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ACCESSING THE SERVICE FROM PRIMARY CARE The impact of direct access booking
Dr J A Gibson
Consultant Gastroenterologist
Mid Staffordshire NHS Trust
NHS A Patient Focused Service
DIRECT ACCESS BOOKING SYSTEM -PART OF THE NATIONAL BOOKED ADMISSIONS PROJECT
AIMS
Consultants, GPs, Health Authority & IT working together to
improve booking systems
Gives GPs a simple secure means of bookings patients directly on to
operating lists during a consultation at the surgery
Allows patients to choose date & time of their investigation/operation
and provides medical information at the time of booking
Progress to Date
• 1 995 DABS introduced to GPs• 1997 Open access Gastroscopy• 1998 Gastroscopy through DABS• 2000 Procedure available at
second site• 2001 Demand for services increased
Booking increased• 2002 Increase in procedures
offered
Currently 25 practices used the system
During quarter 1/10/2001 to 31/12/2001
53 patients booked for Gastroscopy
Anaesthetic Assessment
Example of Current Process
GP Consultation
HospitalReferral Consultant
Prioritisation
Waiting List
TCI Letter
AdmissionPre-op
Assessment
Operation Recovery Discharge
Appointment Given Consultant
Consultation
Process for Direct Access
Anaesthetic Assessment
(Streamlined)
GP Consultation
Admission
Pre-op Assessment by GP
Operation RecoveryDischarge
Direct Booking
DIRECT ACCESS BOOKING
The Patients view The GPs view The Hospitals view
Patient views
popular as It speeds up the waiting time
Patient has choice of available dates/times/consultants whilst in Surgery
Reduces anxiety waiting for appointment
Patient can phone to change appointment once on the system
GPs views - advantages
Like efficient complete service offered
Providing a patient centred service
Speeds up appointment process
Allows GP to control the waiting list
GPs view - disadvantages
Patients are waiting longer for appointments Question Sets too comprehensive Time consuming by answering questions on line Complex referral form Duplication of paperwork Simpler to send basic referral
Hospital view
Reduction in number of incorrect referrals
Correct patient clinical information provided
Patients have information booklet about theprocedure
Patient choice reduces the number of DNAs
Booked Admissions Officer provides Gastro Dept with theatre lists/patient referrals
weekly
The Future
• Increase no of slots available on system
• Compatible with all GP systems
• Expand services for all open access referrals
• Use of system for access to other services
• Review the referral form/screen
My Thanks to the Patient Access Team
Helen Perrin
Judith Williams
Katherine Aston
New Booked Admissions Process
GP Consultation
Hospitalreferral to Central Admissions
ConsultantPrioritisation
Booking Clerk to discuss date
Nurse led pre-op assessment
Operation or treatmentRecovery Discharge
Appointment date discussed Consultation and
decision madeto treat
Consultant to discuss date
or
INTRODUCTION AND PRESENTATION BY
DR JOHN GIBSON
CONSULTANT GASTROENTEROLOGIST