Yesterday afternoon (Friday) the Nairn and Ardersier Practice's appoinments system, the subject of much controversy since its inception, was debated at the NHS/Highland Council partnership meeting in the Courthouse.
Dr Baker began his presentation with an
admission, stating: “We didn’t do particularly well at the preceding practice “
then went on to say that the new practice offered “ a substantially different
and very, very local model of care that we do deliver and we strive to continue
to deliver.” He continued: “We’re at the forefront of integration with health
and social services, here and establishing a single point of access.”
He then went on to the mechanics of the new
appointments system: “In terms of delivering holistic and overall care to the population
we are doing our very best. We’ve discussed our new appointments system in the
run up to it with patients in the summer of 2012 and in the autumn as well. We
implemented our new system on the 5th of November funnily enough and
we’ve seen a few fireworks since then.
What we have dealt with since then in the
last four months we’ve had twenty four and a half thousand telephone calls, we’ve
seen 7,000 patients of which 5,000 we’ve seen on the day , 6.and a half
thousand which were seen within seven days of calling. In comparison with our
previous model, people were waiting 3 to 6 weeks to see a doctor. So it’s done
what it’s said on the tin really which is to improve access. It’s not pleased
everybody and we as a practice accept that and apologise that we can’t please
everybody. We are working and revising the current system to improve that.
we have been surprised with really is the volume. We weren’t quite expecting
10% of the population to contact us every week, which is quite a lot of calls.
But we have dealt with that and we’re looking to do a little piece of research
with NHS Highland and public health to look at what’s coming in and why and why
our contact rate seems to be quite high.”
The meeting also learned that the system
was in the process of continued improvement and the practice looking for
constructive feedback and are looking at significant changes in the future.
Liz then asked if there had been recent
changes to the appointment system.
Dr Baker indicated that they are looking at
accommodating people who are at work better. He said that the practice recognises
that some people at work are unable to take telephone calls we are looking at
that. He confessed that they had been
criticised on their speed of response He told the meeting that there were a limited
list of people who can book directly such as people with vision, hearing impairments
and those patients with mental health problems and dementia.
Liz continued her questioning and asked “Will
there be any more public information going out about the service?
Dr Baker replied, “We fully accept that we have not been as good as we could
have been in publicising the service and we accept responsibility for that and
once we have significantly refined what we are doing we’ll be publicising that
with more detail.”
Liz then commented, “I’ve certainly not had
any complaints from anybody over the last week, two weeks. I think it must be
getting ironed out a bit now.”
When asked about what the contact rate was
before the new system. Dr Baker said that it wasn’t measured before and he didn’t
know where the people that got fed up went. He stressed, “Clearly a lot of
people got fed up and just gave up.”
He said the contact rate for the first of
January was 12%. He gave a normal contact average figure for other areas of the
UK of within 5-10%.
There were a couple of questions later on
from the public benches at the end of the meeting. Graham Vine asked Dr Baker,
“I noted your point when you say you had some people who had got fed up and you
don’t know where they went. Bearing in mind that the Nairn and Ardersier
practices are now merged and are a sort of monopoly provider in the town, Where
could anybody go who was dissatisfied with the practice in Nairn?”
Dr Baker replied, “I don’t personally know,
however some self-limiting conditions get better of their own accord and within
some weeks some things improve. We all recognise that. There are other
providers of health care in the town, we’ve got the third sector, we’ve got
pharmacies[…] It’s not just the GP that provides health care, there’s an awful
lot of provision out there and if you are waiting 3-5 weeks you may make
Another comment from the public benches
followed. One patient thought that the appointment system was only set up for
people who made one off calls and that for somebody with a long-term condition
it doesn’t really work.
Dr Baker replied that for long-term conditions
they tried to give a long term patient the same GP.
“I tried to get an appointment with my own
doctor but he didn’t know who he was,” came the reply from the member of the
This observer feels that the heat and
intensity that was expressed in recent weeks in the Nairnshire and on the Gurn
has faded somewhat. Liz indicated a few weeks ago that she was constantly
receiving complaints and now they have ceased. Either the teething troubles
with the system are receding or weary resignation has set in with those that
have found that the system hasn’t worked for them. The system does seem to have
worked for a lot of people however and it is obviously here to stay. What is interesting is that significant changes are promised, we will have to wait and see if these changes placate those still upset with the new system.