Patient Access & Accessibility

Patient Access Policy

Version:                   V4
Author:                    Angela Marwood – Practice Manager
Date issued:            January 2020
Review date:           January 2022

Version Control Sheet

Document Title:   Patient Access Policy
Version: V4

Drafts: 0.1, 0.2 etc
First Approved Version:  V1
Draft Reviews of approved versions:  V1.1, V2.1 etc.
Next approved version:  V4

The table below logs the history of the steps in the development of the document.

Version	Date	Author	Status	Comment
0.1	April to June 2016	Sarah Shepherd and Greg Connor – CCG	Draft	Drafted and amended following feedback, with final version being shared with practices
0.1	July 2016	Angela Marwood Practice Manager	Draft	Awaiting approval by GP partners at next partners meeting
V1	14 September 2016	Angela Marwood Practice Manager	First Approved Version	Approved at Partners meeting – 14.09.16
V1.1	25 July 2017	Kate Lamb Assistant Practice Manager	Draft Review of First Version	Awaiting approval by GP partners at next partners meeting
V2	15 August 2017	Angela Marwood /Kate Lamb	Second Approved Version	Approved at partners meeting 15.08.17
V2.1	28 November 2017	Angela Marwood Practice Manager	Draft Review of Second Version	Awaiting approval by GP partners at next partners meeting
V3	5 December 2017	Angela Marwood Practice Manager	Third Approved Version	Approved at partners meeting 05.12.17
V3.1	13 December 2019	Angela Marwood Practice Manager	Draft Review of Third Version	Awaiting approval by GP partners at next partners meeting
V4	15 January 2020	Angela Marwood Practice Manager	Fourth Approved Version	Approved at partners meeting 15.01.2020

Contents

1 Introduction

2 Aims and Objectives

3 Scope of the Policy

4 Accountability

5 Equality Impact Assessment

6 Implementation and Dissemination

7 Monitoring Compliance with and the effectiveness of Procedural Documents

8 Training

9 Rights and Responsibilities for the Patient

10 Surgery Opening Hours and Appointment Times

11 Access Standards

12 If You Miss Your Appointment or You Are Late

13 Seeing the Doctor or Nurse You Prefer

14 Improving Access for Patients

15 References

16 Associated Documentation

1  Introduction

This document sets out how the practice ensures that all patients are able to access timely and appropriate clinical care.

2  Aims and Objectives

Patients are able to access information, care or treatment by a GP or appropriate member of the practice team in line with their clinical needs.

The ability of patients to access the above does not vary on account of characteristics such as age, disability, gender, race, religion or belief, sexual orientation, geography or socio-economic status.

Clinicians and staff are able to manage available resources to meet demand effectively so that the best possible levels of service and access are maintained at all times.

Patients and carers are aware of how to get the best from the practice and are involved in monitoring and developing the systems and procedures to ensure that their needs are met.

3  Scope of the Policy

This policy applies to all healthcare professionals and staff working for the practice involved in caring for patients. It must be followed by all members of staff who work for The Grange Medical Centre including those on temporary contracts.

This policy is also applicable to individuals who may be sub-contracted to the practice.

4 Accountability

The Practice Manager is responsible for this policy.

The Practice Manager is responsible for monitoring compliance with this policy.

The GP Partners are responsible for the formal approval of this policy.

5  Equality Impact Assessment

The Grange Medical Centre aims to design and implement services, policies and measures that meet the diverse needs of our service users, population and workforce, ensuring that none are placed at a disadvantage over others.

6  Implementation & Dissemination

This policy will, following approval by the GP Partners, be disseminated directly to staff and sub-contractors via the Line Managers.

A copy of the policy can be found in all Line Managers Policies and Procedures files and is also held electronically in the library.

All staff and sub-contractors are required to sign the signature sheet to confirm that they have read and understood the policy.

7 Monitoring Compliance with and the Effectiveness of Procedural Documents                                                

Implementation of this policy will be subject to regular review by the Practice Manager who will ensure that the document is revised and modified to reflect changes in practice and/or regulatory requirements.

8 Training

All staff will be made aware of this policy.

All new staff will be introduced to the policy as part of their induction.

Details of training where applicable are noted in the training records which are held by each of the Line Managers.

9  Rights and Responsibilities for the Patient

9.1      Patients’ Rights

As a patient you have the right to:

• Join the practice of your choice in the area where you live following acceptance by the practice (and within the practice catchment area);
• Easily-accessible information about your practice and how to access care via the practice leaflet and website;
• Appropriate urgent care as per Section 11 Access Targets;
• Clear information about your treatment in a suitable format and language so that you and the Clinician may make an informed decision about the best course of action;
• Privacy and confidentiality;
• Be treated with dignity and respect at all times (including access to a chaperone if required);
• Ability to comment or complain if you are not satisfied with the service provided.
• Be registered in accordance with the NHS Choice Framework (https://www.nhs.uk/using-the-nhs/nhs-services/gps/how-to-register-with-a-gp-practice/
• Be registered or receive treatment without delay where the patient cannot produce photo ID or proof of address.

9.2       Patients’ Responsibilities

As a patient it is your responsibility to:

• Treat all practice staff with respect;
• Ensure that you attend any appointment made at the surgery and arrive on time;
• Cancel an unwanted appointment as soon as possible so that it can be offered to someone else;
• Inform the practice if you change your address or telephone number so that the practice can contact you urgently if needed;
• Inform the practice if you have any special needs, including communication needs, so that the practice can make any necessary arrangements;
• Let a member of the practice staff know if you are unsure about or dissatisfied with your care so that it can be explained or put right;
• Do your best to look after your own health;
• Use the services of the practice appropriately.

10 Surgery Opening Hours and Appointment Times

The practice operates from the following surgery premises:

The Grange Medical Centre – Main Site

Highfield Road
Hemsworth
Pontefract
WF9 4DP
Telephone: 01977 610009

Opening times: Monday 8am to 8pm, Tuesday 8am to 6.30pm, Wednesday 7.30am to 8pm, Thursday 7.30am to 6.30pm and Friday 8am to 6.30pm.

The Kinsley Medical Centre

Wakefield Road
Kinsley
Pontefract
WF9 5BP
Telephone: 01977 610009

Opening times: Monday 8am to 6pm, Tuesday 8am to 8pm, Wednesday 8am to 6pm, Thursday 8am to 6pm and Friday 8am to 6pm.

Greenview Medical Centre

Waggon Lane
Upton
Pontefract
WF9 1JS
Telephone: 01977 610009

Opening times: Monday 8am to 6.30pm, Tuesday 8am to 6.30pm, Wednesday 8am to 6.30pm, Thursday 8am to 8pm and Friday 8am to 6.30pm.

• Patients are able to access all services across all 3 sites regardless of where they live.
• Appointments can be booked over the telephone, in person or through online access. Appointments can be made at any surgery site as all of the systems - telephone and appointment booking systems - are linked.
• All sites are closed for staff training for a maximum of ten Wednesday afternoons (from 12 noon) each year. Details are displayed clearly on the practice website and at each practice site at least four weeks in advance, together with instructions on what to do if you need help when the surgery is closed.
  The practice provides a first and last pre-bookable appointment with a GP or senior nurse at;

• The Grange Medical Centre – 7.30am and 7.40pm
• The Kinsley Medical Centre – 8.00am and 7.30pm
• Greenview Medical Centre – 8.00am and 7.30pm

• The practice provides a standard appointment length of 10 minutes but longer appointments are available on request for patients who need more time. One appointment is for one person and one problem only.
• Appointments are provided outside of standard GP contract hours (8am to 6.30pm), and are shown above under the heading, “opening times”. These appointments are provided under the extended hour’s access scheme.

11       Access Standards

11.1   Routine Consultation Standards

All patients will be offered a telephone or face-to-face consultation with a doctor or other suitable practitioner (such as an Advanced Nurse Practitioner) within two working days of contacting the practice, unless the call is triaged to be safe for a longer time frame, or the patient may choose to wait longer if they want a more convenient appointment or to see their preferred practitioner.

11.2    Urgent Clinical Assessment Standard

The practice aims to offer all patients an appointment when requested; however, we do have a huge daily demand for appointments and only a limited number of appointments available.

If patients believe that they have an urgent medical problem which needs to be dealt with on the same day, and the practice is unable to offer an appointment, then the patient will be directed to the Urgent Treatment Centre (UTC) at Pontefract Hospital.

If a patient contacts the surgery with an acute illness/injury after 4pm, the practice can book them an out-of-hours appointment (if available) at either Pontefract Hospital or Trinity Medical Centre in Wakefield.

Patients can also request a telephone consultation with a triage nurse at GP Care Wakefield (if available). Patients can speak to an advisor and get same-day advice, assessment, a prescription or an appointment locally if needed.

The GP Care Wakefield Service is also available for patients between 6pm and 10pm on weekdays and between 9am and 3pm on weekends and bank holidays. Patients can contact the usual surgery number (01977 610009) during these times, and they will be put through to GP Care Wakefield.

Patients can also contact NHS 111 24 hours a day, 365 days a year for advice.

11.3    Repeat Prescriptions Standard

The practice will generate and sign all repeat prescriptions within three working days of receiving a request to do so, except where;

• The practice has tried and failed to contact the patient where this is needed before the prescription can be issued safely.
• A medication review is pending and must be undertaken before the prescription can be issued safely. The request for a medication review will be highlighted on the patient’s most recent prescription. 

The practice will do its best to provide prescriptions in urgent circumstances but will not compromise patient safety to do so.

The practice procedure and patient information available on the practice website is as follows:

The practice operates a repeat prescription service for all patients who are on repeat medication.

To order your repeat prescription you can do any of the following;

• You can use the right hand side of your previous prescription as a request form to be handed in at any of our reception desks.
• You may also use a practice repeat prescription request form which are available at the reception desks at each surgery site.

Once completed these paper requests can be posted into the repeat prescription box, again located at reception desks at each surgery site.

• On-line prescription request is also available via SystmOnline mobile ‘phone App (provider TPP) or via the following link:

Click here to login to systmonline.

A user name and password is required for this option, please see below for how to use this service.

Want to order your repeat prescription online?

We now have the facility for you to order your repeat prescription online. To do this you will need a unique user name and password.

For patient safety and confidentiality you will need to provide two forms of identification to include at least one form of photographic ID (passport or the small driving licence ID card). You can take this into any of the surgery sites.

Alternatively, the receptionist can take an application verbally if you are able to provide adequate information on security questions posed. 

You can also request user name and password for your child/children but we will need to see their birth certificate(s).

You will be given a secure user name and password to access your details through the website; you will then be able to order your prescription without telephoning or visiting the surgery.

For all prescription requests, please allow 72 hours (three working days) to process the prescription. Please note for requests received after 2pm on a weekday or over a weekend, your prescription will be ready 72 hours from the next working day.

Giving us 72 hours enables us to check, record, issue and sign the prescription. We get several hundred requests for prescriptions every day, so please allow us this time. It is also helpful to ensure that you do not run out of medication before ordering your repeat prescription. Remember that you can order your repeat prescription up to one week before it is due.

For all repeat prescriptions, there is a review date. If this date has expired it will be necessary to have your medication reviewed. This review date will be shown on your repeat prescription slip or indicated when you try to order on-line.

Please note we also now offer an electronic prescription service. If you currently collect your repeat prescriptions from your GP, you will not have to visit your GP Practice to pick up your paper prescription. Instead, we can send it electronically to your nominated pharmacy, saving you time. You will have more choice about where to get your medication from because it can be collected from a pharmacy near where you live, work or shop. You may also not have to wait as long at the pharmacy as there will be more time for your repeat prescriptions to be prepared before you arrive.

Click here for more detailed information and a nomination form to use this service.

12 If You Miss Your Appointment or Are Late

There would be much shorter waits for appointments if every unwanted appointment was cancelled and so available for another patient to use. It is frustrating for doctors and nurses to be under pressure to provide better access when up to 1 in 10 appointments are wasted by people who simply do not turn up. Each appointment costs an average of £30, putting the total cost to the NHS at more than £216million pounds on top of the disruption for staff and fellow patients (https://www.england.nhs.uk/2019/01/missed-gp-appointments-costing-nhs-millions) correct as of 2nd January 2019.

A letter is sent to patients who fail to attend two or more of their appointments reminding them of the importance of both attending their appointments and of contacting the surgery to cancel/re-arrange their appointments if they are unable to attend.

The options are as follows:

• Send a text message with your name, date of birth and brief details to       0782 660 5897
• Through our automated telephone system ringing 01977 610009 option 1 and then option 1 again
• Through our website using the online facilities, please click here to login to Systmonline. You will need a unique user name and password to use Systmonline - please speak to a receptionist for more details.

In line with the practice DNA procedure, if a patient fails to attend a further appointment within the same 6-month period, then their registration will be  reviewed by a Partner GP to consider removal from the practice register if clinically safe to do so.

The practice will extend a 4 week period whereby the patient can contact the surgery by letter addressed to the Practice Manager to review this decision and to detail any specific problems preventing them from cancelling these appointments.

If you are late for your appointment it may be difficult to fit you in without making other patients wait longer. Please try to attend just before your appointment slot - but not too early. If the surgery is running late you will be informed by reception so that you have the option of re-booking or through other communication methods where available, such as the self-arrival screen or other patient information screens in the waiting area.

If you are going to be late for an appointment then please let the practice know where possible. Upon arrival please report to the reception desk and the reception staff will liaise with the Clinician to confirm if you will be seen. This will be at the clinicians’ discretion; whilst every effort will be made to see you, it may be necessary to re-arrange the appointment for an alternative date and time.

On occasions surgeries do run late, and in these circumstances the reception staff will keep patients informed by making an announcement over the tannoy system.

13  Seeing the Doctor or Nurse You Prefer

For some problems you may not mind which doctor or nurse you see, but there may be times when you may have a firm preference or it is best for you to see a particular practitioner.

All patients have a right to express a preference of practitioner, so please tell the receptionist if you would prefer to see a particular GP or healthcare professional and we will always do our best to oblige. However, this may not always be possible, and if that were to be the case then an explanation would be provided.

The practice is required by the Government, under the terms of the latest GP contract, to allocate all patients a named accountable GP.

Individual patients will be informed of their named accountable GP at the first appropriate interaction with the practice.

For convenience if you have a medical card your Accountable GP will be the named doctor you are registered with. Patients registering over the last 2-3 years will not have received a medical card as these are no longer routinely sent when registering with a new GP Practice.

However, the practice does keep a record of your registered (accountable) GP. If you wish to be told the name of your Accountable GP then please ask the receptionists when you are next in the surgery.

Please note: there is no need to telephone the practice for this information.

Where a patient expresses a preference as to which GP they have been assigned, the practice will make reasonable efforts to accommodate this request.

Having a named GP does not prevent you from seeing any other doctor in the practice. Your named GP will not be available at all times, and if your needs are urgent you may need to discuss them with an alternative doctor.

14  Improving Access for Patients

The practice is always pleased to receive comments and suggestions about its services, including how easy it is to access them.

• We have comments and compliment slips available at each reception site and these can be completed and left in the appropriate boxes at each site.
• Family and Friends cards are also available at each site and we would encourage patients to complete these forms and hand in at reception.
• Comments can also be left on the NHS website by following the link: https://www.nhs.uk/Review/LeaveReview/H85063 .

Patients are encouraged to join our Patient Representative Group (PRG) and the practice keeps the group up to date with the audits it carries out every six months to monitor access.

New members are welcome to join the PRG at any time - please leave your name and contact details at reception and we will be in touch.

The practice achieved a ‘Young Person Friendly’ accreditation during 2017.  All reception staff received training in assisting young people to get the best from the practice. There is access to resources specifically for young people via the practice website, and the practice will eventually provide a dedicated clinical advice service for young people at least once per week (in consultation with young registered patients and at least equivalent to 30 minutes telephone or face to face surgery conducted by a suitably qualified nurse or doctor).

The practice has now implemented the Accessible Information Standard (AIS). This tells NHS organisations how they should make sure that disabled patients receive information in formats that they can understand and receive appropriate support to help them to communicate.

The practice is committed to supporting, promoting and protecting breastfeeding in the community and is signed up to the Wakefield Breastfeeding Welcome Service. Posters and signs are displayed at all three surgery sites.

The practice has also joined the local authority’s ‘Stay Safe Scheme’, providing a safe refuge for vulnerable adults.

As a practice we have achieved Dementia Friendly status. We have a staff member trained as a Dementia Champion and all members of staff are trained as “dementia friends”. Being Dementia Friendly focuses on improving inclusion and quality of life for people with dementia.

The practice believes that everyone should have equal access to our services, including those whose first language is not English. The practice provides comprehensive and professional interpreting services either over the phone or in person, including British Sign Language (BSL) support. If you or members of your family or a friend need this service then please let a member of staff know and they will be able to make the necessary arrangements.

15 References

Wakefield District CCG Patient Access Policy V1.0 final.

16  Associated Documentation

Online Access Policy

Patient Accessibility Policy 
(Full copy available on request – please see link below)

The Grange, Greenview & Kinsley Medical Centres fully support equality of access for all including in line with commitments set out in the Equality Act 2010.  We are committed to complying with the Accessible Information Standard (SCCI1605 Accessible Information), and the policy sets out how we will ensure that we do so.

The Accessible Information Standard (“the Standard”) sets out a series of requirements for organisations that provide NHS services and /or publicly-funded adult social care or health services, for commissioners of such services, and for IT suppliers.  These ‘applicable organisations’ have a legal obligation to comply with the Standard as set out in section 250 of the Health and Social Care Act 2012.

As a provider of NHS services, the Standard requires The Grange, Greenview & Kinsley Medical Centres (The Grange) to identify, flag and share and meet the information and communication needs of people with a disability, impairment or sensory loss.  These ‘five steps’ must be routinely and consistently followed.

This policy describes the actions that The Grange’s employees, and those acting on behalf of The Grange are expected to take in order to ensure that we comply with The Standard.

Full policy available on request by emailing wakccg.grangemedicalcentre@nhs.net

If any patient wishes to advise us of any special requirements please let our receptionist know when you next phone or visit us.  You can also contact the surgery via email at wakccg.grangemedicalcentre@nhs.net .  Alternatively you can download, complete and return the attached form to any of our receptionists.