The headline impact of the new service saw a reduction in the DNA for the clinics from 12.6% to 1.2% over the period 25 January 2021 to 30 April 2021.
Patient feedback on the new service was very positive with patient’s surveys identifying that the choice of locations, ease to book appointments and communication direct with their GP about their on-going health care were popular benefits.
From a clinical perspective, GP Connect; Access Record: HTML meant there was an effective flow of patient information between hubs and practices. Clinicians felt more ownership of the end to end patient journey.
There were lessons learned in the configuration of the GP Connect technology where appointment sharing was well thought through and delivered but the patient record sharing aspect had not had the same focus.
The issue was highlighted when one site (using EMIS) could not see another patient's records (within TPP). This was discussed with the GP Connect Team who highlighted that practices had not set up their systems to share records with each other.
This was quickly resolved with help from the PCIS IT support and GP Connect teams, and checked with each practice. Visibility was available within 24 hours of the patient being seen - as long as data sharing was enabled for patients on the clinical system.
This project has delivered value for money because GP Connect technology made it possible to deliver this service using a single administrator, whereas there would have been 12 people without this solution. Patient bookings and letters could be processed much more effectively and efficiently.
The PCIS employs 2 INR Technicians who incorporate the administrative work into their daily clinical hours. Due to the ease of GP Connect this has allowed a minimal 5 hours per week, per technician for their administrative duties at a cost of £100 per week. If GP connect had not been an option, the cost implication would have been up to £1000, dependent on practice protocol for assigning clinics over the 12 practices and monitoring of each of the hubs patient data.
This model of delivering INR into primary care was one of two models deployed. The other model deployed as a comparator used traditional delivery via a secondary care setting. The PCIS model has had the best results according to patient feedback, community nursing feedback and reduction in DNA’s rates.
Patient communications was a vital element in this project. Before implementation there was a lot of time spent on finding out what the patient wanted from the service and ongoing communications to gauge patient experience and whether the new service was meeting expectations set during the consultation process.
All patients identified as being on Warfarin and requiring INR monitoring were sent letters at 3 important milestones of the project:
- 12 weeks prior to launch advising patients of proposed changes to the new service and asking for feedback or concerns
- 6 weeks prior to launch advising patients of proposed hub model and appointment booking system and launch date
- First appointment with service – patients provided with patient satisfaction questionnaire to highlight any changes which were required to make the service more accessible to patients and improve their experience.