Pressure in our system

I am writing at a time when I know that the demands on general practice services and in the community are high.

Our local hospital services are under immense pressure and it is likely these pressures will continue across the north east London system through the winter months. Currently Queen’s is at OPEL (Operational Pressures Escalation Levels) 4 which is the highest level with associated impacts on care, and KGH is on OPEL 3. All our hospitals will likely face extreme pressures at times this winter.

We are working hard to direct more people, including through the Community Pharmacist Consultation Service (CPCS) pathway, where appropriate to do so, to our pharmacies to alleviate the pressure on our system, including on our General Practice and UTCs. 

Some of the actions that we would like your help with to alleviate some of the 999 and 111 pressure are the following; 

• We would appreciate if you could check the number of slots you have available for 111 to book into and that this meets the 1 slot per 3,000 levels. Please make these slots available throughout the day rather than first thing in the morning – ideally between 11am and 6pm. We do understand that there has been some concern about the appropriateness of some of these booked slots and we are seeing a great deal of low acuity within the demand for all of our services including GP Practices and UTC.
• Use the CPCS service to direct appropriate patients to pharmacy appointments. 
• To check all answerphone messages to review whether 111 online is recommended before calling 111, UTC or EDs. We would appreciate if this could be changed to direct people to 111 online, if this is not currently the case. Suggested script below.
• To prioritise answering bypass numbers from the 999 service. This will enable either a call to be closed by the ambulance service or release an ambulance crew from a patient’s home so they can assess another patient as quickly as possible. 
• Help direct people to the access hubs and, where appropriate, extended access GP appointments. 
• Make use of this communications toolkit (attached) which has links to a range of content which you can use on your digital screens, in your practice, and on your website and social media channels to help people access the right NHS services. This includes a range of videos about routine and urgent GP appointments, the role of MDT teams, and how GP receptionists and local pharmacies can help:
  
  • How and when can I access my GP practice? (subtitled) https://youtu.be/1qJlzANrE6M  
  • How your GP practice team can help you (subtitled) https://youtu.be/NNxfyAc2VUM  
  • How your GP receptionist can help you (subtitled) https://youtu.be/GstPdzc974c  
  • What can a pharmacist do for you? (subtitled) https://youtu.be/QJdd6Kx3pew  

I do know the pressure you are under and I appreciate the levels of sustained hard work. 

Kind regards

Sarah See, Managing Director for Primary Care at NHS North East London

Recommend voicemail messages for when the practice is closed: 

• Thank you for calling. We are here to help you. We are open Monday to Friday 8am – 6.30pm
• We are currently closed and will next be open tomorrow or Monday at 8am. Please call back then or visit our website
• Many local pharmacies are open every day and you don’t need an appointment 
• If you can’t wait and urgently need to speak to a GP please use NHS 111 – you can visit 111.nhs.uk or call 111 if you don’t have online access, for help and advice, including booking you an appointment out of hours