Welcome Anne Hooper - Event Facilitator, CCG Lay Member for Patient Engagement Purpose of event: What: One Health Lewisham Patient Participation Group Event Who: Group made up of local PPG representatives Why: Input in to local general practice �At scale� developments Focus: This meeting will focus on �Access� - helping people to command appropriate health care resources in order to preserve or improve their health.
Format of event 12.00pm Lunch and market place stalls 1.00pm Welcome and housekeeping 1.15pm Primary Care in Lewisham, Dr Rowland 1.35pm The GP Extended Access Service Improving Access to General Practice, Dr Egboh 2.00pm OHL Innovations and Sensely application (E-consultations), Dr Politi 2.30pm Comfort break 2.40pm Activity: Developing e-consultations in Lewisham 3.20pm Final remarks and close Housekeeping: Registration, toilets, fire alarm, photo consent and questions
Primary Care in Lewisham Dr Marc Rowland GP and Chair, NHS Lewisham CCG Tuesday 27 March 2018
Constantly evolving and adapting since 1948 • Technological advances • Heart transplants • Immunisations • Better diagnosis • More care outside of hospital
Health inequalities in Lewisham • Life expectancy lower in some areas e.g. in Crofton men typically live for 5 years longer than in New Cross and women for 5.3 years longer. • Fewer black women are screened for breast cancer than others. • HIV infection is often diagnosed later in black African heterosexual men • White men and women are more likely to be admitted to hospital for alcohol related problems.
Patient access • GP Extended Access - GP and nurse appointments 7 days a week 8am- 8pm • GP Online services – booking appointments, repeat prescriptions and access to medical records • E-consultations – on-line video consultations and symptom checker • Pharmacy first - providing advice, treatment and medicines for common ailments at local pharmacies • Evaluation & improvement - practices have undertaken a self-assessment of current arrangements and developed action plans to improve access • Self management programmes for Long Term Conditions (LTCs) - supporting patients to better self-manage their conditions. 9
Our focus for 2018/19 In 2018-19 we will be focusing on redesigning services to: • Improve people’s access to information and advice and participation in activities and opportunities for health and wellbeing • Join up the care and support that is delivered at a neighbourhood level and in people’s own homes • Provide the urgent and proactive care people need in times of crisis or when they need more care and support for a short period of time We will be looking closely for example on how we can make improvements in these areas for frail and vulnerable people, those with mental ill health and those with specific conditions such as cancer and diabetes. 10
You can help by: • Looking after yourself - leading a healthy lifestyle • Managing any health conditions you have • Choosing the right NHS services • Using emergency services for emergencies only • Getting involved and helping shape future services
Make a pledge My pledge to help improve primary care in Lewisham is ….. What will you pledge?
Questions?
The GP Extended Access Service Improving access and the patient journey Dr A Egboh GPEA Clinical Lead
Introduction 1. Illustrate the patient journey 2. Summarise what can be seen in the service 3. Share key information about access to the service 4. Share some recent achievements 5. Get input from you
I �a�’t �ait that long for an appointment ……. I need to see a doctor!
M ���……. “o if I go to the GP Extended Access Service, I can have a booked appointment after work today at �.30p�…..?
Let’s see ho� eas� this pla�e is to fi�d…. They told me to: 1. Go to the Yellow Zone 2. Follow the corridor up past the reception desk a�d M�Coll’s shop 3. Turn right after the shop and look for the signs
Past the In the reception Yellow Here it is desk and Zone M�Coll’s shop
�Hello, �el�o�e to the GP extended Access Service. How �a� I help �ou?� �Hello, I’�e got a� appointment with Dr Anthony Egboh at 7.30pm. My GP practice �ooked it for �e�
Please take a Not too �ad so far I suppose…… seat in the waiting area • Convenient appointment time and wait to • Easy to find be called in • Comfy waiting area A children's area…… Children can also have appointments here
GP Extended Access Service Nurse Appointments: • Wound care (Adults): Patient are required to bring their dressings with them where possible • Ear Irrigation (Adults only) There’s one of the • nurses; Friendly, Injections – Patient has to bring the Drug with them • professional Flu Vaccines • Whooping Cough Vaccine for Pregnant women • Immunisations In development: Sample taking – e.g. cervical smears
�Hello, I’� Dr Egboh, nice to �eet �ou�
Only with your consent can your records be accessed Private and secure Access all your records
A seamless service The service has remote access to your GP medical record and is able to save consultations to this Referrals: We complete all referral documentation and forward to your practice to make the referral. Prescriptions: We prescribe in the service using prescriptions that can be taken to most pharmacies. We are able to make test requests (e.g. blood) as you would do in a practice. All results go back to registered practice for ongoing management of care.
“Yes you can, but I’ll defi�itel� �e you would have to coming here again. �Tha�k book an It’s ope� �a� -8pm you. appointment 7 days a week Can I come through your here next registered GP ti�e?� practice as we cannot book appointments here.”
That was a really pleasant e�perie��e…. No� where is my coffee?
Access to the GP Extended Access Service Acts as an extension of general practice offering booked appointments to people registered with Lewisham GP practices 1749 GP appointments per month 744 Nurse appointments per month Access to medical record enabling a comprehensive GP service 8am-8pm, 7 days a week offering a mix of same day and pre bookable appointments Not a walk in service Only booked via: your GP practice 111/SELDOC Redirected from UCC
Service achievements since October 2017 PPG event New purpose built location central to the hospital site Can see children In March 2018 the service has seen at least one patient from each of Lewisham�s 38 GP practices 98% of patients are seen within 30mins of appointment time The service is supporting the wider healthcare system with the UCC and NHS 111 both booking patients in to the service daily 17% DNA rate, with a downward trend. SMS messages, calling patients, better signage and improved dialogue with GP practices
Achievements since October 2017 PPG event continued We�ve expanded our GP and nurse workforce Achieved recognition across London as an excellent service – Site visit from the Health London partnership (March 2018) Access to interpretation service Improved communication and processes – constantly under review
Patie�t’s experience of the service • 87% Very satisfied or satisfied with the care they received • 90% rate service as good or very good Some of the feedback received: �O�e of the best �urses I have ever had the pleasure of �eeti�g. “he has taken care of me and been so attentive over the last 2 weeks. I am very happy you have �urses of this sta�dard. Tha�k you� � XXXX has been a caring, attentive nurse that has been taking care of me. It has been a pleasure to get to know her and she will not be forgotten .� Feedback received February 2018
Some challenges • Late arrivals – unable to see patients that arrive more than 10mins late for their appointment • DNA rate – We are constantly trying to reduce this so that appointments are not wasted. Currently sending SMS appointment reminders and calling all patients • Dressings – limited storage and knowing what patients require prior their appointment is challenging Private work • Inappropriate referrals – Patients being put to the nurse for GP issues Referrals from UCC/Paeds/SELDOC/111 Relationship between own GP and patient
Thank you Any questions
Pan-Lewisham Patient Participation Group Dr Danae Politi GP IT and Innovation Lead, One Health Lewisham
Summary 1. Aims of application (App) 2. Background and context 3. About the application 4. What�s next 5. Your input in to further shape the application
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