Who picks up the phone? Different approaches to NHS admin

Sometimes it’s the small things that make all the difference.

If it was easy to improve patient experience of NHS admin it would have been sorted long ago. The depth and breadth of admin failures that many people continue to experience suggest that fixing admin is a highly complex area that requires resources, skill, leadership – and, perhaps most importantly, standing in the shoes of patients and carers and seeing admin from their perspective. For example, how easy is it to cancel an appointment? Or to manage the admin associated with a condition that takes you from your GP to the hospital and back again?

Health care is a complex business, and the solutions to fixing admin are far from simple. But sometimes the solutions are obvious. And sometimes they are so unconventional they make your head spin.

Here’s one of each – starting with the obvious.

If you’ve ever tried to call a hospital ward to find out how a friend or family member is doing and not been able to get through, then the changes made in wards across the United Lincolnshire Hospitals NHS Trust will strike a chord.

They introduced daily telephone calls from hospital wards to relatives. Putting in place clear and regular communications has reduced the number of complaints and improved productivity. Interestingly, the trust asked a range of staff (nurses, doctors, ward clerks, physiotherapists) and volunteers to make these calls to a relative or the person the patient has designated as a key contact. The scheme has evolved, and some wards now have cordless phones so that calls can be made to family members at the patient’s bedside. And thinking differently about who does the admin takes me on to the second example.

Imagine if GPs, not admin staff, were the first point of contact for people wanting an appointment. Dr Rebecca Forrester recently commented on one of our a blogs that in her practice, ‘GPs answer the phones and deal with the majority of patient queries/calls/requests and book further appropriate tests or appointments’. She added that, for them, thinking outside the box has been hugely successful.

Oak Lodge Medical Centre in North London has also moved to an online system. Here too, it’s GPs not admin staff that review and answer patient requests online every morning. The volume of phone calls is now lower, but the calls are longer. This shift has freed up admin staff to spend longer with each caller – and as a result they say they’re better able to ensure every patient gets what they need. There are many GP practices thinking differently about admin and I’d be interested to hear what the impact has been for them and their patients.

The 10 Year Health Plan suggests that AI and automation could replace many tasks currently undertaken by staff. The promise of greater efficiency and opportunities for staff to have more meaningful work is welcome. But alongside that we need a discussion about the added value that admin teams bring to patients, particularly those that struggle to navigate the NHS.

If we want to fix admin, we need to ask admin staff as well as patients what the solutions might be.