Relevant GMS Contract Clauses
Records Indicator 4 (Value 1 point)
There is a reliable system to ensure that messages and requests for visits are recorded and that the appropriate doctor or team member receives and acts upon them.
Records 4.1 Practice guidance
One recognized area of risk in general practice is message-taking; hence it is important to ensure that there is a robust system. The system should not rely on word of mouth or 'post-it pads'. All receptionists should have full knowledge of the system.
Records 4.2 Written evidence
A description of the system for message-taking and requests for visits is required. (Grade C)
Records 4.3 Assessment visit
Inspection of the system of message taking and requests for visits may be carried out.
Records 4.4 Assessors’ guidance
The receptionists should be observed where possible when they receive a message on the telephone...
Information Indicator 1 (Value 0.5 points)
The practice has a system to allow patients to contact the out-of-hours service by making no more than two telephone calls.
Information Indicator 2 (Value 0.5 points)
If an answering system is used out of hours, the message is clear and the contact number is given at least twice.
Information Indicator 3 (Value 1 point)
The practice has arrangements for patients to speak to GPs and nurses on the telephone during the working day.
Information 3.1 Practice guidance
Good medical practice for general practitioners (2002) states that the excellent GP "has a system for receiving or returning phone calls from patients" and that the unacceptable GP "provides no opportunity for patients to talk to a doctor or a nurse on the phone."
Some practices have specific times to speak to a clinician and others make arrangements for the clinician to phone the patient back. It is useful for this information to be advertised to patients e.g. through the practice leaflet, notices in the practice, slips given to patients when being asked to phone back for a result, the tear-off side of a prescription, the practice newsletter etc.
Information 3.2 Written evidence
The practice has a written policy on telephone availability. (Grade A)
Information 3.3 Assessment visit
The assessors should seek out evidence on when the practice team is available to answer telephone calls by checking practice leaflets, observing the office and asking reception and clinical staff.
The receptionists should be able to respond positively to a request by a patient to speak to a clinician on the telephone. The assessors should confirm with reception staff the information they give patients who require to speak to a GP or practice-employed nurse.
Patients do not require to speak to a clinician immediately unless it is an emergency, but...
Information Indicator 5 (Value 2 points)
The practice supports smokers in stopping smoking by a strategy which includes providing literature and offering appropriate therapy.
Information Indicator 6 (Value 0.5 points)
Information is available to patients on the roles of the GP, community midwife, health visitor and hospital clinics in the provision of ante-natal and post-natal care.
Information 7 (Value 1.5 points)
Patients are able to access a receptionist via telephone and face to face in the practice, for at least 45 hours over 5 days, Monday to Friday, except where agreed with the PCO [Primary Care Organization].
Information 8 (Value 1 point)
The practice has a system to allow patients to contact the out-of-hours service by making no more than one telephone call.
For Records and Information Customer Survey can assist Practices achieve 8 of their QOF points - which equates to £992 for an average surgery.
PE 2 Patient Surveys (1) (Value 25 points)
The practice will have undertaken an approved patient survey each year.
PE 5 Patient Surveys (2) (Value 20 points)
The practice will have undertaken a patient survey each year and, having reflected on the results, will produce an action plan that:
| 1. | Summarises the findings of the survey |
| 2. | Summarises the findings of the previous year's survey |
| 3. | Reports on the activities undertaken in the past year to address patient experience issues. |
PE 6 Patient Surveys (3) (Value 30 points)
The practice will have undertaken a patient survey each year and, having reflected on the results, will produce an action plan that:
| 1. | Sets priorities for the next two years |
| 2. | Describes how the practice will report the findings to patients (for example, posters in the practice, a meeting with a patient practice group or a PCO approved patient representative) |
| 3. | Describes the plans for achieving the priorities, including indicating the lead person in the practice |
| 4. | Considers the case for collecting additional information on patient experience, for example through surveys of patients with specific illnesses, or consultation with a patient group. |
Annexes:
PE 2.1 Practice guidance
A practice will meet the contract requirement if it has carried out a survey of patient views in the previous year, using one of two currently approved instruments (GPAQ – the General Practice Assessment Questionnaire, and IPQ – the Improving Practice Questionnaire).... The number of points allocated to this indicator has been decreased in recognition of the need to move towards the practice team actively addressing issues raised from a patient perspective.
A minimum of 25 completed questionnaires per 1,000 Contractor Registered Population should be obtained in the survey. In order to obtain this return, practices may need to administer a considerably higher number.
PE 2.2 Written evidence
Practices should provide evidence that the survey has been undertaken including the date and methodology. (Grade A)
PE 5.1 Practice guidance
The practice will undertake one of the surveys detailed in PE2.
The practice should examine and summarise the results of the survey from the current and previous year and consider the areas where changes could be made to improve the services and quality of care for patients. This should include a comparison of numerical scores in the relevant survey areas and a review of patient comments. They should then report on the activities they have chosen to undertake to address these issues in their action plan.
The practice need not provide the results of the surveys but should provide an overview of their analysis of the surveys and any subsequent proposals for change. Some proposals for change may have resource consequences which need to be discussed with the PCO. This could take the form of a report from a team meeting.
PE 5.2 Written evidence
A report of the action plan from the practice should be available. (Grade A)
PE 6.1 Practice guidance
Practices should have undertaken a recommended patient survey and have discussed it as a team (see PE2 and PE5) and produced an action with priorities as described above. A lead person for patient experience should be identified in each practice.
Subsequently, the team should share the contents of the action plan with the most appropriate person or persons which may be a PCO approved patient representative.
If the practice has a patient participation group then this group may be used.
If no patient group exists, one could be convened using one or more of the following methods:
| • | An advertisement placed in the waiting room at least two weeks before the meeting |
| • | A random sample of patients who are written to and invited by the practice at least three weeks in advance of the meeting |
| • | An advertisement in the practice newsletter if the practice has one |
| • | A leaflet handed out by reception staff or a notice on the side of prescriptions |
Practices may wish to convene a focus group with particular service needs e.g. mothers with young children, the elderly, patients whose first language is not English, patients with mental health problems etc, with which to share the results of the surveys and action plan.
PE 6.2 Written evidence
Practices should submit a copy of their action plan, with evidence that some change has been achieved e.g. through patient report or by demonstrating a positive change in the patient survey. (Grade A)
For Patient Surveys Customer Survey can assist Practices achieve 75 of their QOF points - which equates to £9300 for an average surgery of 5000 patients.
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