Patient update

Williamwood Medical Practice Patient Update June 2022

Dear Patients,

At Williamwood, we take pride in offering the highest standards of patient care. Over recent years, we have developed and adapted systems to maintain these high standards in the face of increasingly difficult conditions in primary care. Workload in general practice has increased massively. The healthcare system nationwide is currently under a lot of pressure and we would like your support and understanding. We hope that this letter will offer insight into the challenges we are facing and the consequences for our patients and staff.

We understand fully that from a patient’s perspective, when you walk into the surgery and see the waiting room half empty, this seems absurd. Our staff are working harder than ever to ensure that patient care is impacted a little as possible. As a simple illustration of this, last week our on-call GP dealt with an average of well over 100 patients per day on top of his or her routine workload, more than 20 times the average number in the same week 3 years ago. This increase is naturally mirrored in an increase in administrative staff work. We thought it might be useful to explain how primary care is working at present to cope with this. We hope to help you access the care you need as smoothly as possible and also to reduce the amount of time our reception staff are currently spending explaining this to patients.

Safety has always been, and always will be, our number one priority. We are a limited resource and so we triage requests for appointments to ensure that we are there for your when your need us most urgently. This often means that you have to wait longer than we would like for an appointment. We continually look for ways to minimise this with developing skills in nursing and admin staff to free up more GP time. Most of our patients are very understanding and cooperative, but increasingly, our staff report verbal and occasionally physical aggression which is completely unacceptable. We have a Zero Tolerance Policy with regard to verbal and physical aggression. We composed a Practice Statement last August to try to explain the changes we have made to our systems. Part of this is posted below by way of further explanation.

In the past, if you wanted to see a GP, you simply made an appointment. Now we have another method of contacting us: our online form, and if you ‘phone, you will be asked questions about what you require from the practice by our administrative team. You may be redirected to another service, offered an appointment with another health professional, offered clinical advice from one of our clinicians or be given a ‘phone appointment. Below is an explanation of why these changes have been necessary.

But why can’t I just see a GP?

Background to Why Primary Care Has Changed:

The changes that have happened in Primary Care began long before covid. Patients are living longer with more medical problems and many more medications. The complexity of general practice has vastly increased. But the number of GPs has significantly declined.

Image showing GP numbers fallen

One solution has been to introduce specialist roles within the practice, such as Advanced Nurse Practitioners, Practice Pharmacists and Physiotherapists. New services have been set up locally such as Minor Injuries, the Community Pharmacy First scheme for treatment of minor medical issues such as urine / throat / skin infections, Opticians to treat eye problems and the Podiatry Service for foot and ankle problems. The GP’s role is to manage the most complex cases and support the whole practice team.

If patients continued to choose whom they see, GPs would be fully booked and would be unable to deal with our most unwell patients. This simply isn’t safe. The pandemic has increased the demand on our services significantly. We are dealing with many more patients each day than we did pre- covid. This has happened for a number of reasons; patients delayed contacting at the start of the pandemic, lots more people are waiting longer on hospital care and need more GP input as well as the increased workload from covid-19 related illness itself.

Triage of Clinical Requests:

Our absolute priority is maintaining a safe level of care. This requires us to prioritise the patients who need care most urgently. To do this, we need information from you about your problem.

We ask that you contact the practice by using our online form on our website, if possible. This is the most efficient way of us getting information from you about what we can do for you and keeps our

‘phone lines free for the clinicians and our receptionists to call you. Of course, we understand that many patients prefer to contact us by ‘phone and that is absolutely fine. The on-call clinician, who is not booked with appointments, will look at dozens, more often hundreds, of these requests each day and can often respond and complete your request in a few minutes. We know that this can feel impersonal, for you and for us, and we would all rather that we were speaking to everyone or even better seeing everyone. The sheer volume of patient contacts that we get through each day though is several times higher than we could achieve if we spoke to or saw everyone. So, although there are lots of things, we (and you) don’t like about these systems, we have had to introduce them to ensure we are getting to care for those that need help most urgently.

Please be reassured that we are here for you. We are working in different ways than before the pandemic and with a wider workforce of healthcare professionals. We will see you face to face, if needed, often after an initial telephone consultation. If you have symptoms, you are worried about, please do contact us.

Feedback:

We know these are major changes and the primary care service feels unfamiliar to lots of our patients. We care deeply about the service we provide and all our patients and are constantly looking for ways to improve and make things easier for everyone. We have had lots of positive feedback recently and we are so grateful for this. The team are honestly working harder than we have ever worked before and a small word of encouragement really makes a difference. We know that some patients are unhappy with how things are though and we are sorry when we hear that. We listen carefully to all constructive feedback and would encourage you to continue to help us to improve with your suggestions, which are often really helpful. Practices are receiving a massive increase in complaints. Each complaint takes staff away from patient care to respond to. Before complaining, think whether it is appropriate – is it due to an error or mistake which the practice should know about to change or improve their services? Or is it relating to the significant reduction in the current capacity to provide services by practices or hospitals and therefore no change is possible?

Thanks for taking the time to read this; we hope you have found it helpful.

The Williamwood Team.