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Article:

Medical practices: Coping with evolving service delivery

21 August 2020

The COVID-19 pandemic has obviously posed general practice with huge challenges in looking after patients and restricted the range of services they can deliver safely. Practices have had to focus on essential services but are acutely aware of longer term impacts on patient health and wellbeing as a result of this. One of the many great attributes of primary care and those operating within it though is how entrepreneurial clinicians and support teams can be when posed with challenge.

As Specialist Medical Accountants we have seen many creative initiatives emerging to enable services to now be extended safely and have had many discussions with GPs and practice managers about some long term benefits that are emerging as a result.

Practices who were able to engage swiftly with technology have fared best and some are reporting improvements in appointment DNAs by video consultation call backs where the patient is provided with a 2 or 3 hour window when they will get a call from their GP. This has increased efficiency in dealing with consultations whilst also allowing more flexibility if, for example, a patient requires more than the standard appointment length. Likewise, a more remote and flexible way of dealing with extended hours has, in some cases, reduced costs.

Initially, the ability to engage with technology was, in many cases, held back by lack of access to appropriate mobile equipment. Largely this barrier seems to have been unblocked now but, in many practices, more benefits will be achieved if clinicians and support staff can understand the software capabilities better and use these to maximum effect. This isn’t just about training in the basic use of software but the functionality within it that enhances the experience for clinicians and patients.

While practice still face a huge range of challenges on delivery of care, now is a good time to consider how the experiences of the last five months will evolve the service delivery of your practice. Many clinicians are missing the face to face interactions with patients and the variety of medical cases that they are dealing with in the current time. Many GPs we act for have also voiced concerns about the mental wellbeing of patients - there is clearly a fine balance between efficiency and personal contact. This is not so much about full service re-design but learning lessons from what worked well and what didn’t to evolve your way of working in the longer term.

Collaboration across PCN practices will be key to this evolution and we have already seen many examples of practices working collaboratively to set up hot and cold hubs and provide cover for other GP practices who have faced clinician shortages due to COVID symptoms and isolation requirements.

The funding available through PCNs under additional roles reimbursement should also be key to the shape of practices going forwards. These shared resources may be able to safely deliver some further non-essential services across PCN populations using PPE and utilising space from multiple practice sites.

As practices consider how these experiences will shape the future they should have a close eye on the financial impact of their decisions. Scenario modelling is a great way to do this.

For help and advice on any forecasting and scenario planning please get in touch with your usual BDO contact.

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