Cheadle Hulme Medical Group


Patient Notice: From Wednesday 12th July there will be a new way to contact the practice for appointments and all administration queries

The GP Partners wish to share the reasons why significant changes are being made to our existing appointment system. These changes will take effect from Wednesday 12th July 2023.

In 2019 the Government announced the five-year view of the “Long term plan” for modernisation of the NHS. Which included the increased utilisation of IT systems and the digital transformation project. This initiative was deemed necessary due to recognition of an NHS that needed invigoration and as a solution to the well-recognised work force crisis. Over the last decade it has been frequently documented that nationally, patient demand greatly exceeds the capacity of General Practice (also known as primary care). This scenario has worsened for many reasons including the Covid Pandemic.

Secondary care is now also at the point of being overwhelmed as evidenced by unacceptable waiting lists and outpatient appointments. General Practice provides over 300 million consultations each year, 23 million consultations occurr in A&E departments annually across the UK. It may be of surprise to learn that a years’ worth of care provided by your GP costs the NHS less than 2 visits to A+E. (NHS England Primary Care data)

The digital transformation project commenced in 2020 with practices across Greater Manchester being moved by the existing local health authorities (previously known as Clinical Commissioning Groups CCGs) away from the traditional front of house contact with receptionists to the use of digital consultations as the primary method for managing initial enquiries with the GP practices. This was enforced upon our neighbouring GP colleagues in different boroughs across Greater Manchester during the Pandemic and is now commonplace in these areas.

Many GP practices across Stockport refused the directives to swap to an appointment system that was based upon GP led “triage” of digital requests. Our practice has been under continual pressure that we have resisted due to our commitment to preserving traditional General Practice where patients are encouraged to get to know their own Family Doctor and we have made consistent decisions over many years to create a system where continuity of care and relationship-based General Practice has been central to the service we aim to provide. This model is has become less common over the last 10 years.

A major element of the long-term plan has been to remove the existing local health authorities such as Stockport CCG and create a new infrastructure where practices form coalitions with neighbouring practices known as Primary Care networks. These networks are now well established. The newly formed centralised health and social care authority known as “Integrated Care Systems” ICS and is based in central Manchester and now delivers the mandates of the Department of Health to the PCNs in Greater Manchester and sets specific work streams for previously independent GP practices. GP practices are now unable to remain viable if they choose to reject collaborative working within PCNs.

As a result of the Government’s announcement in the last few weeks that they will “do away with the 8am lottery of making a GP appointment” all PCN practices will have to ensure that they deliver this Government initiative. This has occurred as the result of the new 1-year GP Contract of 2023/2024 where attention is focussed upon improving access to General Practice as a core part of the contract. The wording of the contract states “the GP contract will be updated to make clear that patients should be offered an assessment of need, or signposted to an appropriate service, at first contact with the practice”. Failure to produce evidence that Practices are compliant with this contractual obligation could result in GP practices losing their contracts and closing.

In some ways we are more fortunate than the “early adopters” of the digital transformation process as there are already in existence numerous successful models of how digital technology can be utilised to allow patients to contact their surgeries. These methods have been able to produce timely responses that can facilitate all requests from urgent face-to-face appointments to the provision of non-urgent documentation. We wish to reassure patients and their families who may be apprehensive using online technology that our phone lines will remain open specifically to manage “their” requests. One of our reception team will help the individual complete an online request that will then be sent to the GP by the receptionist, for the GP to respond to in the same way as requests generated by patients who may be more familiar with this type of technology. Other patients using the phone lines will be signposted to use the available digital templates and encouraged to provide clear detail of their request.

Our aim as a practice is to preserve continuity of care. We will aim to match the digital requests with the appropriate doctor or clinical team member. We will adopt a Red, Amber, Green traffic light system where “Red” requests will be dealt with urgently. Amber requests will be dealt with within a week and Green requests will be dealt with in 2 weeks where possible. Our capacity is not unlimited and as such, we need you as our patients to support each other and recognise that initiatives such as this need to be successful as we are at a time when both major political parties are proposing to replace GP partnerships. Speculation exists that the development of PCNs has created an alternative method of delivering primary care to traditional General Practice. Our understanding of the potential number of daily requests that the GP triage team will be responsible for managing is likely to be between 200 - 250 encounters each day. Some of which will be simple, and others may be highly complex. Our determination is to continue to provide expert, patient-centred care that is safe and responsive as well as ensuring the wellbeing of our team. We ask for your support and co-operation during the transition period whilst we move the practice towards our new normal.

Drs Richardson, Connolly, Vrahimides, Hudson, Eaton, Ahmed, Farooq, Locksedge

Published: Jul 11, 2023