Welcome Anne Hooper - Event Facilitator, CCG Lay Member for Patient - - PowerPoint PPT Presentation

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.

Welcome

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

Format of event

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.

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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

• f 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.

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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
• nly
• 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

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

Introduction

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 plae is to fid…. They told me to: 1. Go to the Yellow Zone 2. Follow the corridor up past the reception desk ad MColl’s shop 3. Turn right after the shop and look for the signs

In the Yellow Zone Past the reception desk and MColl’s shop Here it is

Hello, eloe 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

• oked it for e

Please take a seat in the waiting area and wait to be called in

Not too ad so far I suppose……

• Convenient appointment time
• Easy to find
• Comfy waiting area

A children's area…… Children can also have appointments here

There’s one of the nurses; Friendly, professional GP Extended Access Service Nurse Appointments:

• Wound care (Adults): Patient are required to bring

their dressings with them where possible

• Ear Irrigation (Adults only)
• Injections – Patient has to bring the Drug with them
• 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.

Thak you. Can I come here next tie? “Yes you can, but you would have to book an appointment through your registered GP practice as we cannot book appointments here.” I’ll defiitel e coming here again. It’s ope a-8pm 7 days a week

That was a really pleasant eperiee…. No where is my coffee?

 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

Access to the GP Extended Access Service

 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 Lewishams 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

Service achievements since October 2017 PPG event

 Weve 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

Achievements since October 2017 PPG event continued

Patiet’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: Oe of the best urses I have ever had the pleasure of eetig. “he has taken care of me and been so attentive over the last 2 weeks. I am very happy you have urses of this stadard. Thak 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

• 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

Some challenges

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. Whats next
• 5. Your input in to further shape the application

Context: Improving Access to Health Care in Lewisham

 We are promoting awareness of online access to general practice.  Another way to book appointments, order prescriptions, have access to your records and reduce pressure on phone lines at peak times  Lewisham has gone from having one of the lowest rates of patients

• nline to one of the highest in south east London

“You can still call your surgery – online is just another option to make things easier” Now we want to further develop on this success!!

Aims

We want an application that:  Delivers patient satisfaction  Improves access to health care  Is clinically safe  Is NICE (National Institute for Health and Care Excellence) accredited  Is GP centric, helps manage growing demand on GP practices  Is technologically forward e.g. symptom triage, video consultation etc.  Has scope for further development e.g. chronic disease management

The Journey

 18 months of market research  Options appraisals  OHL IT steering group  Bids / funding applications

The product: Ask NHS GP

 Ask NHS GP Application  Developed by Sensely  Advanced, UK based company, has designed the clinical decision support technology  NICE accredited  Red Flags included  Improves access to healthcare (especially out of hours)

The product: Ask NHS GP

 Symptom Checker: Determines the urgency of a patient’s case and

• ffers the appropriate pathway of care

 Olivia: Offers dynamic advice to patients  Patients registered with a GP practice in Lewisham will be able to download the Ask NHS GP Application for free  Android and Apple compatible; requires name and date of birth to register  The Ask NHS GP application links the patient to their registered GP practice

The product: Ask NHS GP

 Symptom checker has voice and text recognition  Can be used at any time. During working hours, it will direct to your GP practice based on symptom urgency  Out of hours, it will direct to out of hours services e.g. Seldoc  Olivia can safely advise patients about self care and links to the NHS choices website for information  Ask NHS GP application offers access to routine appointments at your GP practice  Allows you to book or cancel appointments  Contains information about local pharmacies  Uses live Google maps

Implementing Ask NHS GP

 Piloting the triage application in Lewisham GP practices (May 2018)  Phased roll out across the borough (Autumn 2018)  Video consultation feature (Autumn 2018)  Engagement with patients and GP practices (Ongoing)

Future Developments

 Chronic disease management  Manage capacity for GP practices  Family Wallet – parents, carers etc.  Ask NHS GP available from website, telephone line, Alexa etc.  Patients and groups working with Sensely to develop the application further to improve patient experience and access  Currently mental health is not included as a symptom as the pathway is being developed by Advanced

 Please tell us your general thoughts and feedback

• n the Ask NHS GP application?

Any questions?

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Thank You

 After the break, well be talking in groups about further improving access to general practice services using the Ask NHS GP application and the GP Extended Access Service

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Comfort Break

Workshop Questions

1. What support should we offer people to use the Ask NHS GP application and what would stop you from using the application? 2. Do you think the Ask NHS GP application will improve access to general practice? 3. What can we do to make it easier for you to get GP Extended Access Service appointments and what would prevent you from going to the service to see a GP? 4. Can you suggest ways that we can further reduce the DNA rate in the GP Extended Access Service?

Do you think the GP Extended Access Service improves access to general practice?  Yes  No  Im not sure

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Evaluation: Question 1 of 4

Do you know enough about the GP Extended Access Service to inform your friends, family or PPG members about the service?  Yes  No  Im not sure

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Evaluation: Question 2 of 4

Do you think the Ask NHS GP App improves access to general practice?  Yes  No  Im not sure

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Evaluation: Question 3 of 4

 Do you know enough about the Ask NHS GP App to inform your friends, family or PPG members about it?  Yes  No  Im not sure

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Evaluation: Question 4 of 4

 Notes will be sent to all attendees via Practice Managers  Questions will be answered and responses circulated  Please leave your details if you would like to be contacted directly about future OHL PPG events  Pledge cards

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Close

Thank you for your input and for attending

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