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Admin hub helps manage demand for South Warwickshire GP appointments

South Warwickshire GP (SWGP) Federation’s approach of directing patient calls suitable for a referral to the Community Pharmacist Consultation Service (CPCS) – to a central Admin Hub has seen over 800 patients per month streamed for referral to a community pharmacist.

SWGP Federation serves 32 GP practices in South Warwickshire, covering more than 300,000 patients. In March 2022, Rother House Medical Centre became the first in a pilot scheme of six practices in the South Warwickshire area to be supported by a remote Admin Hub of Federation reception staff. The team provided the service to make better use GP appointment times.

Evidence of the service’s success can be seen in the data from Rother House Medical Centre, where referrals rose from nine per month in March to 59 in July – a 556% increase.

PCNGP practiceRaw
population
Target
p/m
Mar
22
Apr
22
May
22
Jun
22
Jul
22
Stratford
Central
Rother House
Medical Centre
16,48846918286259

A remote call centre that automatically diverted calls to the admin team was set up and worked so seamlessly that the team started looking at other ways to support practices. This led to streaming minor illnesses with the help of extensive CPCS training materials from Coventry and Warwickshire ICB.

Susan Collins, who manages the hub service, says: “The divert service is a win-win-win. It’s good for the patient because they are contacted within three hours by a community pharmacist; the practice wins because they save admin and reception call handling time, and the GP practice can focus on those patients with more complex or urgent health needs.

How the arrangement works:

  • patients phone their GP practice
  • they choose minor ailments from the telephone menu
  • the call is diverted to the Admin Hub
  • a call handler triages the patient for minor illnesses using the CPCS structured form
  • suitable patients are referred to the community pharmacist through the integrated IT system
  • the pharmacist calls the patient within three hours

When patients call their practice and listen to the telephone menu options, they’ll hear several booking options. The minor illness option outlines several examples of minor illnesses such as bites, stings, colds and hay fever, making it clear what the patient is choosing. Once they choose the minor illness option, this is seamlessly diverted to the Federation’s Admin Hub team, which is trained to triage the patient using the CPCS suitability check list. If the patient has any red flags and can’t be referred to a community pharmacist, the team will add the patient to a triage list or book an appointment at the practice.

Susan says: “We create the pharmacy referral through our integrated IT system using the Local Services Option. The process is simple and quick, we check the pharmacy opening hours and the time it takes for us to book a patient for a pharmacy referral is the same as it would be to book a GP or nurse appointment.

Challenges are reduced by having similar systems

It was easy for the Federation to set up automatic call diverts because all practices and PCNs use the same phone system, and they all use the system to assess patient records.

Susan says: “At the moment, we are only diverting six practices because of the physical limitations of the IT system we use and our team size. To refer a patient, we need to open the system for each practice we are supporting and we’ve found that this limit is six instances. However, new technology will help us expand because we are looking to use hubs on our system, making it easier for practices to assess for a referral.

“Another challenge when every practice works differently and has different booking methods was deciding how to handle patients who weren’t suitable for pharmacy referral; it’s vital to agree that with them at the start. It’s been a learning process establishing documents and methods of working.”

Huge learning curve structuring the phone system

One of the challenges in setting up the service in South Warwickshire was getting the practice welcome phone message structure right to avoid patients jumping the queue.

Susan explains: “All GP practices have phone queues in the morning. If you have your ‘To Book appointment’ at the beginning, patients will press number 1 all the time and not listen to the rest of the message.

We changed the call tree to give patients a wider choice of service options, made the minor illness the first option on the phone menu, and moved the ‘Book a GP or nurse appointment’ to the end. By changing the call tree, patients listened to all the options and now chose appropriately.

Keep up with change using good communication

The Admin Hub is a remote service, and communication is key to working successfully. Establishing quick and efficient communication links between the receptionist and back to the practices is essential.

Admin Hub advantages over a standard CPCS service

The Admin Hub takes the pressure off practices because patients have already decided they are not urgent cases by choosing the minor illness option when they call the surgery.

Also, as Susan says: “If a patient does not choose the minor illness option (in practice triage) and requests an appointment, the GP practice would quickly run out of appointments.

It’s frustrating for patients and not an effective use of reception time. By using the Admin Hub (and offering the minor illness call divert), patients choose the minor ailments option without reaching the practice reception team. CPCS offers all practices a way of prioritising patients who need to see a GP, whilst those with a minor illness are offered a consultation with a community pharmacist.”

Another way the Admin Hub benefits patients and GP practices is by diverting calls for short-staffed practices due to illness or holidays. If a practices’ registered patients are taken ill on holiday in England, they phone their normal GP, choose the minor illnesses option, and are forwarded to the Admin Hub, who can then refer them to the pharmacist closest to them.

CPCS offers all practices the facility to refer to a pharmacy near people wherever they are in the country, including when they are on holiday, but only some realise this.

Susan adds: “I’d like to encourage all GP practices to triage patients using the CPCS system because it’s proven to save valuable GP time for essential patients and improve the service we offer patients.”

Last Updated on 31 March 2023