Background and Challenge
NHS East Berkshire Clinical Commissioning Group was established in April 2018. A key focus for the organisation was to facilitate greater access to GP appointments including the evenings and weekends for the 470,000 patients registered at practices throughout the vicinity. With an average GP appointment costing £30 to the NHS it is important to encourage patients to contact their practice if they are unable to attend an appointment.1
“DNAs cost the NHS millions of pounds each year. If there were no DNAs, the NHS would be able to afford a lot more treatments for patients. Cancer care could be improved, more scanners installed and waiting times would be reduced. I would therefore urge people in East Berkshire to cancel their appointments rather than just not showing up as this will help improve GP access for patients and make better use of clinicians’ time.”2 Martin Kittel, East Berkshire Clinical Commissioning Groups GP Board Member.
Following consultation within the CCG, it was established that there was a need for two-way texting to reduce DNAs, improve effectiveness and increase cost efficiencies.
Response
To introduce two-way texting, NHS East Berkshire Clinical Commissioning Group conducted a competitive tender exercise which resulted in the roll-out of practice messaging through myGP® across all GP practices. The solution was chosen due to:
- Unique operability across the Clinical Commissioning Group’s mixed estate of clinical systems meaning a reduced administrative burden as cancellations arriving at the centre via SMS response are automatically picked up and cancelled within the system.
- Cloud based system, meaning no local installation of software and associated management in supporting the solution for either the practice or Clinical Commissioning Group. It is robust, resilient and available 24/7 due to its business continuity processes and IT infrastructure.
- Quick access for the practice to contact patients with appointment reminders, offering patients and practices a convenient way to cancel appointments via SMS response or through myGP (patient facing smartphone app). Patients using myGP receive appointment reminders via data rather than text messaging so reducing the costs to GP practices.
- Real-time access to reports, the iPLATO CCG Dashboard allows commissioners and practice stakeholders to view and analyse data collected by iPLATO.
Outcomes
Practice messaging has made it easier for patients to let their surgery know they are unable to attend an appointment, allowing cancelled appointment to be re-allocated.
At a practice level, the pressure on clerical staff was reduced, with less calls to the surgery and automatic cancellation and reallocation of appointments.
During a 12-month period:
- 32,056 appointments were cancelled throughout the CCG
- 12% (3,847) cancelled based on an SMS appointment reminder. This resulted in a saving in excess of £115,000 based on a DNA costing the surgery £30 per patient
Furthermore, the CCG and practices are reducing the cost of SMS messages, as when patients are using the myGP app messages are sent via data for free as opposed to an SMS cost.
Due to its cost savings and improved efficiencies for the CCG, practice messaging through the myGP platform has been awarded a further contract.
- https://www.england.nhs.uk/2019/01/missed-gp-appointments-costing-nhs-millions/
- NHS East Berkshire Clinical Commissioning Group website, News, Featured Thursday, January 17th, 2019