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What to do with 7,000 unanswered calls to local GPs every month?

Like every general practice surgery in the NHS, Gillingham Medical Practice is under pressure. But despite the workload, the priority is always making sure the patients get the right care from the right person in a timely way.

“Gillingham Surgery received 14,500 phone calls a month. Only 53 per cent of those calls got answered; there simply weren’t enough people to pick up the phone”

There has been a lot of publicity in the mainstream media recently about GPs not offering face to face appointments and increasingly long waiting lists. There has been significantly less reported on what clinical staff have done about working ‘smarter’ in order to protect vulnerable people. A lot of this work goes on behind the scenes and is generally invisible to the public - but is, in fact, making a big difference. Dr Chris Pearce explains some of the issues and why Gillingham Medical Practice had to change some of the ways it assesses patients by adopting a new solution. “Prior to the new system, Gillingham Surgery received 14,500 phone calls a month. Only 53 per cent of those calls got answered; there simply weren’t enough people to pick up the phone. It’s impossible to deal with that volume.” Just think about that number for a moment. That’s just one practice in Dorset. Others have the same issues. And it’s not sustainable. The team, like so many other practices across the county, have turned to technology to help them, and implemented a new system called Total Triage and eConsult. Of course there’s still an option to simply phone the practice and make an appointment, but patients can now use an online system to describe exactly what they would like help, along with any symptoms. eConsult is based

Dr Chris Pearce from Gillingham Medical Practice

on evidence-based algorithms - it is will cut in and tell them to call an ambulance. The system also flags people who need to be assessed quickly by the local surgery. Every patient’s data is very secure under the NHS system and the system also links to your GP record. But it’s what happens next that is beginning to make the system more efficient.

What happens to your form?

A team of clinicians at Gillingham Medical Practice look at each online requests; they make assessments and aim to get the patient seen by the most appropriate person. People are usually contacted within a day for more serious issues. Minor issues are dealt with in three working days - sometimes faster. Chris told me they have two meetings a day to review the online submissions and agree who will speak to the patient; it doesn’t always have to be a GP. For example, someone with a chronic arthritis flare up may benefit most from seeing a physiotherapist to help with exercise. Someone with a complex medication issue could be better off seeing the pharmacist. And if a GP has been handling a particular case, the triage system means they can continue seeing them instead of the patient being allocated to a clinician unfamiliar with the history. In Gillingham, the team is managing 300-400 people a week in this way and they are working far more efficiently as a result. Dr Pearce was enthusiastic about being able to maintain continuity by using this system of triage: “General practice cannot function without continuity of care.”

What about those phone calls to the surgery?

As a result of implementing the new service, the number of phone calls has decreased to 8000 a month. 74 per cent are being answered which is a significant improvement. But for those using eConsult, the new system means they are triaged and assessed more efficiently. We’re always open Practice manager Karen Rhys is also keen to emphasise that though the Barn Surgery is temporarily closed for safety reasons, the practice has always been open. ”We have never been shut, and by doing things differently we can ensure vulnerable people are protected.” It is clear that a lot of healthcare needs to be delivered differently in future and all of us will need to adapt to new ways of doing things. What hasn’t gone away is the dedication, the care and compassion from our local GPs and primary care staff who are doing their utmost to ensure that people get the best possible care in North Dorset.