AskMYGP – Service Update May 2024
Hello everyone
As a lot of you have experienced, we have had challenges with our service level on AskMyGP in recent weeks. Today, I’m going to summarise those reasons, and also cover off some of the ways you can help us make the process smoother.
Why do we have more requests than we can handle?
When you move to processing all appointment requests through AskMyGP (will now be shortened to AMGP for the rest of this post) you expect to see an increase in demand because patients now have no barrier to requesting help. Previously the barrier was that we had run out of appointments for the day, but now, there is a queue, and anyone can join the queue
All the research we did before we went live showed that this initial increase in demand subsides after about 6 weeks, which makes sense – people register all the things they previously couldn’t get booked in for (this is called unmet demand) and then once that is exhausted, things return to normal
On this basis, we used funding we had received to heavily supplement our clinical team with locum GPs
Unfortunately we are now in a situation where the demand has never subsided since week one, but our funding for locums has run out – which is why you are seeing longer response times
our challenge is that we can't switch off the demand by pulling the plug on AMGP, so we need to manage things better
Types of requests
We are seeing definite trends in the types of requests we get.
Mental health, menopause, prostrate, ADHD – national awareness of these has increased significantly over the last 10 years and it is great that these conversations are now being held openly without stigma. Unfortunately for us, our funding has not kept pace with this increase in demand, so we therefore have significantly more patient demand than we would have had even 5 years ago. This is not a criticism of any of our patients, more a criticism of the funding not taking account of national trends or awareness campaigns
Prescription requests – AMGP is not the place to request a repeat prescription. Please use SystmOnline or the NHS app (I find the NHS app much easier and user friendly)
Prescription requests because the patient has run out of medication – we are seeing a significant number of these. Every time a patient runs out of medication / cannot request a repeat prescription because they forgot a medication review was required, it costs us a 15 minute appointment that could have been used elsewhere. Please be vigilant with your medication ordering and make sure you do not run out. If you do run out, pharmacies will always give you an emergency 7 day supply
Prescription requests because the medication is not on your repeat list – this can be for a variety of reasons –
It’s a new medication and we want to see how you get on with it
Our error and we haven’t added it to your repeat list
HRT – where it’s not allowed to be on your repeat list
The medication is what’s called a “controlled drug” and cannot go on your repeat list
Solutions :
If you are prescribed a new medication, it will not be re-prescribed without a GP review, so please put an AMGP request in 2 weeks before you are due to run out. This will give us plenty of time to review things
We are changing our process to ensure all suitable meds are added to repeat lists
We are also using a clinical pharmacist to deal with these requests. They are based at the surgery (not a pharmacy) and can deal with adding to repeat lists, medication reviews, change of dosage, how is your new medication working. They will usually phone you to discuss things.
All of these things will help the AMGP queues flow better
Multiple requests
Understandably, when patients haven’t heard back from us for a few days, they wonder if we have received their request, or if their symptoms have worsened, they submit a further request. This means that for some patients we have 2 or 3 or 4 requests for the same thing, and there is no way for us to “bunch” them together.
Please trust that your request is in the queue, and will be assigned as soon as possible. We try to provide updates, especially where you are requesting to be seen by someone who is on holiday, so that you know there will be a delay.
Please don’t submit multiple requests. If your routine request is now acute and you feel it needs to be reviewed within 24 hours, we would prefer you to phone us (if you can, we know this is not always possible) so that we can “upgrade” your original request with new comments. Again, this will help things flow better
Not using your pharmacy
For a lot of minor illnesses, your local pharmacy should be your first port of call. I genuinely don’t think a lot of people realise how helpful a pharmacy can now be. They cover a range of ailments but specifically, they can offer you a Pharmacy First consultation AND prescribe antibiotics for the following conditions –
Sinusitis
Sore throat
Earache
Urinary tract infections in women
Infected insect bite
Shingles
Impetigo (a bacterial skin infection)
The real bonus of this service is that you can go to ANY pharmacy, it doesn’t have to be the one where you collect your prescriptions from, so if you work away from home, just go to one that’s close to where you’re working.
Request no longer required – sometimes, the thing you messaged us about has resolved, and you no longer need to speak to a clinician. Unfortunately there is no “cancel request” button for a patient to use, so the request just sits there and still gets assigned to a 15 minute appointment. If you can, please call us to let us know the request can be closed
Urgent Care Unit
A lot of patients still aren’t aware of our urgent care unit and hours, especially at the weekend. We often see a lot of acute requests on a Monday morning that could have been resolved by the UCU at the weekend – we are open Saturdays, Sundays AND bank holidays from 8am to 6pm
What is routine and what is acute?
I understand why this causes confusion, so hopefully the below helps –
ACUTE – this tends to be minor illness – chest infections, complicated or persistent UTIs, sudden onset of pain, struggling to breathe / shortness of breath.
Our service level for acute is 24 hours – this is not the same as same day, so please be aware you could be contacted the following morning
ROUTINE – this tends to be for ongoing conditions that you need some help with – mental health, menopause, pain, female problems, male problems, my existing health condition is getting worse / not improving with new medication, I need a referral to a consultant, sick note requests, bowel problems. It’s not possible to provide an exhaustive list, but hopefully this gives you an idea.
Our service level of routine is 1-5 days (so it could be up to a week). We are outside of this at the moment, for all the reasons listed above.
The Health Kiosk
Our new Health Kiosk is going to be live very soon and this will also help with some of your requests, specifically –
HRT review
Contraceptive pill check
You will be able to do both of these in the kiosk, at a time that suits you (including evenings and weekends) and it will free up appointment time for us. More information coming soon.
I hope this very long post has been helpful. The purpose is very much to increase understanding and be transparent about the pressures we are under. None of it should be read as a criticism of patient behaviour.
As ever, if you have any ideas, I would love to welcome you to our PPG (Patient Participation Group). We meet about once every 2 months to talk about the challenges and discuss solutions, and to get input. You can take part in person or online, and if you would like to be involved, please click here.
Thank you
Debbie