Understanding patient demand in general practice
Barns Medical Practice
At Barns Medical Practice in NHS Ayrshire and Arran the Practice Manager and Assistant Manager had previously collected some data on patient demand but had limited capacity to review, present and analyse it. They were keen to revisit this and understand the number of calls coming into the practice, how many resulted in clinician contact, and how many were handled solely by the administrative team. This information would then give them a high-level view of the alignment between current patient demand and practice capacity.
Developing the data collection tool
The practice team used a demand collection sheet that would allow them to record the number and type of patient requests coming in over the course of one week. The practice team felt the request categories developed for their previous data collection exercise had worked well and decided to use them again. The Practice Manager chose to group together staff members dealing with similar requests, so GPs and advanced nurse practitioners (ANPs) were grouped together and healthcare assistants (HCAs), phlebotomists and nurses were placed together in another group. They included other members of the practice’s aligned multidisciplinary team (MDT), such as the physiotherapist, mental health and community link worker, and their internal pharmacist. Additionally, a separate grid at the bottom of the sheet tracked how many patients were signposted to external services, such as pharmacy, optometry, hospital, the vaccine helpline, and dentistry services. Once the categories were agreed, the Practice Manager checked in with the administrative team, who confirmed that these categories gave “a true reflection of their day” and covered the most common types of requests.
Collecting the data
The practice reported that during the week of data collection, each member of the administrative team kept a data collection sheet with them all day and returned them to the Practice Manager at the end of their shift. The Practice Manager then counted and inputted the figures from each sheet into a central spreadsheet at the end of the day. They felt the collection had gone very well and was easy for the administrative team to do.
Data collection went very smoothly actually considering we were only doing it for a week. It was a much easier collection and much easier to report back on in the spreadsheet than what we had done previously." Practice Manager
The practice team had initially planned to separate the data between the morning and afternoon, but realised it would be easier for the team to record the data on one sheet over the course of the day. After they tested the tool they were satisfied they had chosen the correct categories to track.
Analysing the data
The practice team used an Excel tool that transformed the raw figures into pareto charts and bar charts showing the volume of patient requests for each category. The tool divides into two separate tabs, one to show patient contact with the practice and another to show calls signposted outside of the practice, each with the option to look at the entire week or at each day of the week individually.
The data clearly showed that while many calls were referred directly on to clinicians (especially on Mondays), a significant proportion of phone calls were handled by the administrative team themselves. For the Practice Manager, this confirmed the importance of the administrative team and their depth of knowledge about their patient population, the practice’s range of services, and the local community. It also demonstrated how much the administrative team were already doing to free up the clinical team’s time.
I think it did show the high numbers that [the administrative team] are actually dealing with that don’t get passed on to anybody else, and that was what I was keen to do because I think that shows the value of the practice reception’s role which is really good." Practice Manager
The data also confirmed that many calls are handled within the practice, by either the administrative team, clinicians, or the aligned MDT, with few being signposted outside of the practice. The practice team found it useful to see this confirmed, as it reflected the good working relationship they have with their aligned MDT and their commitment to handling as many patient requests within the practice as possible.
With the aligned team, they trust what my team are asking of them, and we trust them and know their level of capability… we’re all in agreement about the service we can offer, and we reliably deliver that." Practice Manager
This project has inspired the practice team to further analyse the types of work the administrative team are doing by establishing categories for the requests handled only by them and then running a similar data collection exercise. This will help highlight the types of queries they are handling and how they are being managed. They are also interested in the balance of GP/ANP telephone and face-to-face appointments in light of the COVID-19 pandemic and the increased use of telephone consultations and patient concerns about being able to see a GP in person.