In 2002 the average wait to see a GP at Throckley Surgery was 5-10 days. The practice decided to join the Improving Primary Care Access Programme.

The team measured the capacity they had against the demand of the patients and were astonished to see that they actually had enough capacity to meet the demand.

They developed a new system which included extensive use of telephone consultations. They realised that a doctor could telephone twice as many patients as he could see in a day, and that a lot of consultations did not require a patient to visit the surgery.

They started to triage all visit requests to ensure they were necessary.

To ensure that all of the staff working in the surgery were comfortable with the changes, and to give them an opportunity to voice any concerns, the practice manager organised an away day.

To help the patients understand the changes being made, information leaflets were produced and distributed.

GPs and receptionists were given the authority to override the system if needed to meet unusual patient demand.

Initially patients found the changes in the surgery difficult to adjust to and a few even complained that they couldn't make appointments they way they used to. Because of this, although the appointments system seemed to be working well and the backlog had been cleared, the practice slipped back into old habits and started using the old system. Before long the backlog of appointments had built up again and patients were finding it difficult to get appointments.

After clearing the second backlog, the new system is now working well and the majority of patients are happy with it. The recent GP Patient Survey results were excellent.