(a)
Title of Service:
(b)
Local Position
48 HOUR ACCESS
Recent guidance from the Scottish Executive Health Department has
re-iterated that patients should be able to access a member of a Primary Care
Team within 48 hours. A recent snapshot audit indicates that at least 50% of
GP practices which responded are already meeting this standard. Availability
of 48 hour access often arises in those practices which have participated in
quality schemes such as the Practice Accreditation Scheme, or which already
have open access surgeries.
(c)
Changes to Improve Services
NHS Lothian has initiated pilots of the Advanced Access methodology in
Primary Care. This approach uses a system which measures demand to
allow practices to review their current appointments system, and seek to
match the practice capacity more effectively with the demand.
Up to 20 practices representing all LHCC’s will be given the opportunity to
receive financial and other support to pilot Advanced Access. These pilots
will help us identify the optimal method for progressing this standard across
the whole system. Over and above individual practice action, redesign of
some services may be needed to facilitate access for patients. Patients will
also be informed of and involved in the changes to help their understanding of
the contributions made to their healthcare by all members of the primary care
team. Developments are being steered by a working group representing
Primary Care, NHS Lothian and the LMC.
In looking at development options, this working group has adopted the SEHD
definition of access as contact either face to face or by telephone, with
primary care team members to include GPs, nurses or health visitors.
The Primary Care Trust is leading a Lothian wide group on Demand
Management, reviewing the demand for health services, in primary as well as
secondary care, exploring ways of more effectively managing demand
utilising all available staff and other resources.
How we monitor this
This will be monitored through the PAF process. Access issues already form
part of the assessment criteria for the Practice Accreditation Scheme.
(d)
Outcomes
On completion of the Advanced Access pilots in July 2003 a report will be
produced describing the experiences of the pilot practices and the lessons
learned, and will provide recommendations for action to further roll out the
Advanced Access approach and other initiatives which have facilitated 48
hour access. At this stage, a further survey will be carried out to check the
progress of other non-pilot practices in meeting the 48 hour access target,
through unassisted action or through adoption of nurse triage or other
initiatives.
If successful, the Advanced Access approach will be rolled out across the
Lothians as funding becomes available. Other means of achieving 48 hour
access will be replicated also. Success in the first round Advanced Access
pilots will allow 65% of practices to meet 48 hour access by end July 2003.
Further rounds of pilots and other action should allow Lothian wide 48 hour
access to be achieved by the end of December 2003.