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>What is full time general practice?
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>My model for sustainable full-time practice is as follows:
>-All OOHs handled by COOP/deputising. Saturdays pro-rata
>-Daily visits and availability for telephone advice
>-7 surgeries, 2.5 hrs
>-1 session for administration and non-GMS work
>-1 session free for practice and personal development
>-1 session at home
>-7 weeks holiday/yr
>-Sabbatical every 7yrs
>
>Any thoughts?
>Sounds reasonable.. but.. what is your list size?
Currently 14500 with 6.5 wte (7 including assistant and
GPReg). Current consultation rate around 3.1 con/pt/yr
(range 2.4 - 3.5 including surgery, visits and extras).
First part of the plan is to reduce the 'provided' number of
consultations to 2.8 con/pt/yr. Do this by -
-Cutting surgeries !
-Reduce booking ahead
-Greatly increasing sameday/nextday appt availability
-More time (10 vs 4 min) for extras to do a better job and
modify behaviour
-More telephone access
-Use Duty Dr to triage and manage work rather than try and
do it all
If we manage this (and no one leaves!) we could cut down to
8 'coal face' sessions. With added non-GMS income and an
extra bod (already justified on list size - expanding), we
could achieve the same consultation rate on 7 sessions.
Alternative would be to cut the list
>Have you considered looking at whether most of the work
>needs doing in the first place?
Very much so
-2/12 repeat scripts
-Pharmacist about to take over medication reviews
-Nurses starting to take over HRT/contraception/COAD/Asthma
etc
-No routine visiting
-Telephone surgeries
-Nurses/us keen to start more active triage of visits
(currently 10% of above figures)
-Thinking about video peer review which may modify our
management of self limiting illness
Mike
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