A week in the life of Poplar Grove Practice, Aylesbury

There has been a lot of bad press around primary care and in particular G.Ps and what do they do exactly?  We feel it is really important that we illustrate how hard we are all working.  One of our GP’s, Dr Juliet Sutton, has written this article: “A week in the Life of Poplar Grove Practice” (click to open)

We hope you find it an  interesting insight in to the volume of work that is carried in General Practice. 

Thank you for taking the time to read it.

A WEEK IN THE LIFE OF POPLAR GROVE PRACTICE, AYLESBURY

We studied the activity data for our practice for a typical week starting the 19th October 2020. Opening hours for the practice at present are 7.30am-6.30pm Monday-Friday, although this week also included a Saturday morning flu clinic 08.30am-12 noon.

During this week 3693 telephone calls were answered.

There were 426 face to face (F2F) appointments provided by the clinical team at the practice as well as 834 flu vaccinations given across 2 designated flu clinics on the Wednesday afternoon and Saturday morning. In total 1360 patients attended Poplar Grove Practice for an appointment that week.

The breakdown by clinician is shown below with our nurses/H.C.As seeing 335 patients, G.Ps 74 patients and paramedics 17 patients F2F. The flu clinics were delivered by majority G. Ps with some nurses/H.C.As.

Appointments Pie Chart

The nursing staff are seeing a mixture of patients including:

  • Phlebotomy-both urgent/acute and disease monitoring bloods
  • Dressings including complex leg ulcer dressings
  • Childhood immunisations including flu vaccinations
  • Chronic disease management -asthma, diabetes, heart disease
  • Cervical screening
  • S.M.S (serious mental health) screening checks

Ps and Paramedics were seeing mostly acute problems especially where an assessment couldn’t be easily provided remotely e.g. breast problems, acute gynaecological issues, bowel problems, abdominal pain, children <5 years etc along with 6-week baby checks.

Poplar Grove Practice has a duty team daily with 2 duty G. Ps and 2 paramedics. More acute “duty” calls are placed on a separate duty triage list. This week there were 344 triage calls on the duty list. Non duty G. Ps have a telephone triage list which is mostly booked on the day (by telephone and on line) with a few pre-booked telephone appointments. There were 512 telephone triage / consultations carried out by non-duty G.P ’s over the week. A significant proportion of these calls then went onto become video consultations. The facility to send photos in to illustrate rashes, skin lesions etc was also used commonly. There were also 17 Ask NHS telephone consultations and 18 telephone consultations carried out in extended hour slots. The total number of remote consultations (telephone and video) offered by G. Ps that week totalled 891. This number is actually higher as a number of calls started as telephone calls and then went on to have a video consultation after.

During this week there were also 2 “virtual ward rounds” carried out by G. Ps to our 2 main nursing homes Hillside NH and Hulcott care home. Patients were seen via video consultation.

The nursing team also carried out 40 telephone consultations, which included diabetic and asthma reviews.

8 home visits were carried out by our paramedic team that week. Our new Crisis Home Assessment Team (C.H.A.T) comprising a senior nurse and H.C.A also did a total of 47 home visits including domiciliary flu vaccinations. So, in total there were 55 home visits.

We are a G.P training practice and currently have 2 G.P trainees working at the practice. They both have protected time with the 2 trainers (Dr Wakeford and Dr Sutton) for teaching and case review.

ADMIN

The Prescription team manage all the prescription requests and put them through to the G. Ps and pharmacists for review and signing (electronically). The average workload per G.P is 50-70 meds management daily. There are a number of letters to be reviewed every day, some of which need urgent action. There are also a number of blood and urine results which come back every day which need to be reviewed and actioned appropriately.

MEETINGS

During this week there were also a number of meetings that were scheduled. We are now having twice weekly Covid meetings Mondays and Fridays to discuss our strategy for dealing with the pandemic going forward. We have 3 Covid G.P leads and representation from across all our managerial areas (nursing, secretarial, I.T, receptionist, facilities/building).

There was also a Heads of Department meeting, a salaried partner review meeting and an independent HR meeting. There was a PCN meeting. One of our nurses and our facilities manager had a session for infection control.

On other weeks we have monthly Health Visitor/Midwife liaison meetings. Gold Standards meetings with our linked palliative care nurse, Children’s MDT meetings with our linked consultant paediatrician and Complex patient MDT meetings. These are all virtual at present.

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