RCGP Bright Ideas: Temporary residents service

Dwyfor Primary Care Cluster Team

Dwyfor Primary Care Cluster Team

06 December 2019

At the Royal College of General Practitioners, we celebrate new approaches that reduce workload and increase efficiency in primary care through the RCGP Bright Ideas Awards. Recently, the College recognised the team at Dwyfor Primary Care Cluster, Wales for their innovative approach to treating temporary residents in Dwyfor during holiday periods.

Dwyfor, Wales, is a popular holiday destination, which attracts thousands of holiday-makers every year. The area’s population more than doubles during peak periods, increasing demand for local healthcare services. Dwyfor has five GP surgeries with long standing issues of recruitment and retention because of their rurality and high volume of workload.

GPs in Dwyfor face significant time pressures because of lengthy home visits, commuting requirements and providing support to the community hospital, in addition to their increasingly complex practice responsibilities. This demand is inflated further during holiday periods due to the increasing number of temporary residents. Many stay for extended periods as they make the most of their second home ownership.

Temporary residents brought unique challenges

Before this innovation, temporary residents had to identify a GP surgery within the area, navigate a telephone system designed for permanent residents then secure an appointment with the receptionist. The five surgeries in the area have different booking systems, so it was suspected that temporary residents were biased towards certain practices, which they believed to be easier to access. 

Temporary residents pose their own unique challenges to clinicians: for example, patients’ background medical notes are not available. Past medical history and currently prescribed medications must be established during the consultation. It can be difficult to triage temporary residents and allocate an appointment within a timescale appropriate to their clinical need, given that their full records are not to hand.

Understandably in such circumstances, practices take a cautious approach, often offering a same day appointment to most temporary residents when they ring for an appointment with a GP.

The Bright Idea:

The Dwyfor Primary Care Cluster decided to run a single, standalone service for all temporary residents staying in Dwyfor over the Easter, May half term and summer school holidays. This would standardise the service offered to all temporary residents, offering better access while ensuring that permanent residents continued to enjoy access to their primary care service without being affected by the high volume of visitors during holiday periods.

This challenge was initially met through working with the Health Board’s Out of Hours service (OOH) to provide 'in-hours' telephone call handling and booking of appointments. OOH GPs were recruited to work during in-hours, and the OOH service's medical centre and its IT systems were used.

A dedicated appointment line was set up and temporary residents were signposted to the service's phone number if they contacted one of the five cluster practices.

The cluster support team raised awareness of this new dedicated service, and notified large holiday complexes, caravan and camping sites and Dwyfor’s pharmacies and minor injury units. A second dedicated telephone line for the temporary residents’ service was secured to the practice, and the practice's own receptionists booked and managed the administrative tasks of the clinic. At the practice, the OOH GP was given a consulting room to conduct the clinic.

Impact:

  • Staff: GPs no longer faced a grossly inflated appointment list
  • Patients: The temporary residents found the service easy to navigate and did not mind having to travel further because they were being seen quickly and promptly by the service. The Dwyfor Primary Care Cluster took proactive action to safeguard the local population’s access to GP services
  • Practice: More temporary residents were seen by allied services within the cluster and emergency medication supply services were provided at pharmacies. Surgeries during holiday periods became manageable.

RCGP Bright Ideas

The College recognises and celebrates GPs their teams, practices and patients who come up with ideas to improve efficiency and improve workload through the RCGP Bright Ideas Awards. They are part of the College’s Bright Ideas project – an online platform where people can share ideas for small changes that can have a big impact on general practice. You can submit your Bright Idea by emailing the Bright Ideas Project Team.

In early 2020, the RCGP will deliver webinar masterclass sessions with selected Bright Ideas winners. The sessions will explore the local challenges faced by the team or individual, how they developed and implemented their Bright Idea, the impact it had and how it might transfer or scale in different contexts. There will also be an opportunity for a question and answer session. The one-hour long webinars can be accessed via your computer or tablet and are open to all (but particularly relevant for GPs and wider general practice teams). The first webinar, 'The Cancer Maps' will take place on 11 March 2020. Register here

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