“It makes things possible that weren’t possible before,” says Dr John Hampson, Bury CCG’s clinical lead for information management and technology.
He is talking about the INPS software that underpins radical improvements to primary care in Bury.
The initiative is called Easy GP and uses INPS Vision’s record and appointment sharing to make patient records available and manage appointments across the 33 practices of Bury GP Federation. It was one of the first projects to be funded by the Prime Minister’s Challenge Fund, set up to tackle the problem of primary care access.
For a variety of reasons, people find it hard to get a GP appointment. Perhaps they have a job and cannot get time off work. Perhaps they have an emergency – a sick child, for example, or a crisis arising from a long term condition. Their only option may be to visit A&E, which may not provide the most suitable care and ultimately places greater strain on the NHS.
Easy GP plugs the gaps that make seeing a GP so difficult and frustrating for many patients and causes so much care to take place in the wrong setting.
It does this by making appointments available seven days a week. Slots can be booked between 8am and 8pm on weekdays, and 8am and 6pm on weekends.
Appointments are provided at selected practices staffed on rotation by GPs from nearby practices. Although patients may not see the doctor they are most familiar with, they will see a permanent Bury GP.
The extended service is not an emergency service – it represents a real increase in primary care capacity.
Dr Hampson says: “We are actually seeing scheduled work rather than unscheduled emergency work. Before, out of hours services had little to go on other than the patient in front of them. That’s fine for emergency work, but if we want colleagues to see patients for scheduled or elective work, those colleagues need information to make clinical decisions.”
Vision provides the underlying functionality that makes this approach possible. It allows patients registered at a range of practices to be booked into the extended service, and the GPs staffing the extended service to see patients’ medical history.
Dr Hampson adds: “We chose Vision because it is a critical component in sharing appointments, and works effectively. It also makes the full patient record available, in a secure presentation and with a consent structure around it. The consulting physician cannot see the record until they’ve asked the patient and the patient has said yes.”
INPS has also created a web service that allows people to book appointments by computer, and a mobile app for tablet or smartphone. Currently confined to the core GP service, these will soon expand to cover the extended service.
The out of hours service - which does not have access to shared patient records - still runs, but demand has reduced. Out of hours GPs can book patients into the extended hours service, if an appointment is available.
It is estimated Easy GP will make as many as 150,000 more appointments available every year – a transformational change.
Bury has a track record of making good use of technology – it was one of the first areas to make widespread use of electronic prescriptions, for example. Dr Hampson says: “To extend access, we needed Vision’s CCG-wide record and appointment sharing. That was the key to getting this to work.”
Within Easy GP is a long-standing access project that has been cited by the government as one of the inspirations[i] for the Prime Minister’s Challenge Fund.
Healthier Radcliffe was launched in 2013. It is made up of six practices and uses Vision to allow GPs from those six practices to provide a seven-day extended service.
Vision allows the physicians manning the extended hours service to see each patient’s history in full. The records remain confidential and are not shared beyond the network of surgery staff.
The continuity provided by this approach makes it easier to support patients to self-care, and to plan care for patients with long term or complex conditions.