Crickhowell Group PracticeWe have recently had a very productive meeting with Powys Community Health Council and Powys Teaching Health Board to discuss recent changes to the opening hours of both Hay and Talgarth Medical Centres from 1 October 2020.
On 1 October 2020 most of our services remained unchanged:
- Both medical centres continue to be fully open for at least 35 hours a week (35 hours a week in Talgarth, 40 hours a week in Hay).
- We continue to offer the same level of GP appointments as before – although in common will all health services across the UK, we recognise that face-to-face appointments continued to be affected by the important protections in place during COVID-19 to keep patients safe and keep staff safe.
- We continue to offer emergency appointments at one of our two medical centres each afternoon, alternating between the two surgeries.
- We continue to be open for prescription collection services at both medical centres when the surgery is closed – until 5.15pm from Monday to Friday.
- We continue to offer our Total Nurse Triage service from 8.30am to 5.30pm every day. A member of our clinical team will call you at a convenient time to discuss your symptoms and concerns, offer advice, and where appropriate will arrange an appointment with a GP or another healthcare professional who most suits your needs. In many cases our expert triage team will be able to offer advice over the phone that avoids an unnecessary trip to the surgery.
On 1 October 2020 some of our services changed:
- Overall opening hours at Hay Medical Centre have reduced and it is now closed from 1pm on Tuesday and Wednesday. However, it remains open for prescription collection until 5.15pm. And, as before, emergency appointments are available at our other surgery.
- Overall opening hours at Talgarth Medical Centre have reduced and it is now closed from 1pm on Monday, Thursday and Friday. However, it remains open for prescription collection until 5.15pm. And, as before, emergency appointments are available at our other surgery.
These changes were made to ensure that we could continue to provide you with the Total Nurse Triage service. The Total Nurse Triage service was introduced to ensure that each patient sees the appropriate clinician within a suitable timescale. Results have shown that this service has led to improved access to GP appointments, reducing waiting times for routine GP appointments from 2 weeks to an average of 3-4 days. This service has also led to an increase in appointment duration meaning that GPs are able to spend more time with patients, of whom an increasing number have very complex needs. Following a call with our expert team, patients can be:
- Given an appointment with a GP
- Given an appointment with another healthcare professional from the practice team
- Treated or given advice by a triage clinician
- Encouraged to self-manage where appropriate
- Directed to pharmacy or other health service
- Referred for urgent care if needed – some patients ringing for a routine GP appointment are clinically prioritised to see a GP on the same day.
This has had a hugely positive impact to our practice and patients. It is helping us to maintain and improve access, improve quality of care, increase the length of routine GP appointment, and reduce “Do Not Attends” for routine appointments.
We recognise that these changes have raised a number of issues and concerns for our patients, and our meeting this week provided a useful opportunity to discuss these.
Some of the main issues we have heard include:
- Concerns that the changes represented an overall reduction in services.
- Concerns that the changes would reduce access to GP appointments and increase waiting times.
- Concerns about access to services and appointments.
- Concerns about Total Nurse Triage.
- Concerns about impact on 111, 999 and A&E services.
- Concerns about the level of engagement and communication on the changes.
Overall our aims from these changes include:
- Maintaining access to Total Nurse Triage so that patients have convenient access to expert clinical triage, who can then help you see the right professional in the right place at the right time
- Maintaining the overall number of GP appointments
- Keeping waiting times to a minimum
- Offering a vital service during COVID-19 that will continue to offer benefits to patients after the pandemic is over
- Recognising that travel and transport can be challenging in a rural area such as ours, so maintaining access to expert telephone advice can help to prevent an unnecessary trip
Your feedback has identified some key areas where we need to strengthen and improve the services we offer. For example:
- Engaging and communicating on these changes was more difficult during COVID-19, but you have made some important suggestions for ways we can improve. Thank you to everyone who has offered to share practice information within local communities. If you run a noticeboard, community newsletter, social media group, community organisation, or other route where we can share information and gather feedback please do let us have your contact details. Please e-mail your details to haygarth@wales.nhs.uk for the attention of the Practice Manager
- People with sensory and physical disabilities can find it hard to access online and telephone Some of our patients may be less familiar with online services. We are working with our staff to raise awareness to help identify patients with additional access needs, so that we can give the appropriate assistance when they attend the surgery. We also plan to work with Accessibility Powys to improve access to dispensary services. This includes promoting our intercom services and front door collection of prescriptions for those who are unable to access the dispensary hatch.
- Our latest survey on access and appointments is now available, and we welcome everyone’s feedback so that we can continue to make improvements.
- Your views and concerns are helping us to develop our Equality Impact Assessment, which will is available on our website.
It is really important to us to monitor the progress of the changes we have made as part of our continued efforts to support our patients and community. We want to make sure that this represents an overall improvement for our patients, and this will be particularly important given the changes in opening hours. So, we will be meeting again with the Community Health Council and the Health Board in March to share experiences of the first six months.