On this page
The benefits of this project
Benefits for Your Patients
- Less time off work for appointments
- Easier to remember when tests & reviews due
- Helps patients take ownership of their health
Benefits for Your Practice
- Clear standardised process for all to understand
- Fewer appointments needed per patient
- Financial savings
Benefits for The Planet
- Reduced emissions from patient travel
Opportunity for improvement
- Patient travel forms a large proportion of the carbon footprint in General Practice. Long-term conditions (LTCs) such as diabetes require annual reviews and patients often have multiple appointments for different LTCs leading to increased emissions from travel.
- This project outlines how to use ‘Birthday Month Recalls’ to streamline the monitoring process for LTCs (see disclaimers). Patients are recalled for their LTC reviews in their month of birth, and they have all their conditions reviewed in a single, longer appointment. Ideally, they also have any necessary tests (inc. drug monitoring if needed) performed during the same practice visit. Some patients will need multiple appointments e.g. if their condition is poorly controlled or they take a drug which needs more frequent testing than annually.
- Switching to birthday month recalls makes it easy for patients to remember when to have their reviews. It improves their experience by providing an efficient one-stop shop which saves them time whilst also lowering carbon.
- This project is probably best led by the practice leads including the nursing team. It is quite a broad project so the steps are less ‘step-by-step’ as our other projects as there are many possible ways to achieve this change.
- You might like to make a SMART goal for this project, e.g., for at least 70% of patients with long-term conditions (LTCs) to have all annual reviews consolidated into a single Birthday Month Recall appointment, coded in their records, within the next 6 months.
How to carry out this project
-
Discuss
Discuss the idea with the partners and lead nurse and then include the whole team in the discussions. Gather ideas and feedback. This project will only work with a whole-team approach.
-
Plan
Decide on your LTC hierarchy eg, patients with CKD and DM can be managed in one DM appt but patients with COPD and CKD would need a longer appointment.
- Decide when review lists will be generated, and invitations are to be sent out.
- Patients with multiple LTCs will only need to be contacted once by administrators.
- At their next review, inform the patient that all their LTC reviews the following year will be in their birthday month.
-
Do
- Choose what date to start e.g. 1st April
- Run searches on the conditions you are recalling (eg. Asthma, COPD, CKD etc and divide the patients into their birthday month so you are only sending invitations month by month)
- Alter the appointment invitations to explain how birth month recalls will work. The switch will take one full year to implement.
- Decide how the clinics will run, either by running scheduled “multi-morbidity clinics”, or booking slots in existing clinics.
- Either produce a guide for the administrators outlining or software such as Arden’s to choose appointment lengths for various combinations of LTCs. Make sure the nurses have enough time to review all the LTCs.
- Develop a timetable for reviews so patients can be contacted 3 times before the end of the QoF year to allow exemption from targets.
-
Study
Review the process, summarise learning, share with practice team + decide if any improvements are needed.
Decide how often to check on how the process is working and use the Project Monitoring form to keep track.
Top tip
Inform patients in the year before the change occurs so that they are not too confused if they receive their next review appointment soon after their last one, or some months after their last one, depending on their month of birth.
Also, to help them to remember when to come, let them know this is our birthday present to them from the NHS!
How to scale this project up or down
| Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members. |
Share this QIP and your experience with your PCN, Federation, ICB (England) or Cluster, Health Board (Scotland or Wales) or GP federation, Health Trust (Northern Ireland), so other practices can follow your process.
Case study
The nursing team, with the help of our practice manager, led the switch for our patients to move their recalls to their birthday month. Patients were told that their next review may be quite soon after their current one, depending on when their birthday fell.
The switchover was easier than we had expected, and our fears of mass confusion were allayed!
Our receptionists also found it much easier and quicker to advise patients when their reviews would be, and this led to the nurses noticing a large drop off in the number of patients who had been booked incorrectly for one of their annual reviews when they had already had the review done earlier in the year.
We are now in the process of moving to a more automated recall system with patients being able to self-book into the right length slot with the correct staff member. This would not have been possible without our switch to birthday month reviews as their reviews would not have been amalgamated.
Mile Oak Medical Centre, Brighton
Have you completed this QIP?
Tell us a little about your project in order to generate a certificate showing the probable benefits. This project may help with CQC evidence submission (see disclaimers).
More project guides
-
Extreme Cold Weather Alert QIP
Carbon saving potential: Solid
<10 hours
-
Bath & Shower Emollient Deprescribing
Carbon saving potential: High
<10 hours
-
Reducing Emissions Associated with Banking
Carbon saving potential: Very high
20-40 hours
-
Switching Energy Provider
Carbon saving potential: Very high
<10 hours