Lonsdale Medical Group PPG Update January 2020 The

Lonsdale Medical Group PPG Update January 2020

The Merger – Main Problems The merger went well with only a few minor issues including : • Telephone System - call back system not working • Some staff from PH and Blessing decided not to work at the merged Practice, including a Blessing Nurse; and some Doctors reduced sessions and took emergency leave. • Online Access to Appointment Booking etc for PH and Blessing did not work once systems merged, despite assurances from EMIS ( our clinical system provider) Patients have had to re-register for online access at Lonsdale.

Appointments • Despite losing some Doctor sessions post-merger, we booked locums and Lonsdale Partners increased their sessions. • Numbers of appointments remained as promised in merger planning. • Due to demand, we now operate Telephone Triage all day and have a Duty Doctor throughout our opening times. • We are looking to recruit an extra Practice Nurse • Our Pharmacist is working with our nursing team to support management of patients with long term conditions.

Appointment Capacity • Routine Appointments have remained at two weeks for GPs • We continue to offer routine 10 minute appointments and also 15 minute appointments. • We have always met the required capacity on telephone triage and every patient needing assessment has been assessed within 3 hours. • Triage is now running all day; we will communicate this to patients • We are managing to deal with around 75% of triage calls over the phone. • The triage team have access to face-to-face slots both on the day and in the future, for HCAs, Nurses, Pharmacists and Doctors.

Telephone System • A lot of issues in the first month. • Huge apologies to patients who experienced the problems • Problems included patients being cut off and long waits in the queue. • We have tweaked the telephone contract with our provider and updated our system • Staff monitor statistics daily including average time in the queue and calls abandoned. • Increased number of staff on phones each day. • Recruited 6 extra full-time administrators. • Plan to redo the telephone tree to change the music and redirect patients better

Patient Feedback Huge thank you to the amazing PPG members who came and met patients to help explain Lonsdale systems and get feedback from patients for the Practice. Some examples below and also our response Routine Appointments I have used the online triage once and found it a useful service. I didn’t need to go to the GP for an appointment and was given advice. Since then I have made a routine GP appointment and had to wait 3 and a half weeks for an appointment. It wasn’t urgent but was too long to wait. I know new systems take a while to bed in but I’m hopeful that the wait time for appointments improves drastically. (Jan 24) Re same day telephone appointments – my partner waited about 5 mins, then got an appointment with his favourite Doc! Very good (Jan 17) Thank you for your feedback. We have a 2 week wait for routine appointments however we understand that some patients would like to see a named GP. We are doing our best to try and improve the wait times for this but at present our GPs work on a rota basis and have booked leave to consider. Our Doctors rotate the on call rota including duty and triage although we try and spread the outcome slots across our whole doctor team

Repeat Prescriptions According to QP pharmacy this evening the Lonsdale has a two day backlog issuing prescriptions. That’s not good is it? I’ve just been trying to chase something for my more or less housebound neighbour (Jan 23) Thank you for your feedback. We operate a 3 day turnaround for repeat prescriptions although if these medications have not been agreed to be on repeat then this will take longer as it needs a clinician assessment. Urgent Prescriptions are dealt with by Duty Doctor. All our repeat prescriptions are completed by the PCH Pharmacy Hub, which helps our Doctors see more patients. Telephone Triage I have had good experiences with the new telephone triage system. On the first occasion I had a short wait, spoke to the receptionist and got a call from the doctor later on, with an appointment offered for the afternoon. On the second occasion, my call was answered quite quickly, the doctor rang back later and gave advice over the phone. All very satisfactory and a vast improvement on queuing, sometimes in the rain, at 8 o’clock in the morning! (Jan 18) We have been dealing with an average of 120 triage calls a day and have never turned a patient away and we confirm a maximum 3 -hour callback time with a Doctor. Due to demand we have now been operating an all-day triage system which we will be continuing for now.

Quality of Reception Staff I’ve been with Lonsdale for 7+ years, and my partner 18 months. I have been very impressed by the quality of the receptionist staff all the time I have been a patient and most of my interactions with clinical staff at the practice have been great too. Many of the reception staff are friendly, approachable and keen to help. Two very young receptionists who I think no longer work there seemed very proactive and committed to offering a quality service. However, since the merger, my partner and I both have concerns about the quality of the service. Firstly, I’ve been unimpressed with the ’new’ reception staff’s skill, interest and motivation. For example, I popped in recently to make a pre-bookable appointment with Dr Boutros. The receptionist I spoke with did not seem able to use the system. She asked for repeated help from an ‘old Lonsdale' receptionist and then drew a blank. She could not locate a pre-bookable appointment. It was not clear to me what the issue was and she showed no interest in guiding me. Her disinterest and lack of skill led me not to ask any additional questions. In fact I looked on line when I got home and found a pre-bookable with ease. Thanks so much for your feedback. You are absolutely right that we have had a member of Lonsdale staff resign and we have also moved 2 receptionists to some important back office work. Demand for reception is greater than expected and we have had to recruit 6 new staff. We apologise that often staff have had to train on the job, but demand on the phones and walk-in queries were much higher than expected and we had to work quickly to ensure enough staffing. We used an agency who understand general practice to recruit staff at short notice. We hope to have a fully functioning permanent team by mid-February.

Referrals The second issue that we both have had difficulties with, more so of late, is referrals on to other specialist services. We’ve had significant delays in getting seen and a lot of energy expended from our end. My partner somehow did get referred and waited two hours to be seen by someone who turned out to be nothing to do with the service he required. He has yet, I think, to get to the bottom of this, despite trying to talk to someone in the practice and sending emails. The absence of a practice manager and I assume poorly skilled/motivated receptionists I think did not help. There may have been other challenges. He will discuss this with Dr Boutros next week. Thank you for your feedback. I am very sorry you have had problems with referrals. We have a newly formed team ( Secretaries) who deal with referrals and will be responsible not only for booking patients but also for auditing to make sure patients are seen. Unfortunately wait times for secondary care and community services are outside of our control and we apologise that often this can be frustrating for patients. We encourage patients to contact the hospital PALS service to feed back concerns.

100 Day Plan Update

Next Few Months New Full time Practice Manager and Management Team New and improved Appointment System with further improvements including more routine appointments from February 2020 ( following review of data using Edenbridge Apex – capacity planning tool) New website and Patient Leaflet – more updates to come New Departments to manage responsibilities including Clinical Administration Team and Secretaries New Doctors – Permanent Team by April 2020 New advanced Document Workflow process, improving the clinical coding at the Practice and supporting our Doctors so they can see more patients. New systems for repeat contraception requests and repeat fit-note requests via reception without needing an appointment. New and improved Month of Birth system, under Secretaries, for Annual health reviews. Improvements to telephone menus and better access for patients by February 2020