Reducing demand. Step 4 - Going Live
When you have determined the demand and therefore the supply (and range of appointment options), and have cleared any backlog, and have developed your protocols and trained ALL staff, you go ‘live’ armed with your new rota and knowledge of what’s coming through the door knowing that supply matches demand every day.
This process may show that you have sufficient appointment supply or not. Often practices do have enough capacity – they just allow backlogs to build, they aren’t strict with annual leave and practice absence (if a GP isn’t about you have to find a way to provide their appointments that day) or simply each GP isn’t doing sufficient appointments. Usually the new system takes a few months to bed down.
“No system is better than the intelligent person who manages it in real-time. Doing this is a necessary and difficult skill. Some doctors have it, as do some practice managers and receptionists. The ability to see things going pear-shaped at an early stage is absolutely crucial. As is the initiative and authority to do something about it.” GP
Example: Clarendon Surgery in Salford found that in the first month it was taking 3 hours to get to 90% call back, but over the next two months this reduced to nearly two hours and with further refinement half the patients where called back in less than 2 hours), and now has a system that enables 90% of patients to be called back within 55 minutes, with 54% within 20 minutes or less and 71% in thirty minutes or less. Another ‘major outcome of this phase was that the initial ‘flood’ of calls at 8.00am began to be spread across the day, making it much more manageable.
