health appointments Archives - Page 4 of 6

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.

Reaching out

A study in the USA has revealed the benefits of automated telephone calls for patients with hypertension. Taking a sample of 64,773 hypertension patients, half were sent a recorded phone message inviting them to have their blood pressure monitored at a clinic whilst the rest received no such invitation.

After four weeks it was found that 32.5% of those who had received a call had controlled their blood pressure against a base of 23.7% for those who had not received a call. Although researchers did not collect data on measures taken by patients to control blood pressure it is believed the calls played an important part in raising patient awareness.

Certainly this study mirrors the findings of other surveys in the way in which patient care can be improved by a simple call. Whether by encouraging patients to have a check up or replacing costly health visits with a simple call, the telephone is increasingly playing its part in enhancing health care.

One particularly successful way in which phone calls are being brought into the front line is in reminding patients about their appointments. Whether issued via automated phone message or by text, a simple reminder can make a substantial contribution towards reducing the number of “no shows.”

This has two benefits. Firstly it encourages patients to attend booked appointments and secondly it encourages them to notify the health practice should they be unable to attend for any reason. With an early warning of a cancelled appointment the practice has the chance to book in another patient; thus benefitting the practice, the patient and boosting the overall level of patient care.

In our ever busier lives, it is inevitable that we will forget appointments from time to time and an automated phone or text message can be that vital memory jogger which we all need. Health care practitioners from opticians to physiotherapists and even vets are using messaging for everything from a reminder to pick up some new medication or book a check up to reminders about appointments which have been made. For example this writer received a text from their vet recently reminding them to pick up a fresh batch of worming medicine for a pet.

In summary, phone reminders can save “no shows, they can ensure patients receive the treatment which they need and they can help to keep health practitioners busy at all times.

Telephone triage

A survey of 1,195 GPs, practice managers and nurses by Campden Health has revealed that the use of telephone triage is gaining in popularity. 56% of practice managers polled revealed that some form of triage is used with 9% of practices triaging all of their patient calls.

Surprisingly those who practice triage reported a wide range of success with some reporting as much as 60% of patient problems being solved without the need to see a doctor whilst other practices only reported a 1% success rate. However 95% of respondents rated triage as either moderately or extremely successful so it is understandable why the practice is spreading across the NHS.

One drawback uncovered by the survey was the fact that in 13% of cases untrained receptionists were being used to conduct the triage and overall 48% had not received any telephone triage training. Nevertheless with surveys showing that doctors daily see 6-10 patients who have no medical needs, if triage can eliminate these unnecessary appointments it will free up valuable treatment time for those who are in need of care as well as more speedily directing patients to more appropriate resources such as social services or other health professionals.

When it comes to other health services, using the services of a trained receptionist to take calls and make appointments can also make a difference to the working day. Virtual receptionist services which use friendly and well trained staff can help healthcare professionals to provide the best level of service which they can to their patients. With no ringing telephone to interrupt treatments and a friendly receptionist taking care of appointment booking, message taking and appointment reminders, the health professional can carry out the task which they were trained for rather than become bogged down in administration.

Better still, a virtual assistant can help to keep the appointment book filled. Appointment reminders have been shown to increase attendance rates and in the event of a cancellation the receptionist will be on hand to take calls which could potentially fill the vacant slot. And with a trained virtual assistant the professional image of the health practice will be maintained.

Divide and conquer

A hospital in Derbyshire has been reaping the benefits of a new cleaning rota. Using an idea gleaned from overseas, the Royal Derby Hospital split its cleaning workforce into teams, each responsible for specific areas such as corridors or toilets. Previously a single cleaner had been responsible for an entire ward or area of the hospital.

The new system of team cleaning by area has lead to a reduction in cross-infections, traditionally a pre-cursor of the need to close wards for deep cleaning. In fact this new working pattern has been so successful that the hospital has been put forward for two Nursing times awards including the Golden Service award.

Hospital bosses have also found that by using teams rather than a succession of individuals, cleaning patterns are more flexible. This in turn has reduced the incidence of wasted cleaning processes, such as cleaning a patient area just before a patient is due to be discharged as well as ensuring teams are on hand in case an emergency clean is required.

The story is a perfect example of the way in which those at the forefront of health provision are finding ways to work smarter rather than harder. For example many health providers are looking to make savings by replacing follow up appointments with telephone calls or using the phone to make routine check-ups on those with ongoing problems.

It has to be acknowledged that telephone coaching is not universally successful if used in isolation as a study by UK researchers revealed earlier in August. They concluded that telephone coaching of those with long term conditions is not effective unless it is carried out as part of an integrated system of care.

Health professionals too are using this “divide and conquer” principle to maximise patient treatment time and minimise disruptions. Simply by outsourcing their phone answering to a virtual assistant service, health professionals can ensure that their phones will be answered, appointments made and reminders sent out whilst the health professional can concentrate on treating their patients. With no need to interrupt a treatment to answer the phone and no missed calls, professionals such as osteopaths, chiropractors and others can provide a more streamlined and efficient service to their patients.

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.

The Olympic legacy – one year on

On 21^st July sporting stars joined 15,000 runners to commemorate the anniversary of London 2012. With 2,500 adults and children racing round a family friendly 1.5 mile track, the remainder of the runners tackled a 5 mile course which wound around the Queen Elizabeth Olympic Park.

The National Lottery anniversary run was started by Sir Chris Hoy whilst athletes such as Victoria Pendleton and Paula Radcliffe joined the mass runners cheered on by family and friends. Finishing on the Olympic athletics track itself every runner who completed the course created their own special memory to treasure and add to the host of positive memories of the Olympic and Paralympic games.

The run is not the only way in which the games are being remembered. As part of the legacy programme sports clubs across the UK have offered and continue to offer special taster days and extra coaching to tempt people to take up or return to sport. The ongoing success of these programmes can be seen with increased numbers of cyclists on our roads and a heightened level of competition enjoyed at many sporting events.

But the legacy is not just about competition and the true legacy can be seen in those who are enjoying sport as a means of keeping fit. Inevitably this results in an increase of sporting injuries as old joints and muscles are coaxed into working that little bit harder and those who once gaily set off on a run without any preparation discover the importance of stretching.

For physiotherapists, chiropractors, osteopaths and other health practitioners the sporting revival therefore carries the potential for an increased caseload. But in order to benefit from this legacy potential, health practitioners may have to optimise their working time. One option available is for activities such as diary management, client notes management and appointment reminder calls to be outsourced to a virtual assistant service. With phones diverted and day to day practice management outsourced, health professionals can concentrate on maximising patient treatment times.

The Queen Elizabeth Olympic Park is due to open its doors fully for business in the Spring of 2014. When it does it will offer many more opportunities to participate in sport. In the meantime there are lots of special events, taster sessions and trials taking place across the country for those whose appetite has been whetted for Rio 2016 and beyond or who just want to take up the challenge and get a little fitter.

I just called with a reminder

There are good calls and bad calls; calls you treasure, calls you feel are unwanted intrusions into your day and calls you will remember for the rest of your life. But from time to time a call arrives which is so useful that you are simply pleased to receive it.

We refer here to appointment reminders, those simple texts or automated calls which remind you that your doctor/dentist/hair or other appointment is due. They don’t take much but can play a huge part in ensuring that you do arrive at your appointment on time, thereby reducing the vast numbers of no-shows which daily cost health practitioners both time and money.

One recent convert to the benefits of automated reminders is the Great Western Hospitals NHS Foundation Trust. From the start of August, those with outpatient appointments will receive a communication a week before their appointment date, asking them to confirm, cancel or rearrange. The Trust hopes that this will make a dent in the 39,871 appointments which were missed in the last year.

In fact the trust has calculated that every no-show costs an average of £108 which means that the Trust spent over £4 million last year in dealing with those who failed to turn up for appointments, money which would have been better spent on providing treatment. In announcing the new service David Moss, deputy general manager for outpatients, Great Western Hospitals NHS Foundation Trust, said: “By making sure all of our appointments are used, we can see more patients and patients will be seen sooner.”

But it is not just hospitals and NHS trusts which are affected by no-shows. All health practitioners are similarly affected and for those providing direct-pay services such as physiotherapy, a no-show not only means another patient could have been treated, it also equates to a direct loss of income.

Contacting patients to remind them of their appointments can also take time out from that available for treatments. One solution is to use a virtual assistant service to both make appointments and to send out reminders. With diary management online the health practitioner can quickly view their upcoming appointments but still be free to maximise patient time. Add in a patient notes service and even more time can be found for the practitioner to do what they do best, treating patients.

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Tag: health appointments