors in the Practice rather than be re-directed to A&E or the Out of Hours service.

​What are the benefits of this service?
We hope the majority of consultations will be dealt with over the phone safely and effectively without patients needing to come to the surgery. This saves you time, allows you to continue going to work or carry out your daily activities with the added reassurance of knowing that if the doctor needs to see you then it can be arranged. It also means we can offer slightly longer consultations for patients that have complex needs.

How will I know if my preferred doctor is working that day?
We will post details of which doctors are working in the forthcoming week here - When is my preferred doctor in?

We will do our best to deal with calls taken before 4pm on the same day,  calls taken after 4pm may be asked to phone back the next day if the doctors are fully booked until the end of the day.
​
Can I call anytime?
Yes, as before, calls will be taken in normal working hours.  Mornings tend to be a busier time of day to call.

Do I need to call early?
No, the service is exactly the same whatever time you call. There is often a rush at the start of the day, so you may find a quicker response later on.

What happens when the doctor calls?
The doctor will discuss the problem with you and work out what to do next. This may mean advice, a blood test, a prescription, or you may need to come in. The doctor will arrange an appointment if you need to be seen. Usually this will be the same day, but you can ask for a later day if you wish.
 
Will the phone lines be able to cope?
We have sought advice from experts in this field and we are installing additional phone lines.  Patient will also be able to continue to book telephone consultation slots online.  Our practice staff are also receiving additional training.  While there will always be teething problems and a period of time when everyone will need to adjust to this new way of working, patient feedback in other areas that are using telephone consultations is positive.
 
How soon will the doctor call?
The doctor will call as close as possible to the guideline time you are given. Please stay in or with your phone (and make sure the ringer is switched on and turned up).  Please tell the receptionist if you need the call at a particular time. We do say that telephone appointment times are “guide times” as we offer to each and every patient the time needed to fully discuss their problem.
 
What if the doctor rings me back and I miss the call?
The doctors will do their best to ring you back as close as possible to your guide time, but this may not always be possible. If you miss the call, the doctor will try again.  If you have not received a call back within 2 hours we would suggest you contact the surgery again and let us know. Sometimes we may have the wrong number and by asking you to call back, we ensure that contact is always made.
 
What happens if I need a follow up appointment in a month's time for example?
Instead of booking an appointment to see us in a month's time, your doctor might advise that you call in a month’s time, you will then be able to speak directly to a doctor who will be able to advise you or arrange a face-to-face appointment where necessary.  You can also arrange a suitable time for your GP to call you via the online booking system.  If there is a clinical need to see you in the future, the doctor can arrange a future appointment.
 
What about patients that have a disability for whom a telephone consultation may not be appropriate?
We appreciate that this system may not work for all patients all the time. Those who are unable to talk to us or hear us on the phone will be given a face-to-face appointment with a doctor as they do now.
 
What happens to home visit requests?
This will work in the same way, with a doctor phoning to see if the problem can be safely managed over the telephone. If not, we will arrange a visit, usually the same day.
 
What about appointments with a nurse?
This is one area where there won’t be any changes for the moment. If you know your problem needs a nurse appointment you will be able to book one in the same way you can now. If you are not sure whether you need a nurse, if you feel comfortable to, you can discuss this with a receptionist; otherwise make an appointment for a doctor to call you back.

​What about online appointments booking?
Patients will still be able to request a telephone consultation with a GP of their choice, if you feel you need a face to face consultation with your GP you will need to discuss this in your telephone consultation.
 
What if I need to call about something that’s not linked to an appointment?
We ask that all patients that require anything other than an appointment, call later in the day when the phone lines are usually a bit quieter.
 
What about appointments for things like cancer screening, flu jabs, family planning?
These will work in the same way as they do now. If you are not sure whether your request needs a telephone appointment with a doctor please discuss this with reception (if you feel able to).
Has there been any consultation with patients in the practice?
We have discussed the new appointment system with our Patient Participation Group. This was a wide ranging, fruitful conversation that highlighted some areas that we needed to work further on. As the new system beds in we will continue to meet with the PPG to gather feedback.

What happens if I ring after 5pm or just before the surgery closes?
The receptionist will still deal with your request, and we are trying to encourage patients to call before 11am in order that the doctor can deal with all calls in good time and bring in any patient that requires a face-to-face appointment.
 
Have others done this before or is this completely new?
Many GP practices around the country have implemented the system and it is working very well for them. Some of them have been doing this now for over 15 years and feedback from patients, clinicians and others has been very positive. We have been in touch with a few practices and learnt from them so that hopefully the introduction will be smooth and without too many difficulties.
 
What can I do to prepare for the new service?
The main difference is that patients must either phone the surgery or book a telephone consultation through SystmOnline and wait for a call back by the doctor. Please avoid coming to the surgery to see a doctor unless you have an appointment as all the doctors will be busy.
 
Where appropriate, please ensure you consider obtaining advice from your local pharmacist or getting useful information from www.nhs.uk before calling us.
 
It would also be helpful if you could gather together relevant information prior to the phone call about your condition e.g. what medication you are taking, any blood pressure readings you may have or a letter you may have received asking to contact us. Please remember to try to keep to one issue at a time if possible so that we can deal with as many people as possible.
 
What happens if you can only receive calls between a certain time e.g. before 10am?
Please inform the receptionist when you book the appointment so that the doctors are aware and try to accommodate you as best as possible.
 
Do patients have to inform the receptionist of what their medical problem is?
You do not have to tell the receptionist what is wrong with you if you do not wish to. However it is helpful for the doctors to have some idea of what the problem might be so that they can ensure the right care is offered, first time. We have a robust confidentiality policy that all staff adhere to at all times.
 
What will the receptionist ask?
“How can I help you?” If it is a medical matter they will ask for a few words about the problem to help your doctor prepare for the call.  You may also ask to see the practice nurse as normal.
 
What if I am at work?
Employers are usually pleased that you can save time by not going to the surgery.  Ask your employer for a quiet spot to take the doctor’s call.  If timing is an issue, inform the receptionist.
 
Can the doctor call my mobile?
Yes, a landline is usually more reliable but the doctor can call you back on both.  Please ensure the receptionist has the best number to call you on. 
 
How is it possible to have more consultations with patients and still deliver better quality care for all?
By enabling more patients to be dealt with over the phone, we think it will give us more time to spend with those who need to have a face-to-face consultation, whilst, at the same time, providing reassurance and a plan of action for those who are happy to be dealt with over the phone. Out of Hours services often deal with consultations over the phone safely and effectively too.
 
Whilst considering the new appointment system, all the doctors have been reviewing patient consultations that they had over the past few months. This showed many patients came to see us face-to-face when in fact they could have obtained advice from a doctor via telephone, from a pharmacist, seen our practice nurse or been empowered with information about their condition with is now easily accessible at www.nhs.uk
 
Can patients see a doctor face-to-face if they wish to?
Yes, patients can see a doctor face-to-face but they will need to book a telephone appointment with the doctor first who will make this decision.  Many problems can be dealt with over the phone without needing to be seen face-to-face.
 
Will I still be able to book an appointment with a specific doctor?
Yes, you can request a telephone consultation with a specific doctor via our online booking system. If you call us, we can arrange a telephone consultation with the doctors that are working on that day.  This website will show which doctors are working on which days for the next couple of weeks.  
 
Do you have any further questions that you would like to ask?
We would like to hear from you if you have any questions, concerns or queries.
Please remember to ensure that we have your up to date phone number on our records at all times (and email if you wish).