Timeline and Background
- In 2017, the Riverside Medical Practice identified that approximately 45-50% of GP consultations did not require that level of senior clinical expertise.
- On November 28th 2017, The Riverside Medical Practice, the East Lothian Health and Social Care Partnership (ELHSCP) and NHS 24 entered into an innovative collaboration to manage same-day appointment requests.
- Under this new service some patients seeking a same-day appointment have their call passed to NHS24. These patients are safely triaged by NHS24’S healthcare team who provide the patient with the most appropriate method of care. Importantly, those who require to see a GP will still do so, but for some, their needs may be best met by seeing a health professional. Patients with minor ailments or medicine queries could be directed to their community pharmacist, and where appropriate, some may be sign posted to self – help information such as that on the NHS inform webpages.
- On January 29th 2018, the East Lothian Health and Social Care partnership launched its new same-day primary care access service – Collaborative Working for Immediate Care (CWIC) – within the Musselburgh Primary Care Centre and patients from the co-located Eskbridge Medical Practice merged with the Riverside Medical Practice. The CWIC service provides access to Advanced Nurse Practitioners, Mental Health and Musculoskeletal specialists (advanced physiotherapists) all working alongside and supported by GPs in CWIC and Riverside.
- Following the launch of this collaboration, Riverside has been able to offer patients seeking routine GP appointments as an extended 15-minute GP consultation. This extension is to specifically improve the quality during GP consultations by allowing enough time to address often complex issues in more depth.
- The combined practice is now the second largest in the Lothians with circa 19K patients and each week on average:
- Answer 2500 calls
- Provides 800 15 minute GP consultations, 300 Phlebotomy (take bloods) appointments, 300 nurse-led treatment room appointments plus an additional 200-plus for those with chronic or complex needs
- Processes over 1000 items of mail
- Issues 2000 prescriptions
- The Practice has 14 permanent GPs, 4 nurse practitioners, 4 Phlebotomists and 18 non-clinical staff to manage reception, call room and general business requirements
- Weekday opening hours running from 08.00 to 18.00 hrs, and NHS 24’S support from 08.30 – 13.3 hrs
- The Practice operates a Call-Room which is also open from 08.00 until 18.00 hrs and staff are answering calls from patients and supported by a duty doctor, who is based in the same room
- In addition, NHS 24 can triage up to 100 calls per day with Riverside patients
- The Collaborative Working for Immediate Care (CWIC) service has a further 11 Allied Health Professionals providing over 300 hours to Riverside patients. The CWIC service sees over 350 patients a week
The Practice is aware that telephone access is frustrating some of our patients and it is actively working to resolve this. At present, patients go through a two-step process:
- Calls arrive at the telecoms platform, provided by NHS Lothian, and which serves a number of medical practices and departments. The platform is running at maximum capacity and a patient’s call can be delayed here before even entering Riverside’s Call-Room. The Practice is working closely with NHS Lothian colleagues to explore every avenue to help resolve the issue.
- Calls are forwarded to one of Riverside’s eight lines within its Call-Room. Patients are held in a queue with the message of “you are xth in the queue” Once the call is answered, it is processed through the appropriate route. The Practice is currently recruiting additional staff to support access and aim to have additional staff in post by the end of June 2018.
Early indications are that the Riverside Practice is attracting and retaining GPs which is something to celebrate in a difficult climate nationally. As well as keeping the four GPs from the former Eskbridge and the 6 from the former Riverside, the Practice has recruited a further four doctors on permanent contracts. There is currently one short-term vacancy and the Practice is actively working to recruit. The Practice has additional locum doctor support in the interim
Routine GP Appointments
Routine GP appointments are usually bookable three weeks in advance. Some patients report that this is too long and the management team are at the early stages of reconsidering this.