Written by Dr Neil Geraghty, GP at Bridgend Group Practice
Demand for healthcare services is on the rise. But those entering – or staying in – the profession, are continuing to deplete. Consequently, primary care is not what it once was, and it’s having to transform to keep pace with this supply-demand challenge. Clinicians have to be selective about the work they take on and weigh up which tasks will have the most benefit to the system, and to the patient.
As the patient backlog grows, time poor clinicians are being forced to juggle three work streams: patient care, driving digital innovation in their practice and upskilling junior GPs. All of which are crucial for a stronger health system, and importantly, will cut contribute to easing the pressures associated with the elective backlog.
Consequently, however, some GP’s are having to merge their practices together to increase resources, cut overhead costs and ensure that more patients can be seen, faster. But, if local practices keep closing their doors to merge together, patients have to travel further for care, and GPs are commuting further to their already demanding jobs.
I therefore question how it is possible for GPs to balance these three crucial elements in a way that keeps their lights on and prioritises the patient.
Driving digital innovation in primary care
Seeing patients face-to-face, as and when they need it, should always be front of mind in primary care.
We’re not looking to replace this with digital services. Instead, we’re looking to digitally innovate to support primary care practitioners in effectively triaging patients, pointing them to the right point of care, at the right time. The goal is to use this as a complementary technology to human decision making, to support us in seeing more patients, more quickly.
This doesn’t mean adding in an extra channel through which over-worked reception staff end up having to deal with irate patients.
At Bridgend Group Practice, we’ve implemented eConsult’s digital triage technology which acts as a digital front door for us, to enable safer access for our patients to our services.
The more efficiently we triage the demand we are experiencing, the more patients we are able see, and the more quickly sick patients can be treated – whether face to face or online.
The eConsult system we’re using has a series of carefully curated questions built into it for triage, as designed by clinical experts. Its inbuilt flagging system then helps our staff to quickly and accurately assess the patient’s condition and the next steps for treating it. For example, should someone present with symptoms of a headache, that actually point to something more serious, the flagging system will alert us to this patient straight away, routing them to the front of the triage process for more immediate care. We want our patients to see this technology as the first two minutes of their GP appointment, gathering the information needed to make an accurate diagnosis, not just a tool for booking it.
So far, we’ve found that this technology has been incredibly helpful to us in routing patients to the correct diagnostic pathways, at speed.
Training and development for new GPs
Upskilling can often fall down the pile as reception phones keep ringing and waiting rooms fill up. But, arguably, if we are to increase the volume of patients seen, we need more skilled clinicians to care for them.
At Bridgend group practice we strive to be at the forefront for digital innovation, of which training is at the centre. Moving to a total triage system meant we needed to invest time to train our staff for a new way of working to encourage them to think differently about dealing with patient requests. For example, questioning who is the best person to see a specific patient.
This has meant we have empowered our staff to make decisions on clinical need and to utilise our wider multi -disciplinary team both in house and in the local community more effectively. This decision-making process is backed up with access to our own care navigation tool as well as having 2 of our highly skilled GP’s assigned to the care navigation process on a daily basis.
This new model of working has been enhanced by the development of our digital triage tool, eConsult. The use of eConsult Smart inbox technology, and the use of patient self-book functionality coupled with a change to cloud-based telephony have streamlined the patient journey from first contact to clinician engagement.
The move to digital triage means long queues and overflowing waiting rooms should no longer need to be associated with the GP surgery. Instead of working tirelessly to get on top of the backlog – with no end in sight – with technology integrated into the practice, it becomes possible to free up clinician time to focus on where value can be added – from upskilling the team, to seeing more patients who need it, quickly.
Image: stock photo