Modern General Practice Overview
Many of you will be aware of the need to address changing patient expectations and patterns of demand and optimise the routes of access now that we have digital tools in place and a wider primary care team to deliver. The modern general practice model is a way of organising work in general practice to help enable practices to continue to provide fair and safe care in the context of increased demand, while also supporting the sustainability of services and an improved experience for both patients and staff. This model is a way of organising work in general practice that enables practices to:
- see all patient need, by providing inclusive, straightforward online and telephone access
- understand all need through structured information gathering
- prioritise and allocate need safely and equitably (including continuity of care)
- make best use of other primary care services and the multi-professional team
- improve the efficiency of their processes and reduce duplication.
The National General Practice Improvement Programme (GPIP) provides a three-month support package made available as part of the Primary Care Access Recovery Plan, includes facilitated in-person sessions, data diagnosis and tailored analysis to understand and manage demand and capacity. Different levels of support are available, tailored to the needs of individual practices, and there is also a cross-PCN offer for those who would find it most useful. The three-month support package, made available as part of the Primary Care Access Recovery Plan, includes facilitated in-person sessions, data diagnosis and tailored analysis to understand and manage demand and capacity.
A good starting point is to understand what is happening with appointments as opposed to what is perceived to be happening. Data and evidence can inform and influence discussions from decision-making within the practice. Data can be collected from telephone calls, online consultation systems, and appointment systems.
For example, appointment types that occur on Mondays, which are usually assumed to be the busiest day, can be analysed. Another common way of finding demand and capacity data is through the slot type in the appointment book, which might be through a GP Demand and Capacity Planning Tool or the clinical system. If slot types are used correctly, they reflect the type of work done, as well as times associated with and taken for the work.
GPAD, Online Consultation, and Telephony Data can all help understand what activity looks like, and clinical systems may have workload tools that can help see patterns of demand versus capacity. demand and capacity tools provided by the ICS and/or funded by the NHSE South Region can further highlight these trends and support operational decision-making.
Benefits for GP practice
- can provide data to support decision-making within the practice
- allocate resources and better manage workload across the day, week and year
- identify what type of patient need goes where (to other services, type of healthcare professional)
- improve care navigation, reduce avoidable appointments and avoid duplication of work for patients and staff
- understand the volume of need to inform capacity and skill mix requirements and inform how to distribute available capacity
- understand how much demand same-day demand versus routine demand (and understand variation by day of the week)
- supports planning appointment books and avoids clinicians needing to squeeze in ‘urgent extras’
- helps to articulate in a more timely and accurate manner the pressures faced by general practice, which, along with potentially identifying public health issues at an earlier stage, also facilitates the provision of external support in a more responsive way
Benefits for patients
- appointments are allocated based on clinical need and prioritisation rather than first come, first served
- more routine appointments available to book directly
- patients directed to appropriate modality for their needs
- service offers can be tailored to better match demand
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