Advanced Access

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Advanced Access

• Tom Campion
• GP Reg Kiriemuir

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• What is it?
• Why did it come about?
• What is involved in setting up?
• Who benefits?
• The future.

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Government..

• Primary care 1st access point to NHS.
• 90 of NHS activity.
• Improving access to primary care top agenda.
• NHS Plan.commitment by december 2004 100 of
  patients will be able to see a GP within 48 hours
  (or primary care professional within 24 hours)

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NPDT.. NPCC

• Service modernisation through National Primary
  Care development team.
• Set up Feb 2000led to National Primary Care
  Collaborative
• Dr.John Oldham.advanced access in primary care
  2001

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Advanced Access

• Aim to improve access to primary care.
• doing todays work today
• Many systems deflect demand to another
  dayprotecting today
• knock on effect on access Magnified

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Advanced Access/ Access Models

• Traditional system urgent non urgent appt. -
  open access (people turn up wait long time to be
  seen)
• Problems- battles between patient/staff
• Gaming system access urgent appt.
• High DNA rate.

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Advanced Access

• Understanding demand/capacity
• Shaping handling of demand
• Contingency plans
• Communicating effectively
• doing todays work today

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Advanced access practical elements

• Daily demand- record total appt requests.
• predictable variation
• Handling of demand- Shaping
• Self help, e-mail, telephone access, group
  consultations
• Reducing backlog- hard work!
• Monitoring- 3rd available appointments
• Plan Do Study Act

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In short

• Work pulled into today to protect future
• No distinction between urgent non-urgent appt.
• Maximum control over workload
• DNA significantly reduced
• No gaming
• High practice staff/patient satisfaction

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Tayside and Advanced Access

• Feb 2001- Advanced access pilot.
• 18 tayside practices involved (inc Kirriemuir)
• Positive responses
• 2002- Dundee practice moved to Advanced access.
• How many are advanced access?

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• Tayside..(May 2003)
• 24 overall improvement in GP appt time.
• 32 practice nurse appt time
• High patient satisfaction.
• WHAT IS EVERYONES THOUGHTS?!

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Any Questions?
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