Tackling changes

In 2012 and 2013, each GP at Nightingale Practice was seeing an increasing number of patients every day, and reception staff were manually recording the data to help understand patterns in demand. The practice still had unmet demand, no cohesive solutions, and had stretched and stressed staff. 

After installing Apex in 2019, their aim was to understand how the appointment requests were captured, how better capture unmet demand, and develop data led plans to help manage appointments better in the future.

Nisha added: “Initially, the data didn’t ring true.  But once there was an understanding of how the appointment book was used, we trained our reception team to capture the data through EMIS Web and Apex. Then, services were created by us to accurately reflect the capacity needed to provide the right number of appointments. This was done in line with creating a robust system of recording unmet demand, the data for which again, was extracted through Apex.”

They found multiple factors at play in the practice which affected capacity and demand. Now, the team can tap into clinical data and use information such as demographics, and patient cohort analytics which empowers the practice to plan resource effectively, and redesign services to meet local population needs with maximum efficiency.

She said: “By using objective data for our capacity planning, we can employ ARRS where we need them most, we have appointments being met, less dissatisfied patients, and empowered practice teams. They can make proactive planning decisions and reactive changes, or even intelligent decisions on GP recruitment rather than guessing and risking financial waste.”

In terms of demand, patients can get the appointments they need within 24 hours of a request without having to call back the next morning. Nightingale Practice can allocate for needs such as double appointments, home visits, or appointments with a translator.

For capacity, staff can better manage workloads, knowing what each day will look like, and GPs can spend longer with patients in double appointments to provide better care where singles were the usual norm.

Nisha adds: “Before Apex this was so much harder, but once we had our appointment searches set up, we could extract the data, map trends over time, and respond accordingly, on a daily basis, if required.” 

Ben Hampshire, Business Development Director at EMIS, said: “Nightingale Practice got to the heart of detailed reporting to help them amend their service requirements and plan capacity appropriately. By using Apex, they gained critical insights to run quality improvement programmes to improve utilisation, productivity, and ensure improved access for patients.

“To make it easier to extract data in Apex, the results are presented in an infographic style, perfect for practice teams like those at Nightingale Practice, to identify trends and insights. They extract the information they need, in near real-time, to pivot their approach in a flexible way.”

The future with Apex

Nisha adds: “I became a clinical lead and board director for GP City and Hackney Confederation, and in that role, I wanted to roll Apex out to other practices and share our experiences because I was sure we’d be able to improve patient and staff experiences across the confederation.

“As each practice was so different, I looked at the nuances of the different ways of working, used common themes and incorporated it into a programme of support for practices to enable them to do the work that we have found so helpful at Nightingale Practice.”

To date, Apex has been rolled out to two thirds of City and Hackney and across north east London. It has helped the practices and reception teams respond to long-term and short-term changes, such as staff being off sick, and accommodating vital team meetings, without negatively affecting the bottom line.

Nisha concluded: “What’s great is the reception staff on the front line can really get involved, understand how useful the data is for planning and have ownership over how the data is collected.  Apex helps us to employ a system that works.”

To find out more about Apex and how it can help your ICB or practice manage capacity and demand, click here