Practice Toolkit it all about
Reducing admin effort
Reducing appointments to the fewest possible per patient while meeting all patient needs
Generating income (but that's not impacted by this...)
Many practices operate by inviting a patient back in on the anniversary of their last review of that recall - let's do an example;
If the patient's last Hypertension review was Apr 26 they'll be re-invited for Apr 27.
Not uncommon that they may be started on Ace-Inhibitors lets say a month later May 26, and then re-invited for bloods/med reviews in May 27.
If they also have COPD and that review was in Aug 26 they'll be re-invited for Aug 27.
Now this one patient with just 2 conditions will now be invited for:
3 distinct visits (Apr, May and Aug) -
requiring invite costs and admin time each visit)
Seen in likely 4 distinct appointments
This is what we want to change.
To manage this, we 'Anchor' the patient to a month of the year. Based on Optimisation Settings that could be the:
Patient Birthday month (we recommend this as it's easy for patient to remember and be proactive in booking AND it spreads evenly through the year) OR
The Last Medication Review
Note: this is set for each patient from the first time we see them - if the Medication review is done in a different month it'll not adjust the anchor.
Secondly, if they've never had a Medication Review it'll default to the Birthday month for that patient.
This automatically optimises the patient needs to look like this;
Still have all the tests or reviews needed but all anchored to a particular month. In this case the Patient's Birthday month in July. Now the practice is managing;
1 visit worth of invites (Practice Toolkit enables you to invite the patients for all their appointment needs in one go) so 1 message per patient not 1 per appointment and only 1 set of admin to manage
Seen in likely 1-3 appointments (bloods/HCA or Nurse/GP or Pharmacist depending on your practice settings.
For this example alone it reduces admin/invite effort by over 66% and appointments by 25-75%
Transitioning
The outcomes are well worth it - huge reduction in effort for the practice admins, clinicians and patients, plus frees up appointment capacity. BUT what about patients who may end up being moved from when they would otherwise be coming in.
Remember that the DMARD/High Risk recalls generally have high frequency check-ins - every 3, 4 or 6 months - any change to the anchor month will have very limited impact for these recall appointments before the next check in.
Transitioning will only impact the recalls with 12 month reviews
What we'd care about is the duration between when a patient was last seen and when they're now scheduled to be next seen.
1-3 Months: last appointment to new schedule
This is automatically completed due to your 'Tolerance Windows' - generally 12 weeks for a 12 monthly review - so anything within 3 months of the requirement date will automatically be completed and NOT need to be repeated or invited for. Generally QOF or GMS requirements have a 15 month window
4-12 Months: last appointment to new schedule
For patients just outside the Tolerance Windows (e.g. 4 months) you could choose to ignore or mark as completed (or consider extending the Tolerance Window for the first few 6 months of usage)
Patients may be scheduled to repeat their required appointments at a shorter duration for this first year only - the appointment reduction through optimisation will far exceed additional requirements to bring patients into the new schedule.
12-15 Months: last appointment to new schedule
Ideal category, the patient will be coming in within the 15 month window.
15+ Months: last appointment to new schedule
These are the only patients who may need attention/decision making.
They can be highlighted using the Transition Support Searches
Right now we'd recommend booking in an ad hoc appointment somewhere between the two dates per the recommendation in column I of the excel (see Transition Support Searches above)
We have incoming functionality to speed up this process - planned for Autumn 26 release to enable 'Breach Prevention'. This will highlight all patients already overdue, or who are predicted to be in breach (last appointment to future planned appointment) of the intended test frequency (per your Recall Settings) so that you can decide to
Ignore
Click to automatically add in particular tests to already planned appointments to then be managed within the normal invite process
Click to add an appointment requirement as a one off in whichever month you select to then be managed within the normal invite process
A special note for Northern Irish Practices
The NI GMS Contract requires within 24 month reviews vs within 15 so to maintain GMS adherence you don't need to add in any ad hoc appointments, all patients would be scheduled to be seen within the coming 12 months.
However, all other good practice guidelines would advise to see patients in a short than 24 month timeframe.
We're seeing most practices temporarily make the tolerance window longer (could be up to 26 weeks) to auto-complete more appointments, allow for an 18 month window vs 15. Or making judgement calls on which recalls or duration they want to engage with.