Tips on dealing with appointment demand in general practice from MDU

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30 June 2014

With demand for GP appointments at record levels, a well-managed appointment system can help to ensure complaints are kept to a minimum, the MDU says.

During the year to March 2013, there were nearly 5,000 written complaints about practice management systems in England, including the appointments system, according to national statistics.

The MDU recommends that practices review their appointment procedures to ensure patients are provided with clear information about what services are provided and how best to access healthcare practitioners.

Writing in the latest edition of inpractice, the MDU's publication for practice managers, Dr Beverley Ward, MDU medico-legal adviser, said:

"Practice managers face a considerable challenge in finding innovative ways of meeting patient demand for appointments, without compromising patient safety or overloading the system.

"Many practices are already using alternatives to face-to-face consultations such as telephone consultations and triaging systems to determine urgent and not so urgent cases. Practices may offer online appointment booking and cancelling services and text messages reminding patients about appointments can reduce  do not attend rates.

"However, such processes must be properly thought through to ensure confidentiality is protected and patients can be seen in person when necessary.

"Poor communication and perceived rudeness during telephone calls are a common cause of complaint. It's worth considering regular training for reception staff in telephone skills and ensuring there are enough staff to deal with calls at peak times. If non-clinical staff are involved in triaging urgent and non-urgent cases for a GP to call back, they must have appropriate training and there should be a full written protocol which includes red flag symptoms such as weight loss or persistent cough."

The practice appointments policy should be available on the website and in the waiting area and the MDU recommends new patients are also made aware of it. The policy could include the following:

  • Surgery times – extended hours sessions and how to get medical help outside these hours.
  • Types of appointment available – urgent, advance, practice nurse, travel clinic.
  • Appointment booking methods – telephone, online.
  • Call answering target – the practice commitment to answering telephone calls within a certain time and whether calls are recorded.
  • Home visits – how to request one and the circumstances when they are provided.
  • GP access – whether patients can request a particular GP, a longer appointment.
  • DNAs – how to cancel an appointment and the practice statement on patients who miss appointments.
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