Beacon Medical Group
- Patient List size: 6 sites across Devon – 43,000 patients
- Launched with Total Triage: November 2019
- Model: Total Triage
Beacon Medical Group are one of the pioneer practices when it comes to the Total Triage model of care using an online consultation solution. Following the initial model that was co-created with eConsult and another practice, Beacon Medical Group developed their own Total Triage model, and have been using this since November 2019. In the Total Triage model of care, all requests to the practice come via an online consultation where possible. This allows the practice to manage the demands of their patients through one, information-rich channel. Total Triage is now being highlighted by NHS England as a blueprint for online consultation models.
In November 2019, Beacon Medical Group implemented a new access model of total triage supported by the use of eConsult. The model is simple, allowing clinicians to decide which patients need an appointment in the surgery and which could be dealt with remotely. eConsult allowed Beacon to consider this model because of the greater amount of clinical information provided on each eConsult. This full patient history provided in each eConsult has also reduced the need for face to face appointments and enhanced any that are required, supporting clinicians in making safe and impactful clinical decisions.
“This [Total Triage] model, using eConsult, allowed us to move from a 5-6 week wait to a ‘same or next day’ service where patients were either offered an appointment, called for more information, sent a SMS or emailed by a GP or member of our urgent care team.”Joesph Nicholson, Lead – Improved Access Project Manager
Since November 2019, eConsult had made up, on average, 36% of clinical triage work. The remainder has come as phone calls from patients and work from other members of the multidisciplinary team. “As the COVID-19 pandemic has become a reality, we have not needed to significantly alter our access model or cancel routine appointments with our GPs and urgent care team.” The eConsult usage at Beacon Medical has now increased from just over 1000 eConsults a week to over 1400 a week and now makes up 66% of our triage requests. As the phone staff numbers have dwindled due to self-isolation and sickness, Beacon has been able to direct patients to use eConsult to allow continued access to their services.
“With members of our GP and urgent care teams also in isolation, we have enabled them to work remotely and further decrease the number of in surgery appointments, safely, because of the greater amount of clinical information being received in the first instance in each eConsult. We have decreased our appointment rate for GPs from 35% to 7%. This has reduced the demand on clinical team members, who are able to see patients face to face, where safe and appropriate. Having the patient history upfront prior to the patient’s arrival also gives clinicians information about key risk factors associated with COVID-19.”Joe Nicholson
eConsult has helped support Beacon care for their patients during COVID-19
The increased information on COVID-19 related symptoms has allowed Beacon to redistribute clinical work across their practices to create ‘hot and cold sites’ and an isolated administration site. Processing of eConsults can still occur across any sites for all the vulnerable staff members which allows practice staff members to continue working, but also allows them to socially distance themselves.
In the week commencing 16th March 2020, Beacon saw a significant increase in the number of online consultations coming from patients aged 65+. eConsult allows these patients to stay in contact with the surgery despite the phone queues and enables the practice team to care for them and maintain social distancing. eConsult does also enable a true continuity of care for all patients and helps free up appointments for those that are more likely to need a face to face. If the majority of patients do use eConsult it means those that cannot for whatever reason have better access via phone lines.
Throughout the current situation, Beacon has also been able to maintain elements of their QOF work around hypertension. Beacon identified patients who have blood pressure monitors at home and asked them to use the eConsult review templates. This has also further helped to reduce footfall into the practice.
“We have been able to reduce the number of COVID related queries reaching our GPs and have been able to direct patients to government advice or other services. We have also been able to utilise our weekend opening to continue responding to eConsults where we don’t have a phone service running.”Joe Nicholson
The new normal
The next step is the introduction of video consultations within the surgery to allow clinicians to “see” more patients without potentially exposing staff to COVID-19. The hope is that this pandemic offers patients an opportunity to use eConsult to continue addressing their health concerns. Once things calm down, Beacon Medical hopes to identify how they can continue to use eConsult to support the practice and become the ‘normal access’ to the practice.