The Access to In-Hours Standards were introduced by the Minister for Health and Social Services on 20 March 2019.
The Standards set clear requirements on GP practices in terms of minimum expectations relating to access, including an increased digital offering.
Clearly the pandemic has had an impact on our ability to provide appropriate access.
As we strive to provide the best service possible (in terms of access) it is important to recognize that primary care is under incredible strain and while we are doing our best , the public also has a role in making the right choice when seeking help and advice. A cultural shift is required to recognize that a GP, or even the GP practice, is not always the most appropriate professional or location for the issue.
Our staff have been asked to navigate patients to ensure patients are seen by the right person at the right time in the right place.
Welsh Government has introduced additional standards for 22/23 and are summarized below -
All patients telephoning the practice have their calls received by a standard recorded message, and subsequently calls are answered and care navigation undertaken. Where clinically appropriate, patients may be signposted to another appropriate service.
Where access to a service is clinically appropriate and patients require access to GMS services, they will be offered an appropriate consultation, whether urgently or through advanced booking consistent with the patient’s assessed clinical need, without the need for the patients to contact the practice again.
Available appointments must be a mix of remote, face to face, urgent, on the day and pre-bookable to reflect the blended model of access, as determined by the practice in discussion with the patient. A more planned and forward looking approach should be taken to the scheduling of appointments throughout the day, or for future dates, meaning it is no longer acceptable for all appointments to be released at 8am for that day.
All practices must provide a telephony service (preferably Voice over Internet Protocol solutions or sufficient incoming and outgoing lines) that fully meets the needs of patients.
Longer term work is underway with a view to identifying a national solution to the ongoing provision of digital tools, with tools for GP practices forming part of that. In the interim, Health Boards will be encouraged make digital tools available or to support practices in securing these, to ensure all practices offer a digital means of access, in addition to telephone and in person. The digital platform is for non-urgent access and only to be used during core hours.
Practices will be required to take a more open and transparent approach, through an automated and standardised public facing dashboard, to the sharing of information and reporting, at a practice or cluster level, on GMS activity.
The approach to this will be enabled via the Data Project with support from HBs and DHCW. The Access Standards have 2 phases; Phase 1 - The GMS access standards introduced in April 2019, will remain as pre-qualifiers.
All practices are expected to achieve, maintain and embed those working practices in order to make any claim for achievement of the phase 2 standards. Phase 2 – The reflective phase, this allows practices time to reflect, listen to patient experience and make improvements to access