Fylde & Wyre GP Extended Access

Barbara McKeowen, Transformation & Planning Manager Utilisation by clinician - Extended Access (both FWCCG sites) Booked (% of total Attended (% of total DNA (% of total Cancelled (% of Available available) available) available) total available) ANP 78 0.64% 54 69.23% 49 62.82% 5 6.41% 0 0.00% GP 3580 29.52% 3127 87.35% 2690 75.14% 437 12.21% 0 0.00% HCA 3856 31.80% 2566 66.55% 2246 58.25% 289 7.49% 31 Note0.80% current NP 34 0.28% 34 100.00% 28 82.35% 5 14.71% 1 figures2.94% include Nurse 4579 37.76% 2655 57.98% 2227 48.64% 417 9.11% 7 0.15% Fast Track TOTAL 12127 8436 7240 1153 39 referrals

Utilisation by clinician - Extended Access (Whitegate Drive) Booked (% of total Attended (% of total DNA (% of total Cancelled (% of Available available) available) available) total available) GP 3127 23.78% 2074 66.33% 1635 52.29% 439 14.04% 0 0.00% HCA 5979 45.46% 2319 38.79% 1976 33.05% 288 4.82% 55 0.92% Nurse 4045 30.76% 917 22.67% 758 18.74% 149 3.68% 10 0.25% TOTAL 13151 5310 4369 876 65 Note current figures include Fast Track referrals What we have achieved

 Communications via: o Practice bulletins o Media using the Why A&E campaign o Leaflets in practices o Social media campaign  Work commenced developing Data Sharing Agreements to allow patients to access three sites  Discussions have commenced with NHS regards working towards booking appointments via 111  Presented utilisation at Council of Members on 13th March 2018  Formed part of the winter resilience plan

Ongoing Developments

• Explore the possibility of providing a telephone number for patients to book appointments directly • Patients to book appointments via 111 • Providers (such as Walk-in-Centres and Urgent Treatment Centres) being able to view available slots and book appointments for Extended Access to support the management of primary urgent care capacity across Coast

GP Extended Access GP Extended Access Project

• Four MBA Students • 23rd April 2018 • 2 weeks • GP Extended Access, Project Focus  Understand the perspectives of different stakeholders  Analyse and interpret existing data  Summarize the causes of under utilisation  Recommendations for improvement

Stakeholders

• 16 Practices • Fylde Coast Medical Services • CCG colleagues • PPG Chairs/Influence Panel • County Council • Fylde Borough Council • Wyre Borough Council • Greater Preston CCG

Performance

• Service exceeds the existing national standard of 76 hours per week, an average of 13% since September 2018 • Average utilisation: Fleetwood = 62% Freckleton = 78% • Under utilised: Fleetwood = 18 hours per week Freckleton = 9 hours per week

Strengths & Opportunities

• Practices to share good practice regards engagement of patients • Different approach to offering

appointments • Practice promoted via social media • Refer routine care and episodic care to the service

Strengths & Opportunities cont’d

• Offer appointments as part of the core service before advising of other services i.e. Walk in Centre • Over Wyre Medical Centre offers (outside of extended access): Offering GP services from 7.30am daily Offering own EA services until 8pm on Mondays Employing 10 nurses providing service for patients with chronic illness • Continuity of care for two neighbourhoods

Key Challenges

• Additional training required for receptionist to utilise the system • Location/travel (Over Wyre and St Annes) • Limited GP appointments (approx 25%) • Display skillset of clinicians • Engagement with patients for extended access • Engagement with patients for appropriate use of all services • Medical supplies required on site Recommendations

1. Reallocate unused capacity for delivery by WIN and LSA (excluding Fernbank Surgery and Holland House) 2. Benchmark practice utilisation and cascade to neighbourhoods with a view to share good practice 3. Introduce a Service Quality Model to identify gaps between service delivery and patient expectations Next Steps

Recommendation Timeline

Review the existing service locations with the provider and the Present to PCCC on requirement to increase the number of appointments to reflect 21st August 2018 Garstang and Great Eccleston inclusion Liaise with the provider regards availability of GP appointments 13th July 2018 Liaise with the provider to offer further training support to practices 29th June 2018 Liaise with IT to ensure nurse skill set is displayed Complete Continue to: Ongoing Support practices in offering the appointments to patients Engage with patients about the appropriate use of appointments

CCG to collaborate with local councils to promote the service 29th June 2018 Undertake a patient survey 28th September 2018 Liaise with the provider regards medical supplies 31st July 2018 Develop a briefing document to share with stakeholders 29th June 2018