Q. How many patients are likely to be referred to NHS 111 once the list is full?
A: It is difficult to estimate how many patients will be referred to NHS 111 or other services once the list is full as this depends upon demand, which fluctuates daily, and if we have a GP on holiday or off sick. In the period February to April 2023, the extras per day varied from 2.4 – 6.2 patients.
Q. The article mentions pharmacy triage but not nurse or paramedic.
A: Pharmacy is mentioned in the article as one of the services our reception team will direct you to. We do not have a pharmacist or paramedic doing triage. We are following the ‘care navigation’ model instead of full triage which means the reception team direct patients to other services they feel can help rather than a clinician assessing all patients and booking appointments.
Q. It also looks like first come first served on the 25 appointments. Who makes the call on urgent? And prioritises in a way that doesn’t disadvantage those who may need them most?
A. Our reception team assess the urgency of the call and will be care navigating all calls regardless of when they are received. This means all those that are able to use the other services available will be directed to do so. On days where we have high demand, for conditions the other services can’t help with, our appointments will get booked up quickly and patients will be directed to NHS 111. We appreciate this isn’t ideal but our GPs cannot continue to work the incredibly long hours they have been.
Q: Does it mean if you can’t get one of the 25 appointments you can get one the following day? Or do you have to try and be first in the next day?
A: We have urgent ‘on the day’ appointments and ‘routine’ which are typically booked up at least 2 weeks in advance. The only way you would get an appointment the following day is if we have had a cancellation. Under the Government’s ‘Delivery Plan for Recovering Access to Primary Care’ we are no longer allowed to tell patients to call back the following day.
Q: This will create pressure for the receptionists. Are they being supported? Some people may be angry and it upset if they think the need an urgent contact and won’t get them.
A: We agree there are going to be unhappy patients and we hope our communication pre-warning patients will mean that they are understanding and kind towards our reception team. Our receptionists are receiving additional training and are supported by the GPs and managers with zero tolerance towards abuse.
Q: Will the change be tracked and what will happen if it creates patient safety issues?
A: We are unable to track patients being directed to other services as our systems do not link up. The other services all have red flag processes which means they will direct patients back to us (or NHS 111 or A&E) if they feel they are unable to help or have concerns. We will monitor complaints and continue to investigate significant events if they occur. The alternative of allowing our GPs to continue to work 12 hour days also risks patient safety due to mistakes being made through rushing, tiredness and GP burnout.
Q: How and to whom should people complain too? Given that in essence that is about money?
A: We suggest patients write to NHS England who have put together the ‘Delivery Plan’ NHS England
Q: The BMA is a Union. What is the view of the General Medical Council (GMC) and Royal College of GPs (RCGP)?
A: Our Local Medical Council (LMC) and RCGP are advising GP practices to put in place the recommendations of the BMA’s ‘safe working in general practice’.
