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.”
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”.
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!”
READ ALSO: Changes made to appointment system as Firs House battles capacity issues | HI HUB
