16th May – High Levels of Staff Sickness

We are experiencing high levels of staff sickness in our frontline staff. Please be patient and kind when contacting the practice and speaking to our staff, who will do their best to support you as quickly as possible. We are continuing to see high levels of patient submissions through our Klinik system, which is much

Contact us online. Get help from your GP with our online consultation service.

Klinik – A Better Way to Access Care

Welcome to our Klinik information page. Here you will find videos and information on what Klinik is and how were use it here at The Adam Practice.

Watch this video to see the journey of a Klinik form through our triage team:

To access Klinik click the ‘contact us online’ logo below:

Click ‘Start here‘ above to go to the Klinik homepage

How to submit a Klinik form online

To book an appointment to see a clinician you need to complete a Klinik form via our website. If you are unable to do this please call the surgery and a receptionist will help you with this.

Klinik – Patient Questions & Answers

New to The Adam Practice or haven’t used our Klinik online consultation service yet? Read our Patient Questions & Answers below:

Klinik – Patient Feedback Survey

We’ve been using the Klinik online system in our practices since the end of May 2022. We are constantly reviewing and improving how we use Klinik, using feedback from patient comments and complaints.

We’re now beginning to actively contact our patient population to ask for feedback on the experiences of using Klinik, either online or via telephone contact with a receptionist. If you would like to support our continuous improvement of Klinik then we want to hear from you and would be extremely grateful if you would complete our short Klinik survey HERE.

We will share the results of our survey with our patients once all feedback has been collected.

Klinik – What is Klinik?

Klinik is the new software platform we have chosen which will bring improvements to both the way patients access care, and the way our staff can then assess your needs and find the most appropriate clinician or service to help you.

Click on the image below to access the main Klinik submission link

Here’s a short video on how to use Klinik created by Klinik owners. Please note that our Klinik access is only available during working hours and is NOT a 24hr service we also do not uses Klinik SMS text service to contact patients:

Video glossary words:
  • Landing page – The front page of Klinik where you can access both clinical and non-clinical support. This page also includes information on the opening hours of Klinik and the timeframe you will receive a response, based on the urgency of the details submitted.
  • Tile – A list of options for a patient to choose depending on their reason for contacting the surgery.

How will I access care?

Similar to now, there will be two main ways to access care: via Telephone or Online.

Whichever route you choose, you will be asked a range of questions to help our Clinical Triage team assess and direct your request to the best place to meet your needs.

Your request will be handled in exactly the same manner whether you complete the form online yourself, or contact us via telephone, where our call handlers will ask exactly the same questions as the online system. This ensures equity of access for all patients.

Background – Why do we use Klinik?

Appointments at The Adam Practice have traditionally been booked on a first-come first-served manner. Even before Covid, this system was coming under increased pressure as requests from patients have risen significantly in recent years, whilst funding and therefore staff numbers have not been able to increase to match that in demand using such a model. This has led to increased waiting times and delays, and significant pressure on our staff and clinicians.

Online consulting was introduced in 2020 using the eConsult system, used by the majority of Practices in Dorset after being procured as a single system for the whole county by Dorset CCG. This system improved access for some patients who were comfortable using it, however it was difficult to fully integrate with our existing appointment system and caused further inequity of access for some patients.

The overall impact was that whilst both telephone and econsult requests were handled on a first-come first-served basis, those patients with a more urgent clinical need were often unable to book an appointment, or had to be seen as an ‘extra’ patient by GP’s after the end of a full clinic.

This system also placed pressure on Reception staff to meet patients needs and find appointments where there often were none – leading to patients repeatedly being asked to call back the next day.

On some days our GP’s were seeing 6 or more extra patients per session, plus related tests, follow-up or paperwork. Most GP’s were working between 12 and 14 hours per day every day, leading to significant concerns about the welfare of our staff and the sustainability of such a service.

Pilots, drivers and some other professionals have legal restrictions on the number of hours they can work to ensure they can perform to the best of their ability where safety is a primary concern. GP’s have no such restriction despite having to make decisions that directly affect the health and wellbeing of their patients in every consultation.

Patients were also understandably unhappy with this situation, as telephone delays and waiting times for appointments grew longer. Covid exacerbated this with telephone triage being required for the majority of patients to reduce risk, and staff sickness also increased significantly, placing more pressure on those who were able to work.

Before Covid began we had started to look at alternative appointment systems but this had to pause when Covid struck. The subsequent successful delivery of the Covid Vaccine programme, whilst essential for the health of our patients, also restricted our capacity to implement a new system as staff were stretched across multiple demands.

This year however, we were able to make progress and began a project to address the above concerns, with the key outcomes being agreed as follows:

  • To ensure patients receive an appropriate appointment for their clinical need at an appropriate time.
  • To reduce pressure on staff and clinicians and ensure the service we deliver is safe and sustainable.
  • To maximise the opportunities available using digital tools and access, whilst ensuring equitable access for all patients irrespective of the method used to contact the Practice.
  • To make the best possible use of our limited clinical resources, ensuring the most appropriate clinician sees the most appropriate patient.
  • To improve staff recruitment and retention and reduce the risk of staff burnout.
  • To improve the data quality around demand and resource usage, to enable us to plan services and workforce more effectively, and to also enable more informed conversations with patients and local and national commissioners about the pressures on the Practice.
  • To meet our NHS England contractual requirements to implement online access.

On 23rd May, we made the change to our new system, and the following section describes how the system works.

The new system – how it works

At the heart of our new system is Klinik software.

Klinik is one of many systems approved by NHS Digital for use by GP Practices to meet our contractual requirements and so patients can be assured that it has gone through a rigorous testing and assessment process, is clinically safe to use and meets all national requirements including for GDPR and Data Protection.

From a patient perspective, Klinik is primarily a new tool for entering information about your need for an appointment or other help, similar to eConsult, our previous system. However the main difference to us as a Practice is in how Klinik helps us to manage demand and ensure that we can triage it more effectively.

In our previous system, your request would be handled by one of our Patient Service Clerks (PSC) who would try to find an appointment on a first-come first-served basis. As demand has increased over the years, the appointment numbers we are safely able to provide with current levels of funding and staff availability has been unable to match this increasing demand.

PSC’s have always done the best they can to help patients, and have a wealth of knowledge and experience, but they are not clinically trained and were often placed in a difficult position of trying to find appointments when none were available, or having to escalate urgent requests to clinicians who already had a full clinic booked, putting them under increased pressure to see an unsafe number of patients.

Implementing a more effective clinical triage process was therefore essential to improve patient safety and make the most effective use of appointments. This is very similar to an A&E department, who clearly need to prioritise a patient who has had a serious accident ahead of another patient with a broken finger for example.

All patient requests are now entered into the Klinik system. Patients or their representative/carer, can enter their requests into Klinik directly via our website, which saves time queuing on the telephone, or for those who are unable to use the online system our staff will enter details into Klinik on the patients behalf, either via telephone or in person.

The system asks structured questions about your request. Whilst this can feel intrusive or unnecessary to some, it is vitally important as this information is used by our Acute Triage Team to assess the urgency of your request. Without accurate information, we cannot assess your need. If necessary, we will contact you for more information but the system will ask all appropriate questions and allow you to enter details including if you would like to see a specific clinician.

The Acute Triage Team is made up of a combination of GP’s, Advanced Nurse Practitioners and Paramedics using their combined skills and experience to clinically assess the information you have provided, and ensure you are offered an appointment in an appropriate timescale and with the most appropriate clinician available. Administrative support in the team will then contact you to book the appointment.

Primary Care is changing and there are many more highly skilled individuals who work in our teams than just GP’s and Nurses. The Acute Triage Team may recommend that you see a specialist physio advisor for knee or back pain for example. Pharmacists may assist with medication queries, or our Acute Visiting Team may be asked to come and see you if you are housebound.

Rest assured that where the team agree that it is best that you see your own GP, this will be arranged, and your wishes will always be taken into consideration.

We would very much like to be in a position to offer every patient exactly what they have asked for, but the reality is that we do not have the staff or resources to be able to do this. As a result, we must assess your needs according to clinical risk and find the best possible option under the circumstances.

FAQ

I don’t want to disclose personal information on the phone/before an appointment

We recognise that patient privacy is important and that some patients may not feel comfortable disclosing personal information to administrative staff. For those who can do so, we strongly encourage patients to therefore submit a Klinik request online via our website. Your details are automatically passed directly to the Acute Triage Team to review directly.

If you cannot use the online service, please try to give as much information as you are comfortable providing to help the Acute Triage Team assess the urgency of your need. Our staff are used to helping hundreds of people a day and treat your information in absolute confidence, passing it directly to the Acute Triage Team. If you feel unable to provide any information, we may arrange a telephone call with a clinician to discuss your request further, but this may delay the process slightly as known urgent cases will be dealt with first.

If I need to telephone, will my request be triaged after someone who sends in a quest online?

No – all requests are triaged according to clinical urgency, not the time they were submitted. The system automatically flags up certain symptoms or conditions to our Acute Triage Team, so if your need is more urgent than someone else, you will be prioritised.

Why can’t I just book an appointment immediately when I telephone?

Appointment capacity is limited and if we allow patients to book without clinically triaging your needs, then patients with more urgent needs may not be seen in an appropriate timescale. Whilst this may mean you have to wait slightly longer to find out when your appointment will be, the overall impact will be that you are likely to be seen sooner than under our old system, especially if your need is acute.