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Mynediad Gofal Sylfaenol

Local Models of Care

This step recommends that Local Models of Care are developed and supported to enhance their capacity to meet core hours demand in order to deliver services aimed at maintaining patients safely in the community. The Intended Outcome here is that when appropriate, patients will access their GP as a first point of advice and contact, and receive unscheduled care services outside of secondary care.


Locality and Neighbouring Access

The aim is to support GP practices in reducing variances in same day/urgent access and management of home visit requests through:
  • Implementation of the Evidence Base (see the Primary Care Foundation's Urgent Care practical guide document below)
  • Filtering, signposting and appropriate triage model
  • Improvement in working circumstances for Practices via capacity demand modelling
  • Review of USC activity data sets
A considerable number of Unscheduled Care encounters happen in General Practice and the effect of this on the wider system is significant. The Primary Care Foundation Urgent Care, a practical guide to transforming same-day care in General Practice put forward recommendations to maximise the quality of care provided to patients with urgent care needs and the day to day working circumstances of staff working in General Practice.

Key findings to consider

  • Speed of initial response – and ensuring patients can get through - matters.
  • Review and understanding of the number of appointments and the proportion that can be booked same day is essential.
  • Managing peaks in demand - such as Monday mornings - is important.
  • Practice staff need to recognise what is potentially urgent and agree how to respond.
  • Rapid clinical assessment is sometimes important, especially of requests for home visits.
  • Telephone consultation can play a useful role.

Key Recommendations to implement

  • Match capacity to demand – both in responding to the patient’s initial call and in recognising the different demand patterns for same day and advance appointments.
  • Ensure that the full range of cases that might need urgent attention will reliably be recognised by staff when the patient rings or presents in person and that the process is understood.
  • Pay particular attention to the needs of those requesting home visits, where the chances are that the case may be more acute or complex.
  • Review and audit the processes to refine the way that they operate.

Key Intended Outcomes

  • Reduced unnecessary admissions (by up to 30% for individual Practices).
  • Better access and experience for patients.
  • Less stress and better working environment for GPs and staff.