Changes to accessing treatment and care for patients | Latest updates

The Primary Care Access Recovery programme was launched in May with the aim of improving patient access to primary care and to help tackle some of the pressures facing GPs and other services.

The plan sets out two ambitions; to tackle the 8:00 am rush and reduce the number of people struggling to contact their practice and for patients to know on the day they contact their practice how their request will be managed.

These ambitions will be achieved by:

• Empowering patients to manage their own health, through the use of the NHS website and the NHS App.
• Implementing Modern General Practice Access, moving to digital systems and improve access to GP services.
• Building capacity, with larger multidisciplinary teams to support patients, more new doctors and the retention and return of experienced GPs
• Cutting bureaucracy; by improving the connection between primary and secondary care.
   

There have been changes throughout 2023 which are helping people to get the right care more quickly. Here are 12 of these benefits – one for every day of Christmas.

• More appointments in general practice. In October there were more than 480,000 additional general practice appointments compared to October 2022 thanks to the hard work of general practice teams. The Government has also confirmed that the additional 50 million general practice appointments manifesto commitment has been met, with 8.28 million being the Midlands part of this.
   
• There are more staff working in General Practice. More than 2,600 additional staff working in surgeries in the East Midlands and more than 3,200 additional staff in the West Midlands. People might often find themselves seeing a nurse, pharmacist or paramedic instead of a GP.

Sinéad Love, receptionist at Hollybrook Medical Centre, Derby, said: "When people call, I ask them how long they have had symptoms, is it something that is new, or have you had it before? If it's something sudden and serious that makes me think it would be suitable for our paramedic. If it's something that is musculoskeletal, I would think about making an appointment with our  physiotherapist. If it's something that is continuous and complex - those are the cases where I would make an appointment with the GP."

Paul Whitfield, paramedic at Hollybrook Medical Centre, Derby, said: "I tend to deal with sudden and serious illnesses. I am able to assess patients for conditions such as coughs and colds and cancer symptoms. I can  prescribe medicines and refer on to a specialist for further investigation in the same way as a GP. I have 15-minute appointment times, so I have more time to understand the patient and what their problems are."

• More than 85% of Midlands practices now offer patients access to their GP records online via the NHS App.

Dr Shammy Noor is a GP Partner at Darwin Medical practice in Lichfield. He says: “Our patients have been able to see their records for around a year, and this is proving popular with our staff and with patients. It is now common for staff to tell patients to look on the App for test results and what to do next rather than asking them to phone or call back in. It is also a good way of helping patients to retain information we give them and to go back and look at it rather than relying on what we have spoken about in consultation.”

• In September there were more than 287,000 submissions to general practices in the Midlands using online forms to ask for appointments, repeat prescriptions or for other advice or support. Now, patients have a choice whether to contact practices by phone, in person or by online forms.

At Greenridge Primary Care Centre, based in Billesley, Birmingham, GP Partner Dr Amanda Gough and her team are able to better determine the right person, the right timeframe and right setting to meet the needs of patients by using an online form to communicate requests for appointments, prescriptions  or administrative tasks such as FIT notes. “We are now able to manage requests in a far more effective manner and the number of phone calls in to the practice have reduced by 20% meaning it is much easier for patients to  get in touch.”

• 50% of Midlands patients aged 13 and over are now registered for the NHS App and in November, there were more than 4.2 million log ins to enable  repeat prescriptions to be ordered, general practice appointments to be booked and rearranged as well as GP records to be viewed saving time for both patients and staff and making it more straightforward for patients.

Rupesh Thakkar is chief pharmacist with Solihull Healthcare Partnership in the West Midlands. “Prior to promoting the use of ordering repeat prescriptions on the App, we used to get so many calls to our surgeries asking to change pharmacy nominations, checking if prescriptions had been signed by GPs and were already sent to the pharmacy.

“Patients have told us that it is a real benefit being able to order via the App – they can take more control rather than having to visit or phone the practice. At our PCN alone we have a steady rate of 400-450 repeat prescription requests made via the App – saving time for patients and staff alike.”

• By the end of March all of the Midlands 1289 GP practices should be using improved cloud-based telephony for their telephone systems which includes call queuing, call routing and call back options for patients so helping to reduce the length of time patients wait on the phone trying to get through to the practice for an appointment or for another query.

The Hereford Medical Group introduced new cloud-based telephony earlier this year. Dr Ian Roper, GP partner said: “Our patients tell us that has made a  real difference to how they call our practice. Instead of being in a queue of  several people waiting for their turn they have options for us to call them back. It has also helped us to see far more about how patients contact the surgery    and has substantially reduced the number of calls we lose through patients not waiting for an answer.”

• 34% of practices now offer patients the chance to register as a new patient online. That figure is increasing all the time and means that prospective patients don’t need to attend their surgery in person to register.

Donna Wiits, Practice Manager, Abbey Medical Centre in Daventry said: "We signed up to the Register with a GP Surgery Service just over a month ago now and we’ve already received in excess of 100 new registrations.  Our Patient Support Team are spending less time scanning in paper registration forms, checking documents when these are provided, and also trying to decipher patients handwriting!  This also means less calls back to patients to verify the information they have given and therefore speeds up the process for both our staff and the new patient.

"The Service is usually able to match patients to their NHS numbers, so they are easier to find on the spine and quicker to register them with our Practice. We also knew lots of parents who had recently given birth and had not registered their child, so we sent them a message directing them to our website which has a link to the Register with a GP Surgery Service, and we found that this was much more convenient for them, rather than them having to come into the Practice to complete a registration form."

• In 2023 pharmacists started offering repeat oral contraception to women who had already been prescribed it by a GP or sexual health clinic. Since 01 December this service has been extended to allow pharmacists to start women off on oral contraception following all the appropriate medical checks. So far, more than 1,000 Midlands pharmacists have signed up – 50% of Midlands pharmacies.

Cymran Kandola, pharmacist at Wren’s Nest Pharmacy in Dudley said: “We’re proud to offer the NHS oral contraception service in Dudley as we are always looking for new ways to deliver quality, vital services to those who use our pharmacy.

“The service plays a key part in the reproductive health of females of childbearing age. Uptake has been great, we have seen over 90 patients who can walk in or make an appointment to be seen promptly.”

• The number of people choosing to get their blood pressure checked in a local pharmacy is increasing. In August more than 24,200 people got their blood pressure checked in pharmacies. Free for people over 40 and with no history of hypertension these checks are estimated to have prevented more than 1,350 heart attacks and strokes nationally in the first year.

Emma Anderson is a pharmacist at Evans Pharmacy at East Leake in Leicestershire, where they are having a second consultation room fitted to accommodate more consultations and checks. “Like many other pharmacies we offer NHS blood pressure checks to people over 40 years of age who do not already have their blood pressure checked regularly by their GP practice.

“This takes less than ten minutes. If your reading is high, we can offer you gold standard 24-hour blood pressure monitoring and support you with a GP referral and life-style advice. We also have services to support people starting medicines for blood pressure.”

• More patients are benefitting from the expertise and advice of community pharmacists when referred by their GP practice for minor illnesses or urgent supply of regular medicines. In November 12,617 referrals were made by practices to pharmacists in the Midlands.

Pete Johal is the pharmacist at Calow Pharmacy in Chesterfield. He said, “The referral scheme allows us to use more of our professional skills and expertise. Every patient is seen in a consultation room in a confidential environment whether the consultation is by phone or in person and we follow the same line of questioning, advice and treatment as if you were in the GP surgery.

“If we need additional advice, or believe the patient does need additional care, we will call a patient’s GP practice direct, NHS 111 or alternatively call 999.”

•  More patients are able to go straight to their pharmacist for advice and treatments for a range of conditions such as urinary tract infections, acute bacterial conjunctivitis and infected insect bites.

Imran Mohammed, pharmacist at Orchard Pharmacy in Mansfield said, “We are providing around 120 consultations a month together with advice and treatment. That’s 120 patients who are being seen quicker and at a location convenient to them.”

• More people are now able to self-refer for some conditions for instance audiology for older people, weight management services and community podiatry.

From September, older people in the Staffordshire, Stoke on Trent region  have been able to self-refer into the NHS audiology service if they are eligible by completion of an online form. Once complete, and if eligible, patients can then self-refer to a provider of their choice. Audiology self-referral -  Staffordshire and Stoke-on-Trent, ICS (staffsstokeics.org.uk)

Initiatives will be developed further in 2024, meaning that all patients will start to see real improvements when they seek advice, care or treatment from general practice.