Chris Netherton, M.D.

Delivering improved GP access


The pace at which improved access is being implemented is very good news for patients. At the same time, technology is helping to facilitate new ways for practices to deliver improved access, which will permanently change the way they operate.

The General Practice Forward View set out plans to significantly improve access to GP services by 2020. This plan included sufficient routine appointments at evenings and weekends to meet locally determined demand, as well as effective access to out of hours and urgent care services.

There is little doubt that this move should be very popular with patients. Reports by the National Audit Office had shown that, while people’s overall opinion of the quality of care provided by GPs remained consistently high, there had been gradual decline in patient satisfaction with access.

This is an area where GP practices across the country have delivered very impressive results. The original milestone target for April 2018 was that 40% of the country should have access to these services. The actual figure that was achieved was 52%.

As a result, NHS England have now revised their timings. They now want everyone in England to have improved access to GP services by 1st October 2018, rather than by the end of March 2019 as was originally planned.

Broadly speaking, there are two main ways in which practices can deliver improved access. They can either open the surgery for longer hours or they can collaborate across a group of surgeries (or use a combination of these two approaches). In terms of the collaborative approach, Microtest clinical software is playing a key role in facilitating new ways of working. Patients can visit any practice within a group, and the GP who sees them can be supported by an up to date medical record made available at the point of care.

A great example of this in action is the Three Harbours Group in Cornwall, which comprises the Fowey River Practice, Middleway Surgery, and Lostwithiel Practice. They agreed an improved access trial, supported by Microtest’s clinical system, which meant that one of the practices would be open on each Saturday over the Christmas 2017 and New Year period.

Read the Three Harbours Case StudyA patient from any practice could have an appointment at the designated surgery and the duty GP would have full access to their electronic medical records. Details of the consultation were then inserted into the patient’s own practice’s clinical Workflow, so that their usual practice could manage the ongoing care of each patient.

The practice teams reported a wide range of benefits from this approach. They were able to offer Saturday appointments to ‘at risk’ patients and children. It allowed GPs to monitor any patient they had concerns about who might otherwise have resulted in an emergency hospital admission. It also reduced some of the workload on the following Mondays, freeing up time to spend on improving patient care. The teams were so impressed with the results that they want to conduct further collaborative trials and they plan to set up a shared phone system across the practices to offer a truly integrated service. You can see the full case study here. 

Three Harbours Group is one of the early adopters of this new kind of approach.

Microtest was quick to recognise the benefits of the Three Harbours approach to patient care and over the last six months we have used all of the feedback provided by the practices to enhance Open Evolution further. To this end, new functionality is being assured with NHS Digital and will be released to first practices in July and then on to all Microtest practices in Cornwall and Devon by early September.

This new improved access and collaborative version of Open Evolution will deliver a new registration type. This will allow practices to hold patient consultations for patients from a different practice, regardless of which clinical IT system their own practice uses.

This will help enable our customers to meet the NHS October target of delivering improved access by October 2018.

The consultation will pull patient information directly from the patient’s own practice and the clinician will be able to run the patient consultation using all the rich features of Open Evolution.

The automatically produced discharge summary can then be emailed to the patient’s own surgery. In line with advice from the BMA, any data returned from a patient visit to another practice can be scrutinised thoroughly by the patient’s own practice before adding the document to the patient record.

The new version of Open Evolution will also have GP Connect functionality embedded, so when GP Connect is enabled nationally this autumn, our practices will be amongst the first to enjoy even greater levels of collaboration.

This exciting new functionality will deliver many benefits and will deliver new tools to help implement new ways of working including increased collaboration. This is enabling practices to improve services without adding to their own workload.

It is really rewarding to see how our products are helping practices across the country to take these vital steps forward, resulting in significant improvements to patient care.