Source: NHS England updated 28 May, 2024
Introduction
Modern general practice and telephony
High quality, effective telephony and online journeys are key enablers of a modern general practice access model. They should integrate well with and support care navigation and administrative processes within a practice or primary care network (PCN).
This guidance helps practices and PCNs choose, purchase and optimise the use of advanced cloud-based telephony.
This guidance is 1 of 5 modern general practice ‘how to’ guides’. The other four guides focus on:
- How to align capacity with demand in general practice
- Creating highly usable and accessible GP websites (includes sections on integrating with the NHS App and encouraging patients to use online channels)
- How to improve telephone journeys in general practice
- How to improve care related processes in general practice
These are all available via the resources page of the national General Practice Improvement Programme.
The national General Practice Improvement Programme (GPIP) provides a range of ‘hands on’ support offers to practices, primary care networks (PCNs) to help move to a modern general practice model. Skilled facilitators work with practices to help map out their model, to analyse and interpret their own data and to support them with improvements.
Why high-quality telephone journeys matter to patients
Since 2021 there has been a sharp drop in patient satisfaction with accessing care through general practice, especially by telephone.
- In the 2023 General Practice Patient Survey (GPPS) 54.4% of patients said they had a good overall experience when making an appointment. This is down from 70.6% in 2021 and down by 1.8 percent since 2022 (56.2%).
- Of patients who had tried, around half (49.8%) in 2023 said it was easy to get through to their GP practice on the phone, a decrease of 17.6 percentage points compared with 2021 (67.6%) and a 2.9 percentage decrease from 2022 (52.7%).
- Around in 8 in 10 (82.2%) in 2023 said the receptionists at their GP practice were helpful, this is a 6.5 percentage point decrease from 2021 (88.7%) and 0.1 percentage decrease since 2022 (82.1%).
- 1 in 5 people report they did not get through or get a reply when they last attempted to contact their practice [Department of Health and Social Care pulse-check survey, December 2022].
Long waits, lack of information, no appointments, no choice of accessing appointments and having to call back another day all impact the quality of the conversations when patients do get through to speak to someone. These are all frustrations faced by patients calling their practice. Further information is available in the Patient Experience Library (Healthwatch Sussex September 2022, Healthwatch Barnsley July 2022, Healthwatch)
The benefits of well-integrated telephone journeys
The use of cloud-based telephony (and improved online journeys) alongside optimised care navigation and triage, understanding and better aligning capacity to demand can help:
- smooth the 8am rush and other peaks throughout the day
- reduce call wait times including giving patients the option of ‘call back’, improving patient satisfaction and experience
- support equity of access across all channels as part of an integrated care navigation model
- reduce the burden on practice teams through integration and easy view data dashboards to support demand and capacity planning and through recording functions, which save time and support development of both clinical and administrative staff
- increase practice resilience by supporting remote and at-scale working.
Compared with analogue telephony, advanced cloud-based telephony provides much greater capability to practices including:
- Call back and queue position capability informs the patient of their position in the queue and gives them an option to keep their position and request a call back (where the system automatically re-dials the patient as they approach the front of the telephony queue). This helps reduce the wait times for patients and helps smooth peaks in demand, increasing patient satisfaction and reducing complaints.
- Call routing enables patients to choose options via their keypad or voice options to enable direct routing to the right person or team. These can be configured to match the services in a practice or PCN. This can divert some demand away from phones at busy times. This can be further supported by effective care navigation.
- Welcome and queue messages help set expectations and support up front information gathering, quicker signposting and clinical triage. Recorded messages with health information or information about your practice can help share news and inform callers of other services run by multidisciplinary team members.
- Call recordings (and being able to retrieve recordings) can support individual staff training when used as part of ongoing staff development conversations. The search facility means less time is spent documenting conversations in response to complaints or patient incidents, because they are recorded.
- Reporting supports planning and demand management, improving the ability to plan and track progress and make practice staff capacity and resourcing decisions on evidence.
- Live dashboard reporting enables your practice to react quickly when demand peaks.
- Flexible configuration supports hybrid and home working with the use of ‘soft phones’. The flexible configuration enables the ability to scale with little difficulty when staff and services are shared across more than 1 site or when a new individual, team, service or practice joins. For PCN working, advanced telephony functionality supports business continuity and provides resilience if there is a major incident at the practice (floods, emergencies, covid etc). It supports remote working, sharing of demand or calls being directed to other sites and services.
- Bypass feature allows other services to bypass the usual queuing system.
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