Appointments

Protocol for Emergency Appointments

• Book a telephone triage appointment. Each doctor and nurse practitioner has four, five-minute telephone triage appointments close to the beginning of their surgery. If the clinician calls the patient and decides they need to be seen that day, the clinician who has triaged the patient over the phone, should arrange to see that patient themselves at the end of their surgery.
• If the patient needs to be seen face to face that same day, please offer a Book on the Day Appointment with a clinician, ideally with their own doctor first, or with another clinician if their own doctor is not available. For example, if their own doctor is fully booked, please offer a book on the day appointment with a GP associate or nurse practitioner.
• Urgent children under two years of age should automatically be added to either a book on day slot or as an extra at the end as these children if URGENT will need to be seen.
• Once the Book on the Day and Telephone Triage slots are taken, please add any extras as telephone triage appointments to the end of the usual doctor’s list. A specific time cannot be offered for these telephone calls. Please tell patients they may be called at any time. Please mark urgent telephone triage with an alert on screen, notifying the doctor that they should prioritise the call.
• Telephone triage for GPs who are absent should be shared amongst all consulting clinicians (including GP Partners, Associates and Nurse Practioner) to enable equitable workloads. For example, every clinician gets allocated one extra telephone triage call before allocating a second extra telephone call to a particular clinician.
• The on-call doctor should not receive more urgent telephone triage appointments than any other clinician as they often have other urgent queries to deal with in addition to their own surgery.
• Receptionists should not add any patients as extra face to face appointments without speaking to the clinician concerned. All extra appointments should be assessed by a clinician through telephone triage and it will be the responsibility of that clinician to complete the consultation, either over the phone or bring down and see themselves if required. Therefore, there should be no “sit and wait” appointments.
• Patients should not be advised to call back in the afternoon or the next day, they should be given an appointment (pre-book routine or emergency book on the day), or telephone triaged if no appointments available. Please do not add anything to clinician’s list from 11:00 onwards to enable time for admin, prescriptions and home visits. From 11:00, all queries should be directed towards afternoon slots.
• All clinicians and receptionists are advised not to fill up book on the day slots in advance, or add extras on for the following day. This applies to both face-to-face appointments and telephone consultations. Specialist appointments that are not filled by the evening before, can be opened up as more book on the day appointments eg diabetes, family planning and COPD appointments.

Some slots are not opened until the start of each day to enable patients who need an urgent appointment to be seen on the day. There are two slots in morning surgeries and two in afternoon surgeries. The afternoon slots can be booked from 11:30am at which time receptionists should not add anything further to the doctors’ morning list

Double appointments of 20 minutes duration are allowed in exceptional circumstances, for example, for a learning disability health check, complex diabetic or mental health reviews, postnatal baby checks and employment medicals. These are often booked at the end of a surgery in case more time is required. Patients with visual and hearing impairments and non-English speaking patients who require an interpreter, are also allocated a double appointment.

The practice runs a number of specialist clinics which patients can be referred to internally. These include minor surgery and cryotherapy and family planning clinics, including weekly lunchtime clinics for contraceptive procedures, which is a convenient time for mothers with school age children who find it difficult to attend after 15:00. There are also GPs in the practice specialising in musculoskeletal medicine, dermatology and diabetes who offer specific appointments for patients requiring expertise in these areas.

Each doctor has four triage appointments (of five minutes each) in the middle of each surgery. These are used for patients who request to see a doctor on the day and need to be triaged. The patient is telephoned, triaged by the doctor and brought in to be seen by the same doctor if necessary.

Each doctor has two routine telephone appointment slots in each surgery, at the beginning (of five minutes each). These can be pre-booked by patients who request a telephone appointment rather than a face-to-face appointment. The patient should be informed that the clinician will aim to contact the patient near the appointment time.

Urgent cases can be seen the same day, otherwise you will be given the first available appointment.