Firs House offered around 6,000 appointments to patients in March, according to new figures. Call handlers dealt with over 6,200 calls and the team spent an average of 21 hours and 15 minutes a day on the phones. The average wait time for callers was three minutes and eight seconds.
The numbers were included in the surgery’s Spring 2025 Information Sheet alongside various other statistics which offer an insight into the heavy demand on the service. It also explains some of the operational changes being put in place to help patients who want to contact the surgery.
Improvements
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Libby Mead, the practice manager, said: “A number of initiatives have gone well in the last 12 months. We introduced a call back system on the phones to alleviate call waiting times for patients.
“We are also working on reducing the routine appointment waiting time, which is currently at five weeks compared to nearly eight weeks this time last year. Firs House has also reduced the time it takes for patients to be referred to other organisations such as hospitals or specialist clinics.”
Total calls
Total call time
Daily average time spent on phone
Average wait time
Number of hospital referrals completed
6,212
446 hours 25 mins
21 hours 15 mins
3 mins 8 secs
551
Total appointments offered
Same day appointments offered
Face-to-face appointments completed
Appointments – ‘Did Not Attend’
Number of prescription items issued
5,957
3,252
3,190
79
1,574
Appointments
Libby Mead – Practice Manager – Firs House Surgery
Approximately 12,800 patients are registered with the surgery’s main site in Station Road, Histon and branch location in Cottenham. There are five GP partners, and a further three GPs employed by the practice. It is also a training practice, and four GP registrars work with them.
Of the 5,957 appointments offered to patients, 3,252 were for the same day. In total, 3,190 face-to-face appointments were completed and 1,574 prescription items were issued.
The data also revealed 79 missed appointments, recorded as “Did Not Attend”.
Last year, in total, it provided 70,412 appointments which calculates on average to be 5.5 appointments per patient.
Surgery’s ‘great work’
David Jenkins, Chair of the Firs House Patient Participation Group, said: “[The Surgery] has done great work recently to make it easier for patients to be in contact and to make appointments. The more stress it can take out of this process the better it will be for everyone.
“At the same time we can all be supportive by ‘choosing the right service’. It’s often not necessary to call the surgery. Simple common sense self medication, a visit to the pharmacy or calling NHS 101 can often result in quicker and easier treatment. This makes it easier for those who really need to see their GP to do so’.”
Advice
Firs House says there are various ways patients can also support staff. These include:
Using online services to order prescriptions where possible and not calling the Surgery;
Limited physical space at the Firs House surgeries in Histon and Cottenham has led them to apply for a change to the catchment boundary within which they provide medical services.
The calculation of a practice’s physical capacity to manage its patient list looks at patient population size compared with its internal area.
Calculations for Firs House Surgery, including the branch location in Cottenham, indicate that they already lack 338m2 of space, and therefore do not even have the recommended capacity or resources to maintain their existing property at present, let alone accommodate growth.
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Implications
If the application is approved by the Cambridgeshire & Peterborough Integrated Care board, residents of properties built for Phase 3A of the Northstowe development would not be eligible to join the practice.
No decision about the application has been made yet, but if it is approved, any residents currently registered with Firs House will remain registered, regardless of whether they are outside any new boundaries, unless a house move takes them outside the new boundary.
Firs House Surgery is a vital service, used by most people in the Village at one time or another. Alison Turnbull chats to Practice Manager, Libby Mead to find out what it takes to keep this key village utility fit and healthy.
Libby Mead has been Practice Manager at Firs House for two years, and has worked in the NHS for the last 20. Although she’s steeped in the world of healthcare, she likens her role as more like that of a headteacher in a school. She explains: “I look after the building maintenance, manage the money, make sure the processes are running smoothly and efficiently, and I oversee how things work, recruiting staff, the systems and processes”.
Of the many challenges of General Practice, lack of spare space is a big issue. Libby says: “There is never money for improvements because the NHS only pays for the treatments being offered, not the buildings. The demand is through the roof – if you pardon the pun – but we’re seriously trying our best. It’s not because we’ve not made appointments available, it’s because everyone is fully booked and there is no further space or any more practitioners available.”
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Libby Mead, Practice Manager at Firs House Surgery
General Practice sees 90% of first patient contact but only gets 9% of the budget. Hospitals get the majority of funding that comes from outside investments – such as drug and procedure research and development.
The Primary Care Network, which includes Firs House, also includes Waterbeach, Willingham and Cottenham. Working together, there are services in the community for people who can’t get into the surgery, and for people transferring out of hospital. Libby says: “They are always stretched, but they are a great team including the District Nurses who visit the housebound, and the Community Matron who visit people who are more temporarily incapacitated”.
Same-day referrals
Villagers will be pleased to hear that Libby is currently working on achieving same-day referrals. She explains: “We can be inundated with referrals to hospitals and with the results and reports that are returned. It was taking a few weeks for these to be processed, but now referrals to hospitals are being processed the same day”.
Sadly it’s not always the case for reports and results coming back from the hospitals as there is no automatic link in the systems. Libby continues: “Communication tends to be limited to referrals via computer systems and the systems don’t quite talk to each other, meaning that reports and documents coming from hospitals have to be manually linked to a patients records.
“Often, patients using My Chart on the NHS app have all the details, but the GP Practices don’t have access. So, if you’re consulting your doctor, it’s a good idea to have My Chart on your phone so you can share it during you appointment. Sometimes it can take 4–5 weeks for reports such as ultrasounds to be sent through to the doctors and we are hindered rather than helped by technology sometimes”.
General Practice and the Trust explained
Libby explains the difference between General Practice (GP) and an NHS Trust. “Each GP has a geographical area which overlaps, to give some patient choice. At Firs House Surgery there are five medical partners who own the building and make decisions about the services offered. Trusts are larger organisations that are centred around the hospitals. The Department of Health NHS England, runs the Integrated Care Board (ICB) and it decides what services are to be made available to GP Practices to offer, for a set price”.
She continues: “These are ‘Local Enhanced Services’ and are associated with Primary Care. For example, the ICB will have data showing what the main issues are, for example, if there are high numbers of people with particular conditions that could be treated well by GP practices. One such condition is diabetes – there are eight parts to holistic wellbeing for people with diabetes, and it’s important the whole person is treated rather than focusing on just their insulin levels”.
The GP practice also offers vaccinations – not only for seasonal flu and childhood disease vaccinations but also those for people travelling overseas. “Currently the take up of vaccinations is very high”, explains Libby “as the nurse practitioners are really good at following up on individuals to make sure everyone knows about the vaccine programme”.
Keeping pace with change
Over her two years at Firs, Libby has seen some significant changes, not least bringing back the telephone booking system with the call-back system for people phoning from 8am for a same-day appointment. Libby explains: “The average wait is 3 minutes 13 seconds for the phone to be answered at these very busy times”.
Firs House website homepage
She shares that it is now recognised that the online-only appointment system was a mistake and excluded many people. The online appointment system is still available for non-urgent and routine appointments – it may take a few days, but 96% are dealt with on the same day and an appointment is arranged within a maximum of eight weeks, making it a good option for booking screening appointments.
Don’t be a DNA
Figures for January show a continued improvement in people turning up for their appointments. In that month there were 73 no-shows which, Libby says, is, “still too many, but so much better than the previous year”. Text message reminders have contributed to this improvement. She continues: “It’s one of the benefits of technology, we’ve set it up in the background of the appointment system, so it happens automatically”.
However, “It is difficult to keep up with demand”, she continues “as there are only 4-5 people working on reception, and there are 24 hours of phone-calls being dealt with every day. And that’s without the paperwork arising from each appointment and queries from doctors.
“Sometimes people come in and are surprised because the waiting room isn’t full – they think we’re not working very hard! But we don’t want people in the waiting room. All appointments available each day will be booked up and if everyone arrives on time, and the doctors can keep to time, then there should be minimal people waiting. The doctors surgery may seem quiet, because everyone is in consultation rooms with patients but, as these are private, the building doesn’t give any indication of the level of activity going on.”
So how best to get that all-important appointment? Libby has this advice: “If you need a routine appointment you can help the system by using the online booking service. If you need to see a doctor quickly, phone us from 8am and use the call-back service. Just remember to keep your phone with you and make sure your volume is turned up!”
Local GP, Dr Emma Baldwin is retiring as a Partner at Firs House, the surgery announced this week.
Dr Baldwin, who has been a partner at the practice since 1997, will leave at the end of March 2023.
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Residents of Histon, Impington and Cottenham have taken to social media sites to express their gratitude for Dr Baldwin’s 26-year service, as well as their sadness at her retirement.
Dr Baldwin has served the villages of H&I as well as Cottenham for 26 years. Photo: Firs House
One Histon resident said: “Dr Baldwin is an absolute legend. She is the cheeriest, most compassionate and caring of GPs – a real sunbeam of loveliness. So many of us have been lucky enough to be under her care for over 20 years.”
An Impington Firs House patient commented: “Dr Baldwin has been an exemplary GP, always offering to go the extra mile for the patients in her medical and pastoral care. We wish her a happy retirement but she will be greatly missed.”
The surgery also praised the long-serving GP, commenting: “Dr Baldwin will be remembered for her unconditional dedication, hard work and commitment to the patients of Histon and Cottenham. We hope the community will join us in wishing her the very best in her future ventures”.
New Recruit
Firs House Surgery has also announced that Dr Ben Curtis will be joining the practice as a new GP partner. He is expected to take up the post in July 2023 and will work across both Firs House and Telegraph Street surgeries.
Paying Tribute
Since publication of this article, Firs House Surgery has announced the following:
Anyone wishing to post a tribute to Dr Baldwin can do so by emailing firsppg@gmail.com with the subject title: “Dr Baldwin”.
Alternatively, from 1 – 31 March dedicated notebooks will be available for your messages at Cottenham and Histon Libraries, Cottenham Community Coffee Shop and St. Andrew’s Centre Histon. All tributes will be collated and presented to Dr. Baldwin when she retires.
Cambridge Northern Villages Primary Care Network at the the Firs House Surgery are looking for these roles to join their team covering practices which include Histon and Impington.
First Contact Physiotherapist to provide the first contact for patients presenting with MKS conditions or symptoms, providing the patient with primary assessment, diagnosis, and management options. Using advanced clinical practice skills and clinical reasoning to provide comprehensive diagnostic and treatment support to simple and complex musculoskeletal conditions and multi-morbidity, mental health and pain management needs. FCPs are the link between primary, secondary, community and acute services and are responsible for managing an integrated care pathway for patients (e.g. by triage and referral, as well as direct management advice). This role will allow patients to experience a high level of care for MSK problems, working closely with GPs and advanced practitioners to provide a management plan and onward care. The closing date is 28 February 2023
Clinical Pharmacist to improve patients health outcomes and of the efficiency of the primary care team by providing direct, accessible and timely medicines expertise, including face to face. Clinical Pharmacists proactively transfer workload relating to medicines optimisation issues to improve patients care safety and free up clinical staff to spend more time on clinical care. The closing date is 28 February 2023
Pharmacy Technician to liaise with patients, clinical and non-clinical staff, hospital and community pharmacists, care homes and patients carers to improve the pharmaceutical care of patients. To support the PCN Clinical Pharmacists as the PCN point of contact for all medicines related matter; to maximise support to all clinical and non-clinical practice staff to improve patient care in relation to all aspects of medicines and their impact. To support in the management of the repeat prescribing process, helping to manage repeat prescription requests, resolving queries where possible and producing prescriptions for clinical review and signature. The closing date is 28 February 2023
Firs House Surgery are recruiting via NHS Jobs for this role.
Practice Manager to manage the day-to-day running of 2 practices at different locations in conjunction with the Reception Manager and Office Manager at each site, and will ensure that all aspects of the practices are operating efficiently and effectively, co-ordinating and enabling the work being undertaken by doctors and staff. The closing date is 29 January 2023. Interviews are planned for Saturday 4th February 2023.
Overwhelmed by excess demand for on-the-day appointments, Firs House surgery has amended its proposed system for booking appointments online to help deal with the intense pressure on medical services. This pressure has led to the surgery having to suspend its new online Patient Triage platform for at least some hours each day to give staff time to assess the medical requests submitted.
Concerned that misinformation about its new system was being discussed on social media, the surgery clarified that the system wasn’t faulty, “This is the same process that was used when the telephone booking system was at capacity”, they explained.
Originally it was intended that the online platform would also be open for bookings overnight and during weekends, but this will no longer be the case – even after the current capacity crisis is over. Based on experience in other surgeries, Firs House expects the number of potential appointment requests would then be too great to enable them to prioritise on the next working day.
Improvements
Despite the capacity issues, the online appointment booking platform introduced by Firs House at the start of the year has been effective at improving wait times for priority appointments. And it has been signalling alternative healthcare providers when medical services aren’t available or required, enabling medical staff to reach the most urgent cases sooner. Experience at other surgeries suggests that as many as 1 in 5 requests could be signposted elsewhere as the system settles down.
Also, although the booking system has had to be suspended each day at some point during the morning, it has on some days been reopened briefly in the afternoon if any appointments are still available. When all bookings were coming in by phone, patients were normally told to try again the following day.
“A little bit of tolerance”
The expectation, based on experience elsewhere, is that it will take at least three months for Firs House and the community to get into their stride and use the new system to its best advantage.
In recent days feedback from surgery staff as well as patients confirm it is now working far better than first-past-the-post telephone systems without any triage capability. One patient posted on social media “I prefer this new system and am very grateful that Firs pursued a different system when the phone system wasn’t working. I completed the form yesterday and spoke with a doctor today.” Another commented “My wife and I have had excellent responses [to an online request] so far, with medication prescribed, and non-urgent appointments set up for next week.”
Some social media comments have been critical of the surgery, but others have recognised the huge pressures they are working under and defended it. One patient pointed out “In a nutshell, too many patients need the services of the local GP team, which it simply doesn’t have the resources to meet. If we want to complain, then maybe to higher authorities than Firs/Telegraph Street may be a way forward.”
Another person called for the community to “be a bit tolerant of initial teething problems.” Someone posted: “We need to be patient while [the system] beds in and the staff get used to it. It’s always hard when a new process and system are introduced, especially if it gets swamped like today. I have a friend in Haddenham whose GP surgery uses this and has for a while. She says it’s way more efficient that the first come first served on the phone system.”
Cambridge Northern Villages PCN which covers 8 GP practices including the Firs House are recruiting via NHS Jobs for these roles.
Pharmacy Technician the role will include delivering effective medicine management and medicines optimisation, improving patient care and being part of a multidisciplinary team, whilst working within the strategic objectives of the PCN. The closing date is 5 December 2022
Clinical Pharmacist to improve patients health outcomes and of the efficiency of the primary care team by providing direct, accessible and timely medicines expertise, including face to face. Clinical Pharmacists proactively transfer workload relating to medicines optimisation issues to improve patients care safety and free up clinical staff to spend more time on clinical care. The closing date is 5 December 2022
First Contact Physiotherapist to provide the first contact for patients presenting with MKS conditions or symptoms, providing the patient with primary assessment, diagnosis, and management options. Using advanced clinical practice skills and clinical reasoning to provide comprehensive diagnostic and treatment support to simple and complex musculoskeletal conditions and multi-morbidity, mental health and pain management needs. The closing date is 5 December 2022
Firs House Surgery are recruiting via NHS Jobs for these roles.
Care Coordinator to use clinical systems to identify, prioritise and contact patients requiring health checks or recalls and coordinate multi-disciplinary working within the practice and to facilitate onward referrals to external services. Liaising with local hospitals to follow up patient referrals and to support the practice in quality improvement programmes with a focus on improved patient care. The closing date is 14 October 2022
Pharmacy Technician to liaise with patients, clinical and non-clinical staff, hospital and community pharmacists, care homes and patients carers to improve the pharmaceutical care of patients. To support the PCN Clinical Pharmacists as the PCN point of contact for all medicines related matter; to maximise support to all clinical and non-clinical practice staff to improve patient care in relation to all aspects of medicines and their impact. The closing date is 14 October 2022
First Contact Physiotherapist to provide the first contact for patients presenting with MKS conditions or symptoms, providing the patient with primary assessment, diagnosis, and management options. Using advanced clinical practice skills and clinical reasoning to provide comprehensive diagnostic and treatment support to simple and complex musculoskeletal conditions and multi-morbidity, mental health and pain management needs. The closing date is 14 October 2022
Clinical Pharmacist to work as part of a multi- disciplinary team in a patient-facing role to clinically assess and treat patients using extensive experience an in-depth knowledge. To be directly responsible for care and prescribing of defined cohort(s) of a patients and to deliver and develop pharmacy led medicines optimisation working with general practice and the wider multidisciplinary team, ensuring practice remains up to date. The closing date is 14 October 2022
Social Prescriber to help strengthen communities and personal resilience, reducing health inequalities by addressing the wider determinant of health such as debt, poor housing and physical inactivity, by increasing peoples active involvement with their local communities. Social prescribing is particularly effective for people living with long term conditions (including support for mental health), for people who are lonely or isolated, or have complex social needs which may affect their wellbeing. The closing date is 17 October 2022
Bank/Casual Receptionist – During Peak Holiday Seasons to offer causal cover during the summer and other school holidays. Applications from University students considered. Please send your CV to the surgery FAO Reception Manager.
