Appointments have changed, explain GPs from Bourne Galletly Practice
Dr Rebecca Mitchell joined Bourne Galletly Medical Practice in 2012, having trained in London and qualified as a GP in 2007.
She grew up in Stamford and now lives locally with her children, working as a partner at the practice in North Road, Bourne, alongside Dr Paul Cregor, Mr Ian Robinson, and Dr Richard Coates.
Here, she and the partners reflect on recent changes to primary healthcare, and on how patients can get the best from their GP surgery.
Being able to access GPs and other healthcare practitioners is one of the most important aspects of good primary care, and in April 2024 we changed the way we do this.
Despite having received an ‘Outstanding’ rating from the Care Quality Commission in December 2023, following its inspection of the Galletly Practice, members of our patient participation group were telling us that accessing appointments wasn’t as easy as it should be.
We too were unhappy with the system of telephone callbacks and ‘appointment lottery’ that had come about after covid.
Total Triage
So, in April 2024 we moved to a ‘Total Triage’ system.
Every clinical question or problem is submitted using a form on the practice website or the NHS app, and we ‘triage’ each request.
A GP reviews the information provided that same day - often in less than an hour - replying with questions, advice, or a link to make a clinical appointment with the most appropriate person.
We offer same-day appointments for anyone who is unwell, or the chance to book a face-to-face or telephone consultation for a more routine query.
These could be with a GP, a nurse, a physiotherapist, a pharmacist, or a member of the medicine management team, and consultations can be in person, or over the phone.
Meanwhile, admin staff have more capacity to help people without internet access or mobile phones.
Since Total Triage started in April 2024, more than 28,000 requests from patients have been dealt with, on top of thousands of blood tests, wound care appointments, health checks and other consultations.
New systems such as this mean we have more time for consultations, and so our standard appointment time has increased from 10 minutes to 15 minutes.
If you have a mobile phone or internet access, make 2025 the year you use them to benefit your health and that of others. Once you see how easy it is, and how much time it saves our team, we think you’ll be pleasantly surprised.
Medical records
In May 2024 we changed our medical records system from Emis to SystmOne in order to keep up with new technology needs. This was a really challenging time, and we didn’t receive as much IT support as we had hoped. But we are now happy the system is working effectively.
A knock-on effect of this ‘upgrade’ was some patients had to switch from the Patient Access system to using the NHS app. We employed someone full time to help patients set up the app but unfortunately a minority of patients are no longer able to see some of the health data they could previously.
Despite lengthy discussions with NHS England and NHS IT, we are unable to establish why this is and have been offered no solutions. All we can say is that we are sorry and that we will continue to make enquiries on your behalf.
Regular sessions are held at the practice to help people get to grips with healthcare apps and online systems. Get in touch with the reception team to attend.
Medication reviews
We are also looking at making other areas of healthcare more accessible.
Medication reviews is one of these, and our plan is for a tiered system depending on the complexity of the medication and condition.
Some patients need detailed and lengthy discussions about their medication, some need a short exchange of questions and answers to make sure they have the correct treatment, while others just need a brief bit of information about a medication they take.
Our aim is to proactively contact patients whose review is due, usually annually, and ensure they are still on the correct medication for their health needs. We have 8,129 patients taking repeat medications.
Having patient mobile phone numbers has helped us to contact people when tests, referrals and injections are due. This means patients no longer have to remember to call us to arrange these when they’re needed.
Patient feedback
Feedback helps us work out what does and doesn’t work for patients. As a result of problems accessing appointments, our feedback rightly told us we needed to change. We are usually in the top 5% of practices in the GP Patient Survey (gp-patient.co.uk) and hope improvements made this year are reflected when the 2025 surveys are sent around.
Funding
General practice has been a particularly underfunded area of the NHS for decades – we provide 90% of healthcare with 10% of the NHS budget. Lincolnshire especially is an area with low funding, and our integrated care board (ICB) is second lowest in England and Wales. This is why we sometimes take part in ‘collective action’ to try to increase local funding to provide a better service.
Who we can help
We are accepting new patients, and if other household members are registered at a different practice they can switch.
We are a Veterans Friendly Practice with accreditation from the Royal College of General Practitioners. The scheme helps us to be more aware of veteran health needs and Dr Tollerfield, an army veteran, is the lead GP in this area. A code added to medical notes can mean being seen by a specialist more quickly, and there is help available for veterans who are struggling.
Patients on the autistic spectrum can sit away from the more crowded waiting rooms before appointments.
We try to offer ‘continuity of care’, which means that the same clinician sees you for appointments relating to the same condition. There are times when this isn’t possible, but you always have a choice of who you see unless it’s an emergency.
Counselling is available through the surgery, or patients can self-refer by calling 0303 123 4000 or visiting www.lincolnshiretalkingtherapies.nhs.uk/home
Emergency contraception is available from the surgery, via a pharmacy or by calling 111.
Patients wanting to give feedback on treatment should do so at the time if possible, or they can speak to any member of staff about how to use the NHS complaints procedure. As with all services, good feedback is also encouraged.
How patients can help
All practices have a patient participation group, a group of patients and carers who work with the practice to improve services and communication for patients. Details about the group can be found at each surgery, or on their websites.
