Appointment Questions

There are different ways to make an appointment depending on who you may need to see.

To book with a GP:

• The practice uses a system called total triage. This is part of Modern General Practice, and the NHS encourages all practices to do this.
• Total triage allows us to make sure you get the correct care from the most appropriate clinician within the appropriate time frame by triaging your request.
• To collect the information we require to triage your issue, we use a system called eConsult.
• With this information, the practice can then triage safely and effectively, working within the capacity we have.
• If a GP appointment is needed, we will then send you a booking link via your mobile phone or email for the type of appointment needed. If you cannot do this, our care coordinator team will ring you and help organise this.

To book with a Nurse or Health Care assistant:

• These appointments are usually made by patients ringing the practice and booking in.
• This is because there were many types of appointments needed including long-term conditions, dressings, blood appointments and other reasons. We need to ensure you get booked into the correct appointment.

To book with one of our other health professionals (Pharmacists, Physios, Mental Health Practitioners, Social prescribers)

• You may be sent a booking link if a clinician feels you need to be seen by one of these teams.
• Alternatively, you can contact the practice, and we can help facilitate the most appropriate appointment.

• eConsults are a safe and effective way to gather information about your health condition.
• All practices in England are required to offer an online access tool – eConsult is the most suited to our system of triage.
• They can safely make sure that a patient does not have symptoms that require more urgent assessment such as having to attend the Emergency Department.
• We know that they do ask many questions, but this really helps us to provide the most appropriate care for you.
• We sometimes get feedback that they can take 5 to 10 minutes to complete, and patients can feel frustrated. We would like to reassure you that the information collected does make a significant difference. We hope you can understand that the time it takes you to complete this E consult is part of your health assessment for your condition.

What if I can’t do an eConsult?

• We would first ask if you have a family member or friend who can help you. They are simple and often once you have done it once you will find it easier moving forward.
• If you cannot complete an eConsult, you can ring the practice, and our care coordinator will ask you a number of similar questions so they can forward this information on to the triaging team.

• Yes, you can walk in or ring the practice however we will always treat your request the same as patient sending an eConsult.
• We would always strongly encourage you to do an eConsult at home where possible. This will then save you time by not have to wait to speak to someone on the phone or physically walk to the practice.
• Our care coordinator team will need to ask you a number of questions so we can give adequate information to the triaging team.
• It is important to ensure equity of access however patients present to the practice. We therefore triage all requests for GP appointments. It is no quicker ringing or walking in compared with sending an eConsult.

Why do I have to give information to a receptionist?

• All our team are highly trained and have signed confidentiality agreements.
• We require the information for the triaging team to assess your needs and give you the appropriate advice or care
• We can always provide a private space to take more information at the practice if needed.
• Without enough information, it is very difficult for the clinician to assess your needs. The doctors will always need information before assessing further.

• When requesting an appointment, you will be asked if there is someone you particularly want for that.
• We will always ensure that information is shared with the relevant triaging team.
• Our team of doctors all work different days and have different clinical responsibilities.
• The type of appointment will depend on whether we can offer a specific named GP.
• For more urgent problems, there may be less choice but wherever possible we do try and offer either a male or female GP.
• For routine appointments, patients will be given a link so they can choose who they wish to see and if the GP has availability they want to see, they can book with that individual.

We have several different appointment slot types which are used by the triage and GP team. This is based on medical need rather than patient choice. This allows us to safely triage patients to receive the care within the appropriate time frame and capacity that we have.

Urgent:

• These are on the day bookings for urgent clinical problems.
• There will be limited choice in timings as we must fit this around the clinicians working.
• For acute urgent medical problems, patients would be expected to attend at the time given. If a patient is at work, it would be expected that their employer would let them out to attend.

Next Day:

• We have a small number of next day appointments that are used for clinically urgent problems by the afternoon triaging GPs.
• These are generally used to manage demand and capacity within the practice.

Priority:

• These are semi urgent appointments within five to seven working days.
• We will normally send out a booking link to your mobile phone or email and you can choose a suitable time and day.

Routine GP:

• These are for non-urgent problems where a clinician has triaged your problem and feels it is safe to be seen within the next routine appointment slot.
• Waiting times can vary depending on demands on the practice system. It is usually between two to four weeks.
• You will be sent a booking link to your phone by text or email and given the choice of day, time and clinician you wish to see.

Extended Access appointment:

• You may be offered an extended access appointment. This may be with a GP, Advance Nurse Practitioner or a member of a nursing team.
• These are usually offered outside of normal working hours and at weekends and can be particularly useful for working patients.
• We have three main sites where patients will be seen.
  • Harrogate – at Grove Park Court (off Skipton Road)
  • Knaresborough – at Beech House Surgery.
  • Ripon – at the Ripon Hospital.

Telephone or Face to Face:

• If an appointment is offered, you may be offered to have it by telephone or face-to-face. Often this will depend on the underlying clinical problem.

• There are now many different types of clinicians who can manage health problems.
• Not every patient needs to see a GP and modern general practice means that we can triage to the most appropriate person.
• Unfortunately, we only have limited capacity and so want to use every opportunity to offer the best care for our patients.

Who else might I be advised to see?

Nursing Team:

• Our wonderful nursing team can manage a number of health conditions. They carry out most of our long-term condition reviews as well as supporting with minor illness and chronic wound dressings.

Pharmacists:

• We have a team of highly experienced pharmacists and pharmacy technicians who work within Strayside health.
• They manage many different conditions including blood pressure, high cholesterol, osteoporosis, complex medication problems and medication reviews to name a few.

Physiotherapist (First Contact Practitioners):

• We employ our own physiotherapists who can see patients with musculoskeletal problems.
• They can assess, investigate, request X-rays or scans and diagnose as well as offer appropriate treatment.
• The team are linked directly with the Harrogate hospital consultants and can refer to them.
• They are highly experienced and work closely with GPs when needed.

Pharmacy First:

• Local pharmacies in the area all provide a service called pharmacy first.
• This is a national project where patients can self-refer directly to their pharmacy for several different conditions including:
  • Tonsillitis
  • Sinusitis
  • Ear infections
  • Urinary tract infections
  • Shingles
  • Impetigo
  • Infected insect bite
• There are inclusion and exclusion rules for each of these conditions, but your local pharmacy can give you further advice.
• They do also offer many other services including:
  • Contraception
  • Emergency contraception
  • Many different minor illnesses

Community Eye Service:

• For all eye conditions that cannot be managed by your local pharmacy, we now have a community eye service.
• You can ring 0300 303 4922 and you will have your condition assessed. They can also organise assessment by local opticians or the hospital if necessary.

Mental Health Practitioners:

• Our two mental health practitioners, Phil and Sophie, are experienced in helping patients with mental health problems.
• They have longer appointments and can spend time supporting patients going through many different issues.
• They are also linked with the local mental health services and can access further support where necessary.
• If prescriptions are required, they are able to initiate these or discuss with the GP where appropriate.

Social Prescribers:

• We are proud to have support from our social prescribers who can help patients with many different issues often related to social difficulties and where their health may have an impact.
• They are linked with North Yorkshire County council and are a wealth of knowledge of different services and support available.

• If you have a condition that requires immediate medical attention, you will need to attend the Emergency Department at the nearest hospital.
• If you cannot safely get there, you would need to ring 999.
• For non-life threatening emergencies, it may be more appropriate to go on the NHS111 website or ring 111.
  • Get help for your symptoms – NHS 111

What to do if the practice is shut?

• If you cannot wait for the next working day, we recommend you ring 111 who will triage your problem and decide if you need support from the out of hours service.
• You can also access Ripon Urgent Treatment Centre and other local providers.

Are there any local urgent treatment centres?

• Ripon Urgent Treatment centre (based at the old Ripon Hospital)
• Wharfedale Urgent Treatment Centre
• Leeds Walk-in Centre (Shakespeare Medical Centre, LS9 7ST)

• Primary care has changed significantly over the years, and we now have good access to community teams who can support patients who are housebound.
• If a patient has a problem that needs a home visit, the practice will triage this and decide the most appropriate team to assess further
• If a patient attends appointments with the support of family or carers, we will usually ask if they are able to bring you to the practice.

What is defined as Housebound?

• A patient who is unable to leave the house for any reason (this includes attending hairdressers, hospital appointments, supermarket)
• Some patients may be temporarily housebound such as after an operation or illness.

How might my problem be managed?

• Many health conditions can be safely managed by phone.
• We will triage all request for a home visit and these are discussed by the GPs in the daily clinical huddle.
• We may often ask one of our community teams to visit patients at home especially in a more acute setting.

Teams supporting housebound patients

• District nurses
• Practice nurses for long-term conditions
• Visiting phlebotomy service
• Urgent Community response
• Hospital at home team
• Social services
• Palliative care services
• General practitioners