In January 2018, we launched Health Jobs BNSSG, a recruitment microsite designed to support practices in attracting the best people to come and work with them. On the site, job seekers can find:
The benefits of living and working in Bristol, North Somerset and South Gloucestershire
Information about the dynamic general practice working environment, including the different roles available
Testimonials from current staff in BNSSG GP practices
Practice profiles that demonstrate the unique characteristics of local practices
Opportunity to register for jobs by email alert
In the last 8 months, the site has been visited more than 24,000 times and there have been over 32,000 job views. We’ve advertised 250 general practice jobs and around 40% of practices have used the site to advertise a role in the last 3 months. It’s brilliant to see the site being used. We continue to use paid traffic drivers, including social media campaigns and pay-per-click Google advertising. We recently posted another advert in the BMJ to raise brand awareness. Practices are also supporting us, with one practice being responsible for approximately 30 visits to the site each month as they have linked to it prominently on their vacancies page.
The feedback we’ve received from practices so far has been largely positive, but it’s often difficult to identify where applicants came across adverts if they are posted on a number of sites.
In general practice, everyone is feeling the strain of increased demand, constraints of workforce and income and increasing paperwork. We need to look at ways to reduce workload while maintaining patient quality, safety and experience.
At our shareholders’ meeting in November 2017, a local GP called Nicola McGuinness gave a brilliant presentation about how her practice had started using text messages to send patients results of investigations and tests. Practices hear frequently from patients that making contact with the surgery can be difficult and often many of the calls to practices are from patients who are ringing to pick up their results. It is estimated that approximately 70% of tests are satisfactory and require no further action. If a practice were to contact these patients proactively it would avoid the need for patients to ring in and, in doing so, give a better service to these patients. Furthermore, it would improve access for other patients in need of contacting the surgery. After the presentation, a huge number of practices expressed interest in having access to guidance so they could set this up for themselves.
Over the last few months, we have been working with Nicola’s practice and one other to embed the texting results project and to develop information, create training materials and refine the process so we can share it out to others. We have now published a set of guidance documents and videos to all of our practices. While this functionality is not new, our work will help practices to understand and navigate some of the implications of working in this way. We anticipate it will be very popular with practices, especially as feedback from the pilot practice has been so positive. One GP said “it has revolutionised the efficiency of my communication with patients and has prevented them from getting mixed or unclear messages about their management. Reports back from patients are fantastic – the majority love it.”
In August 2016, we launched the Frontline Customer Service training programme in partnership with The Development People. In the first 13 months, we trained 700 members of non-clinical patient-facing staff. By the end of this year, we expect to have trained a further 300, taking the total to over 1000 members of staff from more than 70 practices. This programme has had incredible reach, and consistently excellent feedback from practices. One practice manager said: “Our team still talk about this course two years later andutilise the learnings on a daily basis“.
Thie idea for this programme came from our One Care Consortium project on improving practice telephony. To maximise the benefit of any new telephone system, the staff using that system need to have had consistent call handling training, so we worked in partnership with practices to develop a programme that would deliver just that. The course then evolved to include much more, and now also aims to introduce:
Consistency of messages to patients
Evaluation processes for managers
Assertiveness when dealing with challenging situations
Sharing of best practice
It also acts as an important foundation on which practices can start to implement healthcare navigation (also known as active signposting), which has been incentivised by NHS England as part of the GP Forward View.
The programme also benefits patients, as they receive a more consistent service from a more confident member of the team, who can start to offer support in directing them towards the right service. If you want to know more about this brilliant training programme, get in touch!
We have made a brand new animation for our practices to inform them about this exciting piece of work that will launch in October. Watch it below!
Building on the analytics work we have done over the last two years, our practices told us they wanted more up-to-date intelligence on activity, so we’re developing a model that does just that. We will be regularly delivering key activity metrics to each practice, such as telephony demand and appointment utilisation by clinician type, clinical profile and routine/urgent demand. This allows us to plot activity trends. Practices will also be able to set limits or thresholds for each metric, which could inform contingency plans between practices and across the system. We are really excited about this development, and once you’ve watched the video, we think you will be too!
We’re excited to announce that we have teamed up with Health and Care Videos to create a One Care patient information video library for BNSSG practices and their patients. This library consists of over 340 simple videos, which can support patients to understand their condition, find simple self-care advice and learn about a wide range of health topics. For the first two months, all practices will be able to access the videos using a link on the One Care website. From 1 October, the videos will go live on the website of any practice who has contacted us to express interest in piloting this new way of working. The trial will then be available for a six month period until 1 April 2019.
We will be carefully evaluating the success of this pilot and will make a decision in early 2019 regarding next steps following the trial period. We are excited to understand more about the benefits this could have for patients and practices in Bristol, North Somerset and South Gloucestershire.
On Thursday 5 July, the NHS celebrated its 70th birthday and we marked the occasion at One Care by holding an NHS Big7Tea party at our head office. Throughout the day we held a bake sale raising money for the RCN Foundation, we took feedback from colleagues about what they love about the NHS, and posted a Twitter moment to share what we were doing.
After an excellent case-study session by a local GP at our shareholders’ event in November, a number of practices expressed interest in using text messages to send patients results of investigations and tests. We are now working with the three pilot practices to embed the texting results project and to develop information, create training materials and refine the process for others. These materials will then be shared with all practices as part of a package that they can pick up and integrate into their own way of working. It is estimated that approximately 70% of tests are satisfactory and require no further action, meaning that this way of working can drastically reduce the number of phone calls a practice receives, which improves access for all.
The CLAHRC have also produced some other easy-to-digest materials that give an overview of the recommendations. Firstly, you can see the highlights in a printable A5 format in this CLAHRC BITE. Watching the video abstract below, presented by one of the researchers, is another way to find out more.
We are so excited that this work means that we have been able to add to the national evidence-base around the use of e-consultations. Online consultations are one of a number of innovative ways to address the sustainability of general practice, and understanding more about the environment and conditions in which they function well allows us to offer best-value to practices and patients.
This graphic shows Bristol, North Somerset and South Gloucestershire split into the three CCGs, six localities and finally the 16 clusters with deprivation levels shown for each. Deprivation (measured here by IMD 2015) is associated with increased utilisation of local health services.
We can evidence through the stock take project we were part of last year that deprivation is significantly associated with increased A&E attendance and emergency admissions.
We are currently working on a ‘refresh’ of last year’s stock take, now called the General Practice Analytics Review. Reports are being published to practices shortly. Practices will be able to see their position compared to their local and national peers on a huge amount of metrics (practice activity, secondary care, telephony, out of hours, QOF, prescribing metrics, surveys, workforce metrics and more). We also have the ability to deep dive into certain metrics that may be of interest to practices, such as the relationship between deprivation (as seen above) and secondary care activity or practice activity.
Understanding practice activity and demand can inform how they deploy their staff, which in turn can contribute to improved patient access. Clusters and localities will also be given the opportunity to request collective reports. Understanding the similarities and differences between practices can inform collaborative working.
We are working with PhysioNet Bristol, a local partnership of 26 well-established physiotherapy clinics, to offer an MSK assessment service in the early mornings, evenings and weekends. It is now available to every One Care practice across Bristol, North Somerset and South Gloucestershire. Following clinical triage from a GP or nurse or non-clinical triage from a receptionist, patients can be booked in to receive a 30 minute face-to-face consultation with a physiotherapist at a location close to their registered practice. The service is suitable for patients with acute muscle, joint or spine pain who are 18 and over. Their appointment will take place within five working days.
Did you know that one in seven GP consultations are related to MSK conditions? This service means that patients can access services quickly and be seen by a specialist who can give targeted advice. It also releases resources and frees up appointments in GP practices.
In January, there were a total of 855 bookings made into this service. We expect numbers for February to increase further, as a number of practices began offering this service after 1 January. We are currently visiting our practices with a physiotherapist from PhysioNet to explain the service and the benefits for patients and staff.
Patient feedback for the service has been very good so far and we have recently launched a new survey to ensure we are able to monitor patient experience more effectively.
“Seen within a few days. I could attend after work which was perfect and the physio was excellent.”