Under the GP contract deal for 2014/15, practices must assign all patients over 75 years old a named doctor responsible for their care.
But from January last year, the Red and Green Practice in Hythe and Blackfield, in the New Forest, went a step further – appointing a named GP to all 25,000 of its patients.
Dr Iain Redmill, a partner at the practice, told GP he borrowed the idea from a nearby practice, but used technology to improve on it. 'We are a large practice, and we wanted to improve continuity,’ Dr Redmill said.
'We didn’t want personal lists, because we like the flexibility and ethos of being a shared-list practice, but we have given everyone a named - or usual - GP based on who they were seeing anyway.’
Dr Redmill used a database and wrote software to analyse patient attendance patterns and found that the 16 GPs – roughly half of them part-time – who work at the practice were seeing a similar number of patients, with a similar mix of complexity.
‘We wanted to make sure it was fair, but the fascinating thing was that we are all seeing similar numbers,’ he said.
‘We designed a set of criteria to work out who was high risk, high need, who was low risk, low need, and found we were already working a very fair system.’ During the process of allocating patients to named GPs, there was ‘clinician override’ if necessary, but Dr Redmill said there had been little movement.
Creating a link between each patient and a named GP had helped doctors feel more in control and made the practice more efficient, he said.
‘The difference is in the office – when a bit of paper comes in, who do they give it to? Now they just look at the screen, find the named GP, pass it to that person,’ said Dr Redmill.
‘Our office efficiency savings are good, and partners’ quality of life is better. We now see the right letters and results about the right patients – we are reliably seeing the information about our patients.’
After going live with the new system at the start of last year, the practice has now begun splitting QOF work by named GP. Each GP considering referrals or reviews that need to be done works on those for his or her list, and reviews decisions with a colleague.
Dr Redmill believes the system would work ‘down to a fairly small scale’, although benefits may be less clear for smaller practices. But he is clear about the impact the change has had.
‘At every point, it is clear where the buck stops. It feels a lot safer.’