Continuity of Care

Practice Leads

  • Admin: Chris Rushton

Date Reviewed

6th July 2016

Date of Next Review

September 2017

The practice is constantly striving to improve access to its services. There is however a tension between providing continuity of care and offering fast access to GP appointments. At times the need to see a doctor quickly overrides the need for continuity of care but at other times patients choose to wait to see a specific doctor.

Try and see the same doctor for the same health problem

You do not have to see the doctor that you are registered under; you can see any of the doctors working in our surgery. However, for a particular problem, we suggest you keep seeing the same doctor so that they can build up a better picture of what is going on through repeat consultations and therefore help you better.  Please don’t hop around from one doctor to the next about the same problem unless you’re not happy with the first doctor you saw.  The consequences to this.

If you don’t go back to the same doctor…

  1. You will end up making an appointment with another GP who will not know about your problem and you may feel very little was resolved.
  2. You will then have to waste time explaining it all over again from the beginning - and that can be frustrating.
  3. For a new doctor, it can be difficult for them to pick up from where the other doctor left off.  The previous doctor you saw would have had a plan to follow you up.
  4. And finally, this means the new doctor having to start all over again.  This results in time just being wasted, you feeling stuck, the doctor overrunning and other patients are kept waiting!

You might be wondering: ‘Isn’t it all in my medical notes though?  Won’t the last doctor have made notes for this new doctor to read?’.  Yes the last doctor will have made notes in your medical records but it is very difficult to capture everything you said in the little time they will have had to write in your notes?   Not everything can be captured in a few lines of text.  So – it’s just easier going back to the same doctor so that you don’t have to start from the beginning.  And most of the time, that original doctor will remember what you had said before.  The same doctor will know what they had done before and will then know what to do next.  So please – if you have a recurrent problem, see the same doctor.   If you have a new problem which you have not discussed with anyone yet, then by all means book in with any doctor (even if you are seeing another doctor regularly for something else).

But I can never get to see the doctor I want to see

“I can never get to see the doctor you want to see” is a complaint we hear from some of our patients.   Actually, it is a common complaint across nearly all GP practices in the UK.

First of all, why is it so difficult?

Did you know that the main reason WHY you can’t see the doctor you want to see when you want to see them is because of the number of appointments where patients simply don’t turn up!   Here are some figures to help illustrate the point.

  • Did you know that on average there are 400 appointments EVERY MONTH where patients simply don’t turn up.
  • They don’t even cancel to help release these appointments for other patients.
  • If these patients would only ring us in advance to cancel, we could slot 400 other patients in every month!
  • 400 waste appointments per month equates to 100 wasted appointments per week and nearly a whopping 5000 appointments per year!
  • Is it no wonder that other patients can't see the doctor they want to see because of these valuable missed opportunities.
  • So, if you ever need to cancel, please ring and tell us (at least 3 hours in advance) so we may offer that appointment to someone else.

 

But, there is a way of seeing the doctor you want to see.

  • If you visit a doctor for problem that is ongoing, and you know you will need a follow up visit in say 2, 3 or 4 weeks time (or the doctor has asked you to do so), BOOK THE APPPOINTMENT WITH THAT DOCTOR AS SOON AS YOU LEAVE THE DOCTOR’S ROOM and BEFORE YOU LEAVE THE SURGERY.
  • We can usually and quite easily make an appointment for you up to 4 weeks in advance.
  • Do not try to book the appointment closer to the time you need it because that doctor will probably be all booked up with other patients by then.
  • The earlier you book your appointment, the more likely it is you will get an appointment with the doctor of your choice.

In some situations, you have to accept seeing any available doctor

If you need an ‘on the day’ appointment either because something is an emergency or is urgent and WE manage to squeeze you in then it is only fair that you accept that you may not see the doctor of your choice.

  • Remember - the doctor you want to see might already have a full surgery and it would be unfair to cancel other patients who have booked their appointments in a timely manner.
  • It would also be unfair to squeeze you in with that doctor because the doctor would then spending less time on other patients, end up running late and their patients kept waiting.
  • And if your issue is a true urgency or emergency, then it really should not matter which doctor you see.  A doctor is a doctor and all of our doctors can all handle emergencies and urgent things.

We hope you will agree that this is a reasonable and fair approach.

Health Advice Available All The Time

Patients should be able to see a GP withing 48 hours of their request (but not for a specifically named GP).   This is in line with the national 48 hour access to a GP requirement.  Patients can also book up to 3 weeks in advance.  Our surgeries vary from day to day - matched specifically to our survey of patient requested demand on different days.

The surgery also provides an emergency doctor service.  There is an emergency doctor for every morning and every afternoon.  Please do no misuse this service.  This service is for EMERGENCIES and URGENT REQUESTS.  It should not be used just because the patient could not get an early appointment for non-urgent or chronic problems.  Be warned that the Emergency Doctor surgery can involved a long wait as the Emergency Doctor attends to other patients.  Patients can choose to book either a telephone or face to face consultation.

Then there is the NHS 111 advice line.  Simply dial 1 1 1.  They are open 24 hours a day and can offer health advice over the phone and will even arrange a doctor to see you (either at the local out-of-hours centre in Eccleshill or at your home if you are too poorly to come in).

If your requirement is an emergency, then of course there is the A&E Departments and you can call 999 for an ambulance.  Please use this service responsibly.

If you are unsure which service to contact or not sure if your problem is an emergency, please call 111 for the NHS advice line.  Remember- it operates 24 hours a day.

Terminally Ill Patients

Palliative care records are held by the patient at home and are therefore accessible to any professional involved in the care of that patient. The records hold a copy of the Liverpool Care Pathway - which is a pathway for the care of a dying patient.   At Ashcroft Surgery, we proactively identify and discuss patients who are terminally ill  at our monthly multi-disciplinary practice meeting, which includes the Macmillan, District and Practice nurses to ensure that all members of the practice team are aware of the patient and any relevant issues.  Each individual discussion is led by either a District Nurse or the Doctor who best knows the patient.

During out of surgery hours, cover will be provided by the local Out of Hours Service at Eccleshill, provided by Local Care Direct.   The Doctors will pass any relevant and important patient information on to ensure continuity of care.  In the case of terminally ill patients there is an Out of Hours contact form, which can be faxed. The Out of Hours provider uses a computerised medical record system. The practice is notified each day of all patients who have been seen Out of Hours by a computerised task and details put into their record by the Out of Hours provider.

Once a patient dies, the practice will contact the relatives via a card expressing our condolences and giving information regarding local support agencies with respect to bereavement.  They are free to contact the doctor or nurse involved in the patient's care if they feel the need.