Guest Blog: Avoidable Appointment Audit, Primary Care Foundation

November 29 2018

*Guest blog by Rick Stern, Primary Care Foundation

All practices across England can now use a free, easy to use, fully automated audit of their appointments, exploring what work could potentially be avoided or passed on others, reducing the workload on your practice. 

Primary Care Foundation have developed a simple tool for reviewing workload within your practice and exploring how things might be managed differently in the future. So far, 450 practices have received reports and a new, fully automated web-based tool is now available at no cost to all practices across England, as all the development work has been fully funded by NHS England. All practices can register for the audit by going to the top of the Home Page of the Primary Care Foundation website.

This audit was developed as part of a research project commissioned by NHS England and the initial results were published in ‘Making Time in General Practice’ available here It helped create the evidence base for the ‘Forward View for General Practice’. Results suggest that, on average, just over a fifth of appointments in general practice are potentially avoidable if other services and support are put in place.  This could include investment in other members of the practice team, in improving communication with hospital services, or better access to social prescribing.

Feedback from practices shows that more than half of practices make immediate changes after looking at the results of the audit.  Practices are improving signposting to get patients to the right person in the team, offering more telephone appointments, making more use of care navigators, advanced nurse practitioners and clinical pharmacists, and making arrangements with the local pharmacy to deal with minor ailments.

One GP commented “the interesting thing is that it made us think about differences in how we work and how we might do things in new ways. The audit is, of course, subjective, how could it not be – the idea of what is avoidable will mean different things in different practices – but at a time when we are drowning in work we need to look at things differently and that’s what made it useful.”

The key has been to get the practice team to talk together about their current workload – collectively developing a better understanding what has to be done by the GP, or what could be picked up by a nurse, the practice pharmacist or GP associate.  Or even what might be directed to others outside the practice.  We have also found that when practices carry out the audit as a group – in one case as a group of 58 practices across 3 CCG areas – it points to how whole health communities can invest in general practice as a sustainable way of building the NHS for the future.

For more information visit the audit tool here.

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