CPD: upskilling practice reception and clerical staff

As part of the GP Forward View, the Department of Health created a five-year, £45m fund to contribute towards the training of practice reception and clerical staff – conceived to ensure that all practice staff are equipped to undertake an enhanced role. We explore how practice managers can ensure their teams are up to the task at hand

General practice is under increased pressure and an increasing number of practices are taking a more strategic approach to the role reception and clerical staff can play. There is a growing understanding that investing in the professional development of staff not only supports the individual but also, by optimising their skills, increases job satisfaction and has a positive impact on the whole practice team – and patients too.

The General Practice Forward View (GPFV) included a £45m fund – available for five years, 2016/17 to 2020/21 – ring-fenced to be put towards the practice costs of training reception and clerical staff in one of the  identified high-impact actions (HIA) which are part of the General Practice Development Programme (GPDP) – active signposting and the management of clinical correspondence which contributes HIA 4 and 5 – so that staff could assume additional responsibilities. With the GP Forward View strategy now well-established many CCGs, GP federations and individual practices are seeking to commission training in these two areas.

Active signposting by reception staff

‘Active signposting’ is aimed at freeing-up GP time and, according to the NHS, releases around five per cent of demand for GP consultations in most practices; it is believed to have the potential to save up to 26% of GP consultation time if fully and effectively implemented. But what is it? Simply put, it provides patients with a first point of contact which directs them to the most appropriate source of help.

There are web and app-based portals which can provide self-help and self-management resources, and these can also signpost patients to the most appropriate care professional. However, the role of the receptionist would be to act as a ‘care navigator’, ensuring that the patient is booked with the right person from the start.

To direct patients effectively to the most appropriate source of care and/or advice, reception staff require training and access to, and knowledge of, a directory of information about services – which may include services in the community as well as within the practice.

Introducing active signposting

How do you introduce active signposting to your practice in a cost and resource-effective way, and what should you consider when commissioning this kind of training and implementation?

‘Having trained many hundreds of practice managers and GP receptionists across the country in active signposting, we have identified six key elements of success which, if adopted, are likely to result in a successful implementation of care navigation and a realisation of the significant savings to be had in consultation time,’ says Nick Sharples, managing partner of DNA Insight. These are:

  1. Preparation; expect changes to how the practice operates and how it will affect the entire practice community.
  2. Engage the whole practice community; the whole practice staff needs to be engaged in the programme for the genuine benefits of active sign posting to be realised.
  3. Face-to-face or online; while some training is delivered remotely, when it comes to active signposting face-to-face practice and interaction with colleagues is an effective learning tool.
  4. Bring everyone to the training; this includes practice managers and GPs; this helps to empower the reception team with the authority to apply the techniques learned.
  5. Promote the service to your patient community; making them aware of the introduction of active signposting/care navigation will encourage them to share their symptoms with the receptionists, which will allow a signpost to be offered.
  6. Have a formal ‘go live’ date; with so many stakeholders involved and affected by the change, getting it right first time is essential.

Read more about active sign posting and find more detail on these six key elements here.

Correspondence management by clerical staff

The GP Forward View guidelines estimate that 80% to 90% of letters can be processed without GP involvement – which would free up 40 minutes of GP time per day. Having receptionist and clerical staff trained to undertake correspondence management can seriously alleviate pressure on GPs – which has a knock-on effect on patient care – leading to quicker response times and more accurate results’ recording.

With the additional training in correspondence management, and the relevant protocols, clerical staff can support GPs in their clinical adiministration tasks. This, of course, requires there to be robust standards protocols in place that are subject to review and continuous improvement.

Working to these protocols, the responsible individual would process any incoming correspondence about patients from hospitals, for example. They read the letters, enter the details into the relevant patient’s record and take appropriate follow-on action – which, in some cases, might involve other members of the team or booking the patient an appointment.

Having a member of staff dedicated to correspondence management, again, can expedite action on some issues and can improve the monitoring and management of certain contitions due to the use of more detailed coding of clinical information in the GP record.

“Correspondence management ties-in most closely to the fourth and fifth HIAs which are concerned with developing the team and creating productive workflows,” Simon Harker, content editor at First Practice Management (FPM) Group. “The crux of this is working smarter, not harder – it’s a case of equipping clerical staff with the necessary skills and information to review correspondence that arrives from hospitals themselves.”

But what does this mean in practice? Well, not only does it streamline processes and save GP time, it empowers staff and results in better outcomes for patients.

Read more about correspondence management and how you can make it work for your practice.

Next steps

So, what are your next steps? Whether you are simply considering embarking on a training programme, mid-way through or already have a body of staff who are already fully-trained, the next questions are, ‘Have you thought of the sustainability of the programme? Do you have a continuous professional development plan in place for your staff?

10 high impact actions to release time for care

  1. Active signposting: Provides patients with a first point of contact which directs them to the most appropriate source of help. Web and app-based portals can provide self-help and self-management resources as well as signposting to the most appropriate professional.
  2. New consultation types: Introduce new communication methods for some consultations, such as phone and email, improving continuity and convenience for the patient, and reducing clinical contact time
  3. Reduce Did Not Attend (DNAs): Maximise the use of appointment slots and improve continuity by reducing DNAs. Changes may include redesigning the appointment system, encouraging patients to write appointment cards themselves, issuing appointment reminders by text message, and making it quick for patients to cancel or rearrange an appointment.
  4. Develop the team: Broaden the workforce in order to reduce demand for GP time and connect the patient directly with the most appropriate professional.
  5. Productive work flows: Introduce new ways of working which enable staff to work smarter, not harder.
  6. Personal productivity: Support staff to develop their personal resilience and learn specific skills that enable them to work in the most efficient way possible.
  7. Partnership working: Create partnerships and collaborations with other practices and providers in the local health and social care system.
  8. Social prescribing: Use referral and signposting to non-medical services in the community that increase wellbeing and independence.
  9. Support self care: Take every opportunity to support people to play a greater role in their own health and care with methods of signposting patients to sources of information, advice and support in the community.
  10. Develop QI expertise: Develop a specialist team of facilitators to support service redesign and continuous quality improvement. 

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