Top tips to reduce missed appointments

“Most clinicians know, when it comes to persuading patients to take their medicines, do a little more exercise or simply turn up for scheduled appointments, it often takes more than just a spoonful of sugar to sweeten the deal.” Martin et al. (2015).

DNAs are a familiar problem to many practices. However, the solution can be simpler than you might think according to recent findings published in the Journal of the Royal Society of Medicine (Martin, Bassi & Dunbar-Rees, 2015).

Increasing engagement with patients is key, and this can be done with minimal effort and some clever nudge tactics:

• Simply asking the patient to repeat the time and date of the appointment over the phone led to a 3.5% drop in DNAs the following month, in the practices taking part.
• Asking patients to write the time and date of their follow-up appointment (instead of nurses filling it out themselves) led to an 18% DNA reduction compared to the previous 6 month average in one nurse-led clinic.
• Communicating on posters how many patients had attended over the past month (rather than had not attended) positively framed the message and promoted the desired behaviour instead of normalising DNAs. This, combined with the other two interventions, reduced DNAs by 32% overall.

Let us know if you decide to implement these tactics at enquiries@onecare.org.uk or tweet us at @onecaretweets

The new ‘accessible information standard’

Practices may need to make changes to ensure they comply with the Accessible Information Standard…

On 24^th June 2015 NHS England advised that the new ‘accessible information standard’ was approved. NHS service providing organisations, which includes GP Practices, must comply with the standard in full by 31^st July 2016.   There are also some preparation and implementation tasks that must be in place before that date.

The aim of the Standard is to establish internal processes so that patients and service users (and where appropriate carers and parents) who have information or communication needs relating to a disability, impairment or sensory loss receive Information in formats that they can understand, and that they receive appropriate support to help them to communicate.

It is of particular relevance to individuals who are blind, deaf, deafblind and / or who have a learning disability, although it should support anyone with information or communication needs relating to a disability, impairment or sensory loss, for example people who have aphasia, autism or a mental health condition which affects their ability to communicate. This includes making sure that people get information in different formats if they need it, for example in large print, braille, easy read or via email or perhaps have longer appointments with their GP.

As part of the accessible information standard, organisations which provide NHS or adult social care must do five things.   They must:

1. Ask people if they have any information or communication needs, and find out how to meet their needs.
2. Record those needs clearly and in a set way.
3. Highlight or flag the person’s file or notes so it is clear that they have information or communication needs and how to meet those needs.
4. Share information about people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so.
5. Take steps to ensure that people receive information which they can access and understand, and receive communication support if they need it.

The implementation timetable is as follows:

NHS England has produced an excellent and comprehensive implementation toolkit which is available www.england.nhs.uk/accessibleinfo

One Care has produced a brief summary of the standard, which is available here.  The summary includes links to other useful guidance and support.

One Care may be able to offer additional support to practices in their implementation and compliance of the standard.   If practices feel additional information, implementation guidance or training would be helpful, please let the One Care team know on enquiries@onecare.org.uk

Transforming general practice: what are the levers for change?

‘Transforming general practice: what are the levers for a change?’ is a report from The Nuffied Trust that was published on 17 June 2015.

The Prime Minister’s Challenge Fund Waves 1 and 2, and ‘The Five Year Forward View’ demonstrate that both the government and NHS leaders believe that “general practice has a key role to play in the reform of the NHS…. But if general practice is to advance with the pace and ambition implied within the ‘Five Year Forward View’, it also needs to develop greater scale and to morph… into larger organisations”.

The report explores how to achieve sustainable change and improvement in general practice and is based on a workshop held at the Nuffield Trust.

It contains a number of case studies and concludes with 6 recommendations:

1. Strike a different balance between financial micro-incentives for small-scale change and investment for sustainable improvement in general practice
2. Create a coherence between existing workforce strategies and training curricula that ensure exposure to new ways of working
3. Develop realistic estimates of the costs of transformation programmes, including the cost of the professional participation
4. Invest in information and data linkage to support transformation
5. Set realistic time frames for delivering outcomes and managing risk
6. Avoid excessive policy to guide primary care transformation.

Read the full report.

Successful outcome of application for PMCF Wave 2 Funding

We are delighted now to confirm that One Care Consortium was successful in securing a further £4.4 million from the Prime Minister’s Challenge Fund (PMCF) Wave 2. This enables us to extend our primary care developments to all practices across Bristol, North Somerset and South Gloucestershire serving almost 1 million patients.

We will therefore be extending an invitation to all practices across Bristol, North Somerset and South Gloucestershire to join the One Care programme and we will be in touch with practices shortly with more information regarding this process.

One Care Consortium is one of 37 PMCF Wave Two pilot schemes which have been chosen to lead the way in testing innovative ways of increasing access and delivering wider transformational change in general practice.

Patient access to general practice: ideas and challenges from the frontline

On 27th February 2015, The Royal College of General Practitioners published a paper which examines a wide range of initiatives to improve patient access to general practice.

Areas explored include:

• Availability and proximity of care: bringing GP services closer to patients
• Timeliness of care
• Ability to see a preferred GP or nurse

A number of brief case studies can also be found within this paper, including initiatives that have been funded by the Prime Minister’s Challenge Fund.

The paper contains information and advice that is relevant to One Care’s vision of improving access in our local area and also stresses the equal importance of both easier access and continuity of care. Proper evaluation and evidence are recognised as vital given the number of different ideas being piloted across different areas.

One Care Consortium Information Event

One Care Consortium will be hosting a large-scale information event on Thursday, 26th March, where we hope to share the primary care service developments that we have initiated over the past year, and our plans for the next 12 months.

The event will include:

• presentations from the One Care Programme Team;
• information regarding the One Care vision;
• an insight into One Care from a practice perspective, from the point of view of both a GP and a Practice Manager;
• group discussions relating to ideas and challenges facing primary care; and
• networking opportunities between practices

WebGP Pilot to begin February 26th

We are happy to announce that our first two pilot practices are ready to “Go Live” with the WebGP suite of online services in the very near future.

Their existing practice websites will allow access to these services from the morning of the 26th February. Using WebGP, patients can find self-care information; pharmacy advice and the opportunity to consult a doctor online.

One Care is looking forward to extending  WebGP services to our remaining pilot practices, with a view to have the next cohort of practices “Going Live” in the coming months.

For more information about WebGP please click here.

One Care Consortium Members Area

We have recently updated the One Care Consortium Members Area! We have added our best EMIS Web Tips and Tricks, along with information from our recent Web GP Training and Information Event held in January 2015 and further information from our Wave One Event from December 2014.

If you are a member of a One Care Consortium organisation and do not know how to access our members area, please contact the Programme Team to find out how.