clinic appointments Archives - Page 3 of 6

Back to basics

A global research study has concluded that lower back pain is the leading cause of disability and work absence across much of the globe. Researchers from institutions in Australia, the US and the UK including the Royal Cornwall Hospital found that whilst there is no evidence linking back pain with a higher risk of early death, it can cause long term disability.

Across the world the study estimates that nearly 1 in 10 suffer from lower back pain with the figure rising to 15% in Europe. An increasingly aging population is only going to exacerbate the issue which can cause emotional and financial as well as health problems for sufferers.

Although lower back pain has no one common trigger point, typically causes include poor posture when sitting or standing, bending awkwardly or failing to follow lifting guidelines. Acute back pain can also cause leg pain which adds to the difficulty of moving and walking. In its extreme form it can also impact on everyday tasks such as washing or dressing.

With the incidence of lower back pain expected to increase alongside an ever-aging population this condition places a strain on all health professionals. Whilst doctors and health visitors are more likely to be in the front line, others such as physiotherapists, osteopaths and chiropractors will all take up the burden of day to day treatment. Maximising patient time and minimising administrative burdens will therefore form an essential part of the way forward in treating this debilitating condition.

For the health professional this will require a switch to “always on” technology which will help patients to book appointments and stay in touch without taking up clinical time. This includes taking steps to ensure phones are covered by internal or external support staff, appointment booking online and automatic appointment reminders. These simple steps can make a huge difference both to treatment times and to ease the strain on overworked health professionals.

In its review of the study, the NHS Choices website concludes that it may be a cliché to say that doctors don’t understand the back but it acknowledges that lower back pain is a “poorly understood condition.” The site therefore calls for further research into the ways in which back pain can better be prevented and managed. Pending the outcome of such research it will fall on health professionals to take steps to manage their back pain management in the most effective way possible.

Changing the UK’s Health

Sometimes for change to happen it requires a seismic shift in technology or actions, but on other occasions a series of small individual acts can come together to create something special. That was the idea behind NHS Change day; a time when individuals can make small pledges which could result in significant change for the NHS.

At the time of writing over 450,000 people have made their pledges and with the last pledge date for 2014 still some weeks away the final total is expected to be far higher. Some pledges are designed to support and strengthen local campaigns whilst others have been made on a far more individual basis.

One national campaign which the NHS is promoting through NHS Change Day is the idea of reducing no-shows. With 12 million GP and 6.9 million hospital appointments missed in the last year costing a total of £270m, every person who makes an individual pledge not to miss an appointment in future will be saving the NHS money and improving treatment for themselves and others.

In an attempt to cut down on no-shows NHS practices are adopting a range of measures from reminder calls and texts to encouraging direct booking online. But it is not just health practitioners within the NHS who suffer from missed appointments. Health practitioners across the board from chiropractors to physiotherapists and from beauticians to counsellors all suffer if a patient fails to attend an appointment. And in many of these cases it is not just the taxpayer who loses out but the health practitioner themselves, not to mention other patients who could have taken that vacant slot.

So for health practices everywhere, anything which can be done to cut down on no-shows should be done. Appointment reminders, online booking services, ensuring continuity of telephone answering; all can play their part in working towards a full diary and effective treatments.

The pledges being made for NHS Change day are not just confined to reducing missed appointments. Challenging culture, enhancing leadership, patient safety, improving skills, the list goes on. Some of the pledges are from patients, others from those on the front line or back office who are working to improve the NHS from within and without. From individual pledges to walk more or eat healthily to sharing knowledge and experience with others, the pledges may individually not be earth shattering. But if enough people see the pledges and join in then health care for all could be the winner.

Improving patient outcomes

There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know

Donald Rumsfeld’s comments on the presence, or otherwise, of weapons of mass destruction may have passed into folklore but they do encapsulate the dilemma facing anyone who seeks to move away from the tendrils of speculation and into a position of certainty. Particularly so in the field of research where some studies result in ground breaking initiatives whilst others merely confirm unproven but seemingly obvious theories.

For example, a Europe-wide study into nursing practices has shown that a combination of nurse education levels and patient/nurse ratios can have an impact on patient outcomes. Whilst the initial reaction to this report may be to dismiss it as stating the obvious, an already known known; studies such as these are invaluable in both proving the theory and in quantifying the extent of the problem.

So whilst we may have thought that we knew increasing the workload of nurses may lead to poorer patient care, a study which concludes that increasing a nurse’s workload by one patient is associated with a 7% increase in patient deaths can only serve to sharply focus the attention. The report also concludes that in return for a 10% increase in nurses with degrees the risk of patient deaths falls by 7%; something which will be of comfort in the UK where with effect from 2013 all new nurses have to be educated to degree level.

Those working within the healthcare profession have always “known” that the more patients presenting for treatment equals the less time available for each patient and consequently the more likely that symptoms may be missed and care not be provided to the standards expected. But studies such as this one highlight the effect of time and patient pressure. For some the solution will be to educate further, to take on more staff; but when budgets are tight that is not always possible. Finding ways to work smarter, to automate, to outsource the routine, to free up time for patients is the way forward.

Before this study we knew that time and education equalled improved outcomes but we didn’t know to what extent. Now this part of the health service puzzle has moved from a known unknown into a known known and that has planning implications for all who practice healthcare and want to maximise patient outcomes.

A ‘Wellcome’ cure

The Wellcome Library has opened up its archives of historical memorabilia for general use. According to the library the collection encompasses ‘manuscripts, paintings, etchings, early photography and advertisements’ and amounts to some 100,000 images.

Releasing the images under the Creative Commons Attribution Licence means that they can be used free of charge by anyone for personal or commercial purposes, provided that the image is accompanied by an acknowledgement as to source. So whether you are treating your patients for gout or for sprained limbs, for persistent pain or for an aching tooth there may well be a suitable image which you can use to amuse or to inform your patients.

In opening up the archive the Head of the Wellcome Library, Simon Chaplin, said “Together the collection amounts to a dizzying visual record of centuries of human culture, and our attempts to understand our bodies, minds and health through art and observation. As a strong supporter of open access, we want to make sure these images can be used and enjoyed by anyone without restriction.” The earliest image in the collection is a fragment of an Egyptian herbal, inscribed on papyrus. From that early beginning the collection encompasses medieval manuscripts, Victorian cartoons and some early photographs exploring the movement of the human body.

Providing effective patient treatments can be challenging at times and those working in the health profession know that keeping the tone light and adding touches of humour can help to alleviate patient anxiety. Access to an archive such as this can help to make the difference; although whether some of the images such as the Gilray cartoons portraying gout sufferers drinking port will teach us anything is a matter for debate.

But to be truly effective light heartedness needs to be tempered with professionalism and this is not always easy to achieve in a busy health practice. Answering the phone, finding or filing patient notes, sending out invoices and other administration tasks can all disrupt patient treatments. Outsourcing some of this work to a virtual assistant service can help to smooth over the working day and maximise time taken on treating patients. Virtual Assistant services can be taken on a permanent or ‘as required’ basis. This means that health practitioners can concentrate on what they do best, treating and reassuring patients, whilst being reassured themselves that behind the scenes day to day administration tasks such as phone answering, appointment reminders and invoicing are not being neglected.

Whole person care

The Institute for Public Policy Research (IPPR) has issued a report examining the measures required should England’s health and care system move towards the provision of ‘whole person care.’ With the benefit of making the connections between physical health, mental health and social care needs, and supporting people to remain in their own homes as long as they wish, whole person care provides joined up responses to individual needs.

Success is dependent on a number of factors including a long-term investment mindset, aligned incentives, effective use of technology and a flexible workforce. The report concludes that there is clear potential to deliver better outcomes if care services are more coordinated.

Commenting on the report Chartered Society of Physiotherapy (CSP) professional adviser, Eve Jenner, said that “physiotherapists were well placed to support whole person care” adding:

“They can act as single point of contact, care coordinators or as part of a team of health and social care professionals providing holistic assessment and treatment to people with long-term conditions.Key success points for whole person care include peer support, tapping into the expertise of others with the same condition, and personalised care plans. For professionals, the ability to share online access to personal health and care records is also vital. This last point echoes moves already being made within the health profession to share records. Not only does this lead to streamlined care, it also saves time and costs and helps to speed up effective treatments.

Simple measures such as electronic storage of patient records are a key step towards this goal. But not only does electronic storage facilitate the sharing of records, it also streamlines processes. When patient records are available at the touch of a button there is no wasted time in searching for mis-filed records, no wondering if the record shown is the latest one and no time spent on gathering evidence in preparation for each client appointment.

For health professionals such as physiotherapists and osteopaths, the electronic storing of patient records helps to save administration time which can better be spent on patient treatments. For health and care professionals as a whole, the move towards whole person care will help them to cost effectively provide the best treatment pathway available for the individual. The IPPR has identified many issues which are critical for the success of whole person care and they will be looking at these in more depth over the next 12 months. We’ll keep an eye out for these follow-ups and report as appropriate.

Booking time

The dawn of the ‘internet revolution’ may by now be lost in the mists of the past but it seems as though at last the benefits of internet connectivity have moved into mainstream living. This Christmas more than one third of all shopping will take place on line with features such as click and collect proving popular.

As we toast the end of the year with internet tills ringing we are also shortly to be waving goodbye to another British institution. The Government has announced that the paper car tax disc is to be phased out. With authorities relying on purely electronic records the move will save time and resources.

In fact way back in the early days of the internet the benefits to be gained from the saving of time and resources were widely predicted but in the intervening period it has sometimes seemed as though all that the internet has done is bring more work. In the early days ‘dial up’ was so slow that many people could get in their cars and drive to the shops faster than they could order goods online. Now thanks to improved internet speeds allied with programmes designed with ease of use and speed in mind, the internet has at last come into its own.

One benefit of this improvement is the way in which health service providers are able to manage their diaries. For the health practitioner the time spent in booking appointments is effectively ‘dead time’; time which is spent away from treatment and time which potentially impinges on another patient’s treatment. That is why practitioners turn to services such as those provided by virtual assistants who can take calls and manage bookings on behalf of the health practitioner.

Now there is a new service available from Callagenix which not only saves the health practitioner from taking calls, it also saves the client from having to telephone. Online booking enables clients to browse and book an appointment at a time to suit them. This quick and simple appointment service perfectly ties in with the general move towards using the internet as the first port of call. The service is flexible and practitioners can choose whether to accept new or existing clients via the online service as well as restrict online booking to certain treatments or to certain times of the day or week. Time saving, easy to use and flexible; online bookings are a perfect example of the way in which the internet can make life better for all.

Chinese Whispers

A GP who is at the forefront of patient engagement and empowerment has revealed that 99% of his communications with physiotherapists are still carried out on paper. According to the Chartered Society of Physiotherapy, Dr Amir Hannan said ‘I don’t think we use email as productively as we might or technology in general.’

With letters being used as the prime communication method, it can sometimes be weeks before the results of patient treatments are conveyed to the general practitioner, resulting in delays in considering appropriate follow up treatment. This affects the perception and actuality of patient care and can in some cases lead to a worsening of the patient’s condition.

In fact, Dr Amir highlighted the way in which delays in receipt of letters can result in the patient having to brief the doctor on the methods and results of treatments. Whilst this does play into the hands of those who advocate patients taking responsibility for their care, it also means that treatments and findings can be filtered with a ‘Chinese whisper’ effect resulting in distortions.

Dr Hannan’s comments were echoed by NHS England’s director of systems, strategy and technology, Beverley Bryant, who confessed herself to be amazed “how much paper flies around our hospitals”. As we have previously reported, one solution to this paper mountain is to adopt smarter practices which benefit from the use of current technology. The health care authorities are working towards this end but there are options available now for those who need to find a way to communicate more effectively.

One of the main barriers to swift communication is the simple lack of time available to those who want to maximise patient treatment time. Every time papers are filed, every time the phone is answered, every time an invoice is sent out is time which takes health practitioners away from their core task. Simply by using the services of a virtual assistant to take control of telephone answering, diary management, electronic records and invoicing enables practitioners to free up valuable time.

Working smarter, not harder may be a mantra which is parroted around the business-speak airwaves on a regular basis but it does carry an element of truth. Health practitioners took up the call to treat and improve the lives of others. By concentrating on that calling and leaving the day to day admin to others, everyone benefits.

Time to ski

With Bonfire night safely out of the way it is time to turn our thoughts ahead to the winter ski season. Whilst some forecasters have predicted a harsh winter ahead for the UK in 2013, the Met Office recently took pains to stress that it is still too soon to produce an accurate forecast and accused those who are predicting “the worst winter in decades” of crystal ball gazing.

Whatever the outcome, UK winters are still too unpredictable to guarantee good snow leaving ski enthusiasts having to look elsewhere to get their skiing fix. This means that the annual exodus to the European slopes and further afield is about to get underway.

The first week in November has already brought a good snow covering to some alpine resorts, resulting in predictions of an early start to the season and no repeat of last year’s green slopes. Hopefully the weather conditions will bring good safe skiing but whilst the majority will return safely from their adventures, there will be some who suffer on the slopes and need attention on their return.

It’s not surprising therefore that whilst eager skiers travel outwards, back in the UK physiotherapists and other health professionals are bracing themselves for a busy winter. Broken limbs, strains and pulls are an inevitable consequence of skiing accidents. Add in those whose year-round sedentary lifestyle has not prepared them for the physicality of skiing and chiropractors, osteopaths, and physiotherapists alike are an unforeseen consequence of a winter holiday on the slopes. And if winter in the UK does turn out to be harsh then there will be an additional crop of home-grown injuries to treat.

Hopefully some individuals will have thought ahead, consulting health professionals for pre-ski exercise regimes which will prepare them for a holiday on the slopes. And hopefully some people (particularly the elderly or frail) will have prepared for icy conditions at home, stocking up on essential supplies or arranging for additional support perhaps from a neighbour or health professional. But many won’t be prepared and even if they are, it is impossible to guard against accidents. All this means additional demands on the services of health professions who in turn will need to gear up their timetable to run as smoothly as possible. This includes taking steps to ensure that the time given to treatments is maximised.

All this means that health professionals need to gear up their timetable to run as smoothly as possible. Missed appointments not only means a lack of income but also another patient who will not be speedily treated. Having to interrupt treatments to take phone calls means that treatment may not be as effective as it should be. And if calls are missed then patients suffer and diaries are not as full as they should be.

The answer is to bring in the services of a virtual assistant. With calls answered, diaries can be maintained as full as practicable without patent treatments suffering. Add in an appointment reminder service and no-shows are reduced again helping diaries to be maintained at an optimum level. Skiing can be fun, but when something goes wrong, a speedy return to fitness with quick and professional help is the best way to prepare for the next season on the slopes.

Telephone reminders

We’ve written before about the way in which telephone reminders can help to cut down the number of no-shows but it is always a pleasure to be able to report on a practical example. Earlier this year the Great Western Hospitals NHS Foundation Trust introduced a reminder service for those with outpatient appointments.

Since the reminder service started the trust reports that no-shows have reduced by a third and the trust is therefore expanding the service to its physiotherapy departments. Using a mixture of texts and automated calls the trust decided to adopt the appointment reminder service as a way of cutting down on the 39,871 appointments missed in 2012.

In announcing the extension of the service the trust’s deputy general manager responsible for outpatients told the Wiltshire Times: “The reminders seem to making a real difference. I hope that patients find the service helpful and it makes it easier to cancel or rearrange. If we know a patient won’t be attending, we can offer the appointment to someone else. By making sure all of our appointments are used, we can see more patients and patients will be seen sooner.”

Patients who fail to show up for appointments are not just a problem for NHS trusts. Health practitioners everywhere from osteopaths to physiotherapists and from beauticians to specialised health clinicians all need to run with as full a schedule as possible if they are to remain competitive. Not only can missed appointments lead to delays in treatment times for the patients concerned and others, for those who rely on the appointment to generate income, every gap is a loss. The Wiltshire trust estimated that for them each missed appointment cost some £108 and the opportunity cost charge can easily be higher for those in private practice.

It is hardly surprising therefore that telephone appointment reminders are increasingly becoming a necessary feature of health practice. This writer has received reminders within the past few months from their optician, dentist and doctor, all of whom have adopted versions of the reminder system. Set alongside a virtual assistant service which can also take calls and arrange bookings, even the smallest of health practices can move towards a fuller diary with fewer no-shows. This in turn means that health practitioners can keep their prices competitive whilst maximising both their income and patient treatment times.

Taxing times

From time to time HMRC decides to set up a task force to investigate the tax affairs of a certain business sector. For example in the past it has reviewed car dealers in the Midlands and fast food outlets in London. Now it is the turn of health professionals to come under the spotlight.

Announcing the initiative on 7 October, HMRC have given health professionals until 31 December to sign up for the campaign and until 6 April 2014 to pay any outstanding tax. By doing so they will face far lower penalties than if they fail to sign up and HMRC subsequently discover amounts of unpaid tax are due.

Doctors, dentists, nurses and social workers are not covered by the campaign but the HMRC announcement highlights other health workers who they will be looking at including:

Physiotherapists, occupational therapists, chiropractors, osteopaths, chiropodists, podiatrists, homeopaths, dieticians, nutritional therapists, reflexologists, acupuncturists, psychologists, speech, language and art therapists.

Whilst the vast majority of health professionals will already have their tax affairs in order, the campaign is a reminder that being a health professional is not just about treating patients. Managing diaries, booking appointments, invoicing and collecting fees, ordering supplies and preparing accurate accounts all take time out of the working day. Larger practices may have the benefit of a team of back-office helpers but health professionals working in smaller practices may find themselves juggling patient time and treatment time to the detriment of income and professionalism.

That is when the services of a virtual assistant can come in handy. Appointing a virtual assistant service to answer the phone, manage the diary, book appointments, invoice and file patient records can free up valuable time both for patient treatments and to provide some free time at the end of a full day. Of course there are some tasks that a virtual assistant won’t be able to perform, such as being there to receive medical supplies, attend CPD training or complete tax returns but with time freed up from other tasks, at least the health professional will not be under as much time pressure when other tasks need to be completed.

In announcing their latest initiative, Marian Wilson, Head of HMRC Campaigns, said “I urge health and wellbeing professionals to take advantage of our quick and straightforward way of bringing their tax affairs up to date. Help, advice and support is available.” Full information including a video and direct phone number is available via the announcement on the HMRC website.

0800 0789333 info@clinicappointments.com

Book your free demo today! Call us on 0800 0789333 or book online

Tag: clinic appointments