H.T Practice
Action Planned
The practice will arrange telephone triage training, provide one-on-one training on systems and processes, re-communicate the operational manual, and create a formal channel for team members to raise concerns about operational readiness and workload pressure. (AI summary)
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Dear duty busy May fact day: uniquc long how they :
see each patient for and plan their clinic accordingly. Our opening hours are 07:30 till
18.30. The blank space next to a time slot represents an appointment not utilised by a patient; it was either un-booked or the patient failed to turn up. On 21/8/2018 there were 11 appointments unused: 6 of these 11 unused appointments were in the clinic of the doctor in question: 3 of these 6 unused appointments were in the afternoon. The 5 minutes slots were simple telephone queries. The doctor in question saw 9 patients in the afternoon, face to face consultations This is well below his usual capacity of 16. Regarding home visits. Most of our home visits are phoned through in the morning before Ilam. These are shared out among the doctors on that All home visits requested are triaged by a GP to assess if the patient needed home visit: If we conclude that a home visit is needed we will visit the patient We have never turned down a visit that we felt needed its not in our culture or clinically safe to do so. On this particular day, there were 3 GPs available to carry out home visits Our operational capacity for visit is 4-6 visits for each GP depending o complexity: From memory its extremely rare for us to do 6 visits each; and [ haven't done 6 home visits on one day for 2 years We normally do between 1-2 home visits per GP per this the home visits requirement was very low. Only 2 home visits were requested in the morning both in the same nursing home One of ouf GP triaged the visits requested and went to see both patients as she felt the visits were necessary: The doctor in question and one other GP had no home visit to do in the momning: A call nursing home came through in the afternoon at 14.30.It was given to the doctor in question to deal with as he had no visits in the morning: In answer to your question we have demonstrated that it was not a habitually or afternoon
3) The in question finished afternoon surgery at 17.20,our surgery closed at 18.30. Attached is our home visit protocol In devising our home visit protocol; we have taken advice our LMC (local medical committee). Its & grey area whether we need to visit patient after we closed at 18.30 and handover to our deputised out ofhours service We have taken the view that if a home visit request came through before we closed then we will visit the patient after 18.30. Our home visit protocol stresses that We have all in the past; and will continue to do in the future; carry out late visits after
18.30 the doctor in question had also visited patients after 18.30. they - day: visiting ` home day: On day _ from busy day = doctor from
On this we operated so well below our normal operational capacity that there was ample time to visit the patient after afternoon surgery: There are two other layers of resilience that ate unique to group practice of our size. We have two other surgeries nearby that can lend support when our capacity is reached o1 in emergencies when we have staff sickness. Medlock Vale Medical Practice and Street Medical Centre. These centres are within 1.5 mile rom Highlands and Trafalgar Square practice: Clinicians from these centres can log in our clinical system and notes remotely: This practice of cross cover is well honed and has been executed with success only as recently as last week We had a group training day on 19Th July 2018 The day was dedicated to our group resilience with home visits and emergencies the centre point of our We stress test our resilience and held a to test our staff 'knowledge of our operational policies. In answer to the points you have raised, the doctor in question had plenty of time to visit patient after afternoon surgery: Should he feel that he was unable to s0 for whatever reason there are tWO other colleagues he can ask for help in the same surgery and 4 other colleagues he could rely on from out group: Please see attached a copy of the clinic appointment for 21/08/2018 and copy of our home visit protocol We have reviewed our protocols in light of your letter and we feel that are robust for the current team that we have in place: We continually review our working practices to reflect changes in work load, winter pressure, staff changes and sickness /emergencies as well as structural and systems failures. forward we will:
1) Arrange telephone training fof the doctor in question: To be arranged by accredited third party trainers.
2) Arrange one to one training of out systems and processes for this doctor as well as reassuring him of the apparatus in placed to help him perform his duties
3) Re-communicate our operational manual to all our staff as we had in the recent group training day of 19h July 2018.
4) Create a formal channel for any member of our team to raise concerns about our operational readiness and work load pressure. day - King being training: quiz they - Going tiage - done
I hope you feel that I have answered your concerns, should you any further information please do not hesitate to contact me Cett Post Grad GP education: Senior Partner: HTPractice Ashton-- ~under-Lyne. require
see each patient for and plan their clinic accordingly. Our opening hours are 07:30 till
18.30. The blank space next to a time slot represents an appointment not utilised by a patient; it was either un-booked or the patient failed to turn up. On 21/8/2018 there were 11 appointments unused: 6 of these 11 unused appointments were in the clinic of the doctor in question: 3 of these 6 unused appointments were in the afternoon. The 5 minutes slots were simple telephone queries. The doctor in question saw 9 patients in the afternoon, face to face consultations This is well below his usual capacity of 16. Regarding home visits. Most of our home visits are phoned through in the morning before Ilam. These are shared out among the doctors on that All home visits requested are triaged by a GP to assess if the patient needed home visit: If we conclude that a home visit is needed we will visit the patient We have never turned down a visit that we felt needed its not in our culture or clinically safe to do so. On this particular day, there were 3 GPs available to carry out home visits Our operational capacity for visit is 4-6 visits for each GP depending o complexity: From memory its extremely rare for us to do 6 visits each; and [ haven't done 6 home visits on one day for 2 years We normally do between 1-2 home visits per GP per this the home visits requirement was very low. Only 2 home visits were requested in the morning both in the same nursing home One of ouf GP triaged the visits requested and went to see both patients as she felt the visits were necessary: The doctor in question and one other GP had no home visit to do in the momning: A call nursing home came through in the afternoon at 14.30.It was given to the doctor in question to deal with as he had no visits in the morning: In answer to your question we have demonstrated that it was not a habitually or afternoon
3) The in question finished afternoon surgery at 17.20,our surgery closed at 18.30. Attached is our home visit protocol In devising our home visit protocol; we have taken advice our LMC (local medical committee). Its & grey area whether we need to visit patient after we closed at 18.30 and handover to our deputised out ofhours service We have taken the view that if a home visit request came through before we closed then we will visit the patient after 18.30. Our home visit protocol stresses that We have all in the past; and will continue to do in the future; carry out late visits after
18.30 the doctor in question had also visited patients after 18.30. they - day: visiting ` home day: On day _ from busy day = doctor from
On this we operated so well below our normal operational capacity that there was ample time to visit the patient after afternoon surgery: There are two other layers of resilience that ate unique to group practice of our size. We have two other surgeries nearby that can lend support when our capacity is reached o1 in emergencies when we have staff sickness. Medlock Vale Medical Practice and Street Medical Centre. These centres are within 1.5 mile rom Highlands and Trafalgar Square practice: Clinicians from these centres can log in our clinical system and notes remotely: This practice of cross cover is well honed and has been executed with success only as recently as last week We had a group training day on 19Th July 2018 The day was dedicated to our group resilience with home visits and emergencies the centre point of our We stress test our resilience and held a to test our staff 'knowledge of our operational policies. In answer to the points you have raised, the doctor in question had plenty of time to visit patient after afternoon surgery: Should he feel that he was unable to s0 for whatever reason there are tWO other colleagues he can ask for help in the same surgery and 4 other colleagues he could rely on from out group: Please see attached a copy of the clinic appointment for 21/08/2018 and copy of our home visit protocol We have reviewed our protocols in light of your letter and we feel that are robust for the current team that we have in place: We continually review our working practices to reflect changes in work load, winter pressure, staff changes and sickness /emergencies as well as structural and systems failures. forward we will:
1) Arrange telephone training fof the doctor in question: To be arranged by accredited third party trainers.
2) Arrange one to one training of out systems and processes for this doctor as well as reassuring him of the apparatus in placed to help him perform his duties
3) Re-communicate our operational manual to all our staff as we had in the recent group training day of 19h July 2018.
4) Create a formal channel for any member of our team to raise concerns about our operational readiness and work load pressure. day - King being training: quiz they - Going tiage - done
I hope you feel that I have answered your concerns, should you any further information please do not hesitate to contact me Cett Post Grad GP education: Senior Partner: HTPractice Ashton-- ~under-Lyne. require