Department of Health Archives - Clinic Appointments

Optimising Sporting Performances with help from your dentist

What does it take to help an elite athlete to stay at the top of their game? Good nutrition, a balanced training regime, access to the best physiotherapists and osteopaths? Well if a recent (April 2014) conference in London is anything to go by the need for good oral hygiene and a trip to the dentist should be added to the list.

In September 2013 a study published in the British Journal of Sports Medicine revealed low levels of oral health among London 2012 athletes, with 40% being bothered by oral health problems and 18% reporting that dental problems impacted on training and performance. The study was carried out on a cross-section of athletes competing at the games.

Now the oral health and performance in sport conference in London has backed up those findings with a series of discussions and presentations on the impact of oral hygiene on sporting performances. Whilst good dental hygiene won’t turn a novice into an elite athlete, for those at the pinnacle of sport where the slightest edge can make the difference between Olympic Gold and also-ran, it seems as though dental hygiene is a contributing factor. And the effect is not just confined to those who seek to be ‘the fastest’. The British boxing team have already noticed a difference since regular dental checks were introduced as part of the training regime.

But good dental hygiene is not just for athletes. Type 2 diabetes and heart problems have also been linked to poor oral health, making a visit to the dentist a potentially life-saving activity. Plaque can lead to gum inflammation and studies have shown that inflammation anywhere in the body, including in mouth and gums, can have a detrimental effect on arterial health. So studies have concluded that regular brushing and attention to oral hygiene including trips to the dentist can help to protect heart health.

But as the British boxing team managers found, a visit to the dentist is not on many people’s priority list. It is important therefore to ensure that making appointments and contact with the dental surgery is made as easy as possible. Systems such as online booking and automated appointment reminders can make a huge difference to attendance rates.

Whilst a nagging toothache is a strong enough reminder that something needs to be done, without pain our impulses to make a check up appointment are fleeting at best. Being able to log in via PC or smart phone and book on the spot enhances the chances of capturing that fleeting idea. And for surgeries which operate a ‘book your next appointment now’ system for those who do visit, an automated appointment reminder will help to decrease no-shows from those who forget the appointment that they made six months ago.

Talking about the boxing experience, Dr Mike Loosemore said of the enforced dental checkups: “They may not appreciate it now, but hopefully they’ll appreciate when they’ve got a gold medal round their neck in Rio.” For non-athletes the reward may well be a lessening of the chances of heart or diabetes problems in later life.

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.

Papering over the cracks?

The Government has announced a funding boost of £500m to help to relieve pressure on the worst hit A&E departments. Statistics have revealed that one million more people attended A&E in the last year compared with three years ago and this, particularly over the winter, has resulted in a virtual melt down of some services.

The funding is aimed at helping hospitals to prepare for the forthcoming winter and is designed to reduce or eliminate the “pinch points” which can so badly affect A&E services. This should enable A&E patients to be treated promptly and provide alternate care pathways for those who currently see A&E as their only care option.

Hospitals which have been identified as being most affected have been invited to submit their proposals for funding. These proposals may involve Accident and Emergency departments directly but could also cover areas such as taking steps to minimise hospital admissions from care homes by providing local specialists, increasing hours at walk in centres or pharmacies or increased social care provision or the provision of more services away from hospitals.

In announcing the proposals the Prime Minister, David Cameron, said:

“The additional funding will go to hospitals where the pressure will be greatest, with a focus on practical measures that relieve pinch points in local services. By acting now, we can ensure doctors, nurses and NHS staff have the support they need and patients are not left facing excessive waits for treatment.

Whether this new measure will be successful in reducing winter waiting times will be a matter for the future but it has to be said that it has not received universal acclaim. The Alzheimer’s Society commented that “while today’s proposals could bring short term benefits, they will do little more than paper over the cracks,” and their comments were echoed by the BMA and others.

However, this is but one stage in an overall plan to provide continuity of care within the community, thereby reducing the pressure on hospitals. This includes a £3.8 billion fund to “focus on joining up services, so that health and care services work more closely together, keeping people healthier and treating them closer to home.”

In the long term this will provide opportunities for health practitioners such as physiotherapists and osteopaths to provide higher levels of care outside the mainstream hospital system. Those health care providers who have streamlined their services to maximise patient treatment time are in a strong position to benefit from this new health care ethos and to provide increasing levels of care continuity to their patients and the community in which they serve.

Designing care pathways around patients’ needs

A report by The King’s Fund has recommended that local organisations be given the freedom to prioritise quality patient care under the supervision of NHS boards. Entitled “Patient-centred leadership” the report acts as a follow-up to the Francis inquiry.

One of the central themes of the report relates to the need to move away from externally imposed targets and towards a culture which puts patient-care at the centre of the NHS. Commenting on the report the NHS Confederation chief operating officer Matt Tee said: “It is very worrying that such a significant proportion of respondents to the King’s Fund survey think the NHS does not sufficiently prioritise quality of care.”

The president of the Royal College of Physicians, Sir Richard Thompson, backed the report but highlighted the way in which technology can play its part in aiding, or hampering, a physician’s attempt to provide quality care. A report on the national health executive website quotes Sir Richard as saying that “Clinicians desperately want to provide high quality care, but problems with systems and resources can often make it difficult for doctors and nurses to treat their patients well.”

Certainly the old days of scribbling a note on a piece of paper and putting it in a patient’s file are gone. But whether the introduction of technology has improved and streamlined care processes is a matter of debate by many health practitioners. As with any new technology, some systems prove a boon in terms of time saving whilst others are so complex that the practitioner sometimes feels they are spending every moment in satisfying the ever gaping maw of IT and processes.

But there are some technologies which can make a real difference to maximising patient care times. For example, systems which record and store patient files electronically can generate huge time savings. Gone are the hours of filing and the wasted time whilst you search for a note which has been misplaced. Instead, a touch of a button and the entire patient file is there before you, with notes, MRI images and other documents available to view instantly. Not only does an automated patient record help to manage multi-practitioner cases, it can prove to be a boon in smaller practices such as those provided by osteopaths or physiotherapists.

Undoubtedly our health practitioners have the will to provide top quality patient care at all times. With automated patient records freeing up valuable time, perhaps technology can lead the way in this transformation.

Going paperless

The Health Secretary, Jeremy Hunt, has set out plans for a paperless NHS by 2018. In a speech to the Policy Exchange the Health Secretary said that a series of milestones would mark key stages towards the eventual goal. These include hospitals being able to accept electronic records by 2014 with 2015 seeing electronic referrals in place.

In advance of the announcement a report by PwC suggested that over £4 billion could be saved within the NHS by better use of information and technology. This includes automatic referrals, e-prescriptions and the smart use of technology increasing the time clinicians spend with patients thus leading to a reduction in waiting times.

This latest drive towards a paperless NHS has been broadly welcomed with the only scepticism coming from those who suffered from the failure of the previous attempt by Labour to bring in a centralised NHS system. This latest initiative avoids the “monolithic system” pitfalls by enabling health providers such as GP Practices and hospitals to commission their own systems which will merely be required to share records with other systems. This means that health providers can develop, store and manage records in a way which suits them, subject to central sharing protocols.

There is no doubt that digitising records can save time and money. For example, the John Taylor Hospice near Birmingham has more than doubled the time clinicians can spend with patients simply by using laptops. But the drive towards a paperless NHS can also benefit others within the health care sector. Software such as that offered by the Clinic Appointments patient records service is already helping health practitioners to digitise their patient records. This means that records can be accessed 24/7, there is no time wasted in finding or sorting records and with clinical notes, x-rays and invoices all centrally handled the health practitioner can spend more time on treating patients.

Combined with the telephone answering and diary management service this means that while an osteopath or physiotherapist is treating one patient the Clinic Appointments team can take calls, book appointments and the health practitioner can then call up the next patient’s details at a touch of a button. With faster administration time and no more worries about losing patient records in fire or floods clinicians can concentrate on what they do best, treating their patients.

Fit for the future?

The 2012 Hospital guide from Dr Foster makes very interesting reading. The headline statistics about hospital occupancy rates alone paints a picture of an NHS which is full to bursting. Against an ideal occupancy rate of 85%, the report shows that for 48 weeks a year most hospital trusts have a bed occupancy rate in excess of 90%.

This not only puts pressure on trust staff on a day to day basis, high occupancy levels mean that when a crisis hits there is little spare capacity to meet it. So, the current Norovirus outbreak which according to the HPA is already 72% up on last year is bad news indeed.

Unfortunately for NHS managers the Dr Foster report highlights one major bed blocker that could easily be avoided. Apparently 29% of beds are taken up by “patients whose admission might have been avoided if their care was better managed.” This includes patients who are readmitted shortly after discharge, patients who would have been better treated in the community and patients who could have been seen as day cases.

The report does conclude that efficient hospitals can deliver good quality care but that areas such as missed hospital appointments, unnecessary admissions, a lack of weekend care and keeping patients in too long (or conversely discharging them too soon) all need addressing. The report also highlights the number of follow up appointments which could easily have been replaced by a quick phone call or visit to a GP.

When looking at outpatient appointments the report also says that “both primary and secondary care providers can take measures to improve the proportion of patients who attend hospital outpatient appointments.” We have previously highlighted ways in which some providers are taking steps to address this issue, using simple methods such as sending appointment reminders by phone or text.

Patients failing to show up for appointments is an issue for everyone working in the healthcare field. For health practitioners who charge their patients direct, a no-show not only prevents another patient from being treated, it also costs the practitioner in lost revenue. That is one reason why an appointment reminder service can pay for itself in reducing no-shows and keeping treatment rates high. Allied to a virtual receptionist service which can take calls, make appointments and even manage patient records, a health practitioner can concentrate on treating the maximum number of patients and providing good quality care.

Combining therapies

We are constantly reminded about the way in which regular exercise can improve our overall health. Now researchers in America have published the results of a survey of 10,000 people into the benefits of exercise, for those taking statins to lower cholesterol and prevent heart disease.

The researchers found that middle aged people who take regular exercise, such as 150 minutes of brisk walking or cycling per week, are 50% less likely to die in the next ten years than those who take statins and don’t exercise. Those who combined exercise with statins were 70% less likely to die in a ten year period than those who simply took statins.

The results add to a growing body of evidence on the way in which even modest amounts of exercise can help to lower cholesterol and prevent diseases such as diabetes from developing. In commenting on the study, Natasha Stewart, senior cardiac nurse at the British Heart Foundation told the Daily Telegraph that the results showed that combining exercise and statins could “provide a winning combination to further improve your heart health, with higher intensity exercise possibly offering more protection.”

It is generally recommended that anyone with high levels of cholesterol or who has lived a sedentary lifestyle take advice from a health practitioner before starting on an exercise programme. This may not necessarily be the local GP, with many GP practices offering support services for a range of conditions. As with any health issue it is important to call on the service which is most appropriate and indeed the NHS Choose Well campaign is designed to help patients to choose the service which will meet their needs.

The aim of the Choose Well campaign is to free up A&E departments to concentrate on those who have a critical or life-threatening need whilst ensuring that all patients receive speedy treatment. For health practitioners such as osteopaths and physiotherapists this may result in patients taking more responsibility for their treatment and calling direct for appointments.

This is where a virtual appointment service such as Clinic Appointments can come in handy. With Clinic Appointments’ trained receptionists taking calls and making appointments, health practitioners can maximise treatment times whilst eliminating missed calls. So, whether you are treating patients who have responded to Choose Well and made appointments direct or coping with the aftermath of a sudden rise in exercise by the middle aged, you know you can concentrate on what you do best without worrying about diary management or missed calls.

Scoring Service Levels

Following a nationwide GP Patient Survey in 2011, users of the NHS Choices website are now able to compare the service provided by differing GP Practices. Underlying data measures a range of factors to produce an overall GP Practice score out of 10.

The Department of Health has responded to BMA fears that the scores fail to take account of challenges faced by individual practices or areas by confirming that this will be considered when the data is published. For patients, the main benefit of the data will be to enable them to compare GP performance within their immediate location and therefore choose a GP Practice which meets their needs.

For those interested in delving deeper into the statistics, the overall score out of ten is broken down into varying areas including the levels of service provided as well as clinical experiences. This broad approach recognises the growing swell of opinion that good levels of health care start with the experience patients have when trying to contact the healthcare practice and make an appointment. Indeed, Patients Association chief executive, Katherine Murphy, told the BBC that the Patients Association helpline “is seeing a trend of increasing complaints about GPs, covering a number of areas, including difficulties obtaining an appointment, complaints about behaviour of reception staff and other factors that affect their overall experience.”

Of course GP practices don’t have a monopoly on the need to constantly juggle clinical and administration time. Other health professionals such as chiropractors and osteopaths also have to manage the twin demands of being easily contactable whilst maximising the time given to treatments.

One answer to this dilemma is the use of a virtual receptionist service. With telephone answering and diary management outsourced to trained health receptionists; clinicians need not worry about receiving a low score for contactability or professional image. Add in features such as appointment reminders, invoicing and managing patient records and health professionals can concentrate on providing the high level of service that their patients require.

The use of a virtual receptionist service also brings a revenue benefit. With ease of contact comes a fuller diary and with appointment reminders comes a reduction in no-shows. This helps to increase income at a cost which can be as little as the equivalent of one new client each month. Whilst this latest NHS scoring initiative is confined to GP Practices, other health professionals can learn from the GP experience. Using a virtual receptionist service may just be the step change needed to improve service levels alongside revenue and patient care.

Prioritising Patient Records

On 21 May the Department of Health published its information strategy setting out a ten year plan for improving information management across health and social care. Key targets include providing people with access to their own records online by 2015, promoting online appointment booking and the ability to share test results on line.

The information strategy, subtitled “The power of information” has a two fold aim. Firstly it seeks to improve the patient-professional partnership by providing patients with access to their records and thereby improve informed choice decisions. Secondly the strategy recognises that a system which efficiently collates patient records will save time and money as well as improving care.

The proposals have received broadly positive responses. Although the BMA has raised a concern over security of records, particularly across shared systems, it has also gone on record to say that it supports “the sharing of relevant information between healthcare professionals.” The Chief Executive of the NHS commissioning board, Sir David Nicholson, commented that the adoption of an information strategy is the first step “in a genuine cultural shift in the NHS that will enable the service to work at its most efficient and give patients real power and choice.”

Certainly the more work which can be done on computerising patient records the better. Health professionals work in a time pressured environment and time spent looking for records is time which is not spent on patient treatment. This is one of the reasons why Clinic Appointments instituted its Patient Records service. This enables health care professionals to upload and view clinical notes, x-ray and scan records as well as client invoices. The software is simple to use and the secure records can be accessed at any time 24/7.

Keeping patient records in one place means the end of searching for missing records; it means that patient histories can be viewed at a glance and eventually it will mean that information can be shared with others under the information strategy. Linking the patient records service with diary management and virtual receptionist services frees up clinicians to do what they do best. So, no more filing, no more searching and no more phone answering, just client treatments.

The Department of Health and the NHS Commissioning Board have until April 2013 to finalise the information standards and route map. In the meantime the Clinic Appointments Patient Records Service is there for health professionals who are looking to cut down on administration time now.

0800 0789333 info@clinicappointments.com

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

Tag: Department of Health