IT and phone systems used by GP practices fail to help practices measure how well they are doing at providing in-hours urgent care, according to a Department of Health commissioned report.

The review of urgent care by the Primary Care Foundation, a consultancy firm specialising in urgent care, found that IT and phone systems currently used by GP practices do not support measurement or monitoring of capacity and demand.

The authors said this was a “significant gap” in current GP software systems and recommended that suppliers develop systems that offer better reporting on urgent care.

The report, Urgent care – a practical guide to transforming same-day care in general practice, looked at handling of urgent care calls by almost 150 practices across five primary care trusts, Doncaster, Lambeth, Plymouth, Bolton and Norfolk.

It said high quality urgent care depended on four factors – access, speed of initial response, capacity and assessment. The report found there were noticeable differences in the number of phone lines and staff available at peak times and in the percentage of calls identified for urgent attention with often the least experienced receptionists identifying a lower number of calls as urgent.

The report said telephone systems used by practices usually recorded all in-going and out-going calls allowing practices to give individual feedback and guidance.

However it added: “In working with practices through the pilot stage we found that the IT and phone systems in use did not support measurement. This made it difficult to examine the timeliness and outcomes of cases from the initial contact with the patient through to the point they were seen by a clinician (sometimes including telephone assessment. We see this as a significant gap in current GP software systems.”

The report recommends that IT and phone system suppliers should develop reports that enable practices to measure and monitor capacity and demand, monitor the timeliness of response, look at outcomes from each stage in an episode of care and review the quality of response by non-clinical staff as well as the quality of clinical consultations.

Other recommendations in the report include a recommendations that practices assess the pattern of demand to ensure enough staff and telephone lines are available at peak times, balance book ahead and same-day appointments with a suggested ratio of two-thirds booked ahead to one-third same day appointments and define the practice standard for the length of time from initial call to assessment by a clinician.

The report was backed by the Royal College of GPs and the BMA which said they hoped it would encourage practices to assess their urgent care arrangements and set achievable goals for improvement where appropriate.



Urgent care – a practical guide to transforming urgent same day care in general practice