Steve Taylor Profile picture
Feb 3 7 tweets 3 min read
GP Appts - Workflows - Thread🧵

Annual reviews- predicable constant flow

Monthly - some Chronic disease follow-ups/Mental Health/ Acute follow-ups - more predictable

Acute - illness/change in condition/seasonal/variable

Urgent - unwell/need treatments/assessments

#TeamGP
Is it possible to manage flows through GP surgeries better

Annual reviews for chronic disease

A birthday month spread throughout the year

Pre-booked months ahead of time
🧵/2
Reviews

Also reasonably predictable numbers

Some needing FU from annual reviews

Some FU from acute presentations

Mental health etc

Prebook within the month - arranged at time of previous appt with clinician
🧵/3
Acute presentation

Illness but not unwell - MSK/Something not right/Pain/Cough

Need to be reviewed in the week

Allocated via triage of urgent / patient choice

Can be very variable / seasonal
🧵/4
Urgent - triaged from ‘unwell’ / urgent

In certain circumstances booked on the day
straight in - unwell child/suicidal etc

Fever/Acute illness/Severe pain etc
🧵5
Expectations of patients need to be met with reality of provision

Clear direction of what to expect, when & how

Would this help managed expectation/demand

Ration numbers of appts within clear guidelines

Allow access for the more in need not want
🧵/6
Thoughts #TeamGP

Can we develop appointment booking flows using existing systems?

Would you as a patient understand a system when you know what sort of appointment you need?

What are practices doing

@drgandalf52 @dave_dlt @BenAllenGP @PrimaryCareIT @Parody_RCGP @DrSelvarajah

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More from @DrSteveTaylor

Feb 4
🆘GP Crisis🆘

GP is the most monitored, regulated, inspected area of #NHS

Tick boxes for referral, monitoring, appts, appraisal, learning, training

It has more targets - CQC/NHSE/GMC/Gov

8000 too few GPs - more leaving

1.4m appts/day

#GPCrisis Image
🆘GP Crisis🆘

Too many targets in order earn the money to provide care for patients

Means many appts are provided just for targets - not necessarily for the care patients really need

2🧵 ImageImage
🆘GP Crisis🆘

The CQC inspection process duplicates much of the monitoring done in GP

Adds levels of bureaucracy to over burdened GPs

GPs pay for the inspection

Little support is given

Would be better replaced with a support service helping practices improve

🧵3 ImageImageImageImage
Read 5 tweets
Nov 7, 2022
GP is changing because the needs of community care have changed over the past 30 years
So in addition to Practice Nurses & GPs there are many other clinicians in the team
Thread 🧵👇🏻
1.4million people a day consult a GP practice
Demand has increased (120% compared with 2019) but GP numbers have fallen (1800 fewer since 2015)
In order to manage demand additional systems have been needed as well as using different methods to consult, & additional clinicians 2/
With 7m awaiting hospital treatment, 10m awaiting follow-up appts, an additional 500k are on long term sick leave since 2019
In addition advances in medical care mean many more are on medications, & have regular reviews of care
People live longer, population has increased
3/
Read 8 tweets
Oct 18, 2022
People are waiting hours for ambulances/A&E appts⬆️⬆️
Although 999 calls up, those conveyed to A&E similar to previous yrs, as are A&E attendances
GP appts are up 120% cc 2019
So where is the problem?
Beds? Occupancy? Discharge? Covid?
What is the fix?
#NHSCrisis 1/🧵
Out-patient attendances just returned to 2019 levels
But 7m awaiting treatments
Treatments and investigations below 2019
Hospitals working more slowly
What’s the problem? 2/🧵
GPs continue to consult at records levels
Fewer GPs doing more
Referrals for investigations/2WW remain
Overall referrals to hospitals slightly lower presumably due to backlogs and use of ‘Advice and Guidance’
So GPs aren’t the problem 3/🧵
#GPCrisis @DAUK_GP @BMA_GP
Read 6 tweets
Aug 29, 2022
GPs - Facts or fiction 🧵
They are not seeing patients F2F
Why are waiting rooms are empty
They are not working
AEs are full because GPs aren’t seeing patients
They shut their doors during the pandemic
They are all part-time
They are paid too much
They no longer care
1/9
GPs are not seeing Pts F2F
1.4million people a day have an appt with GP practices
70% Face to Face 980000
2019 1.2m 90% F2F = 1080000
So 200000 less F2F /day
But 200000 more appts a day
There are also less GPs 2000 fewer than 2015 when the Government promised 5000 more now
2/9
Why are GP waiting rooms empty?
During the pandemic GPs were told to restrict waiting rooms & stagger appts by NHS
They did this by triage speaking to pts first, then a F2F if necessary
So what used to be packed waiting rooms with GPs running late
Now seen every 30m & safer
3/9
Read 9 tweets

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