The surgery had an average waiting times of three weeks, the nurse triage system could not manage demand, receptionists were frustrated and the situation often caused conflict with patients.

The practice became part of the National Primary Care Collaborative in July 2002 and began to devise a plan to improve access, reduce waiting times, reduce staff stress and improve patient satisfaction.

A multidisciplinary access group was set up with task-specific teams assigned to four areas: patient involvement, IT, capacity demand management and staff involvement and training. Away days and public meetings were held and a 10-week implementation plan was drawn up:

• Work down the backlog of appointments
• Introduce telephone consultations
• Address Did Not Attends (DNAs)
• Look at processes and systems within the practice in order to address the lack of space within practice premises.

A huge effort was put into communicating with staff and patients and a public meeting was held to both inform patients and seek opinions regarding the changes being made.

One particular innovation was the development of an electronic ‘Access Advisor’. Receptionists ask patients simple questions about their problem and use a computer-based electronic ‘Access Advisor’ to locate the most appropriate professional.

By January 2003, the practice was able to offer appointments to patients as and when required. The practice have been runners up for the ‘Improving Access Category’ in the HSJ awards and the Northumberland, Tyne & Wear SHA Awards.

Regarding the ‘Access Advisor’ the HSJ Award judges said: “This is an innovative approach to triaging requests for appointments and it has led to a significant improvement in access, morale and satisfaction. The rest of the NHS can learn from its innovative use of IT, the way in which it has extended skill mix and added value to a national initiative.”

Fact and figures:

Baseline waiting time: GP – 7 days, Nurse – 4 days
Current waiting times: GP – 0 days, Nurse – 0 days.

The practice operate a system of advance booking and book on the day. Patients who need to book in advance can do so. The percentage of patients seen by GP on day of choice is consistently at 100%.