As both the North Swindon MP and a local resident (registered at Taw Hill medical practise) I have been as frustrated as other patients with the recent issues following the change of system. Whilst, the aims of the new medical hub are good and based on increasing patient outcomes; I think we are all agreed that the implementation has been very poor.
Background
The majority of GP practices in Swindon (and the UK) are owned and run by GPs (something which has been allowed since 2005-6) with the vast majority working to NHS contracts, following NHS guidelines and seeing NHS patients.
A number of local GPs in Swindon chose to receive the support services of IMH and have said that this has allowed them to stabilise their GP practices & focus more on clinical decisions. A few practices have seen solid improvements since seeking support from IMH (they are not new to Swindon and the CCG).
This sort of collaborative approach is not new as we already have the Wyvern Health Hub in Swindon.
Why was the decision made?
The GP workload has become difficult with more time being spent on managing their back office and not enough time spent looking after patients.
GPs and surgeries have been looking at ways in which they can work collaboratively, reduce waste and increase access to appointments for patients.
There have also been issues with the number of GPs available across the surgeries with over half of GPs over the age of 50 likely to retire in the next 5 years and 25% wish to reduce the number of days they work. It also takes 7 years to train a new GP so whilst more is being done to recruit GPs, there is always demand for more. Swindon itself has recently found it challenging to recruit GPs with extra funding being sought to attract newly qualified GPs.
The hub aims to change the environment that GPs work in to ensure that they spend more time with patients, and less time dealing with back office.
In their own words: “our patients are at the heart of everything we do and changing the way we work will allow us to provide you with greater choice, improve access, reduce waiting times and make GP’s more available for when they are really needed.”
Issues arising from the changeover:
As per my previous updates, I have made it clear that:
- The telephone system, has not been working and is still not working. I have been in daily contact with IMH and the CCG, reporting the experiences of local residents and making it clear that there are problems with the phones, and that their telephone data (which states an average 4 minutes wait time) is wrong. I have also made it clear that the telephone system isn’t working on call backs, as some people are experiencing being cut off when they receive their call back.
- The communication about the whole changes had been non-existent, which has made the whole experience worse for residents and got the new system off to a bad start. Neither I nor Borough Councillors were informed of the changes before happened.
- Online booking. This was something that residents had quite rightly raised and we made the point that people were being told different things on different websites, and that we needed one (well-informed) coordinated way for booking online appointments especially to help relieve pressure on the phones. – Online booking went live on the 6th November, including instructions on how to obtain a log-in and password.
- Routine Appointments. I was very concerned to hear that the hub was only taking bookings for urgent, on the day appointments. I raised this and the senior team agreed that this should not be happening, and that residents should be able to book routine GP appointments.
As the local MP, I have been raising these issues, highlighting the problems and pushing the urgent need for improvements every day. Working with Local Councillors, both myself and Cllr Oliver Donachie and I have had meetings with the CCG & IMH, and will continue to do so until this is resolved.
Apology and solutions
The Chief Executive of IMH (who has a medical background within the NHS & within patient safety) has not been in the role long and has apologised sincerely for the disruption caused and has accepted that things need to improve.
In particular, he acknowledges that the absolute main priority is to ensure that people can get through on the phones without excessive waiting times. As part of this, he is recruiting even more call handlers (on top of the 18 which they have at peak times). As the recruitment process can take up to 4 weeks – IMH will be investing a significant amount of money to ensure that their current staff can work overtime to start addressing the high volume of calls.
He is also working with the operators of the telephone system to make sure that the system is working properly.
He also acknowledged that people should be able to book routine appointments and was looking into this urgently.
Other patient information
I have obtained some further information from the hub for residents following queries which were fed in. Please see below:
Increasing staff & clinicians
To reduce the pressure on GPs, we have employed a range of clinicians to get you the best and most appropriate care. For example, we can refer you direct to our Physiotherapists for an initial assessment and treatment advice. While they cannot give ongoing treatment, having that initial assessment and advice can prevent your problem from becoming chronic and more difficult to treat.
Our clinical pharmacists can see patients, carry out full medication reviews, and issue your prescription without needing to see a GP.
Specialist Nurse Practitioners are now employed to cover long term conditions such as Diabetes, COPD and Asthma, which improves continuity of care for each patient. If you have any minor acute aliments, you will most likely be seen by an Advanced Nurse Practitioner, our Specialist Paramedics or our Minor Illness Pharmacist who can issue a prescription if one is required.
Since the merger, we have recruited 3 GP’s, 2 pharmacists, 2 physiotherapists and 3 Advanced Nurse Practitioners. We are still actively recruiting Practice Nurses, GPs and administration staff. Please bear with us while we increase our staffing levels.
Online Facilities
All patients have access to the online facilities. You can book and cancel appointments, order and review your monthly medication and have access to your medical records. To get access you must come to the surgery with photographic identification. You will then be given log on details and a password. Parents can access their child's records up to their 11th Birthday and up to the 16th Birthday, with their permission.
Prescription Ordering Direct Service (POD)
Is run by the local CCG. We are working closely with the service to allow patients to phone and order the monthly medication. Any issues with your medication will be notified to your surgery and actioned. Please allow at least 72 hours to ensure your medication is re-authorised correctly. The pharmacy also needs time to prepare your prescription. If you experience any difficulties with the POD please contact the CCG on 01793 683755.
In Surgery Prescription Requests
You can leave you prescription request in the surgery. This MUST be on the right hand side of your prescription and must be legible. If not it will not be processed as this can lead to errors in prescribing. In order to reduce errors in issuing prescriptions we do not currently take the requests over the telephone at the surgery.
Going forward
I will absolutely keep up the pressure to ensure that these improvements are delivered. I will keep up my daily contact with both the CCG and IMH, will hold further meetings and will continue to feed in the experiences of local residents.
