An end to the 8am rush

Finding a cure to the endemic primary care 8am rush¹ is critical to NHS recovery plans.  And, at last, a remedy for this primary care malaise has been found.

We recently spoke to Dr. Richard Nedjati (a GP at ManorCourt Surgery in Nuneaton) about the transformation he has introduced.  As well as being a GP and Partner at Manor Court (with 8.7k patients), Dr. Nedjati is also a Clinical Director at Nuneaton and Bedworth PCN, which looks after 130k patients in the Midlands.

Over the COVID peak, Manor Court acquired an online patient access tool.  Unfortunately, they found that it actually increased workload for both GPs and receptionists.  By giving greater patient access, the number of requests received rose.  With no extra resource to deal with the added load, Manor Court ended up restricting online access times.  Staff had a real fear of being drowned by the flood of demand.

The system adopted by Manor Court simply forwarded online triage forms to a receptionist.  Early experimentation with this online patient access tool led to one clear conclusion.  Any robust process had to have a clinician to review incoming requests.  The receptionists alone were unable to make the right decisions as to which patients needed to be seen on the same day and which ones could be seen in a week’s time.  

The need to dedicate a GP to triage inevitably negatively impacted the number of patients that could be seen. Despite the online patient request system, other patients complained about being kept waiting on the phone for up to an hour.  The demand every morning was high; on Mondays it was overwhelming.  Something had to change.

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Urgent Remedy Needed

Dr. Nedjati searched for alternatives to manage patient requests and came across Rapid Health’s Smart Triage.  Manor Court decided to adopt Smart Triage and have been using it now for over six months. Admittedly, they implemented the features of Smart Triage at a cautious pace, but as they got to grips with its true capability, they’ve realised increasing benefit.

The system is currently triaging patients and putting suitable appointments straight into clinicians’ diaries.   In fact, by offering pre-bookable appointments directly to patients online (not just same day), the practice has benefited from an improved operating model. Plus, patients benefit from having system access 24 hours a day.  The system is now being used for around two thirds of appointment bookings, releasing the receptionists and phone system for those unable to seek appointments online.

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Change For Better

Receptionists have noticed that there are far fewer calls coming into the surgery, particularly at 8am. Both they and the clinicians are delighted with the system and see it as a tangible improvement to their work balance. Rather than add to their workload, it saves everyone in the practice team time; time they can use to see and care for patients.

Those patients needing a same-day appointment are now getting one.  The system does the job that care navigators used to do.  Plus, the notes it putsinto the electronic patient record make the triage outcome clear for theclinician and any areas of concern are highlighted.

The added benefit of introducing Smart Triage is that the whole team no longer dreads Monday mornings. Even the practice sceptics have transformed their view.  

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And Into The Future

Thankfully, for Manor Court at least, the 8am rush is now a distant nightmare.  And now, as the system has been a proven success at one practice, Smart Triage will be rolled out across the 16 practice PCN over summer, covering 130,000 patients.  

Dr. Nedjati’s advice to other practices is to embrace Smart Triage, work with Rapid Health, and enjoy the benefits of letting the system do a better, faster job than before.  

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References

1.     Delivery plan for recovering access to primary care (england.nhs.uk)

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