Making the most of your appointment

Here are some suggestions which we think might enable to you to make the most of your appointment with our clinicians. If you can think of any other hints or tips to share with us, let us know and we'll add them.

Before the appointment

Think about what you might need to tell or show us. For example, if it's a rash that has changed, do you have photos you can show us of what it looked like before?
‍
If you have a few questions about your condition or ongoing care, write them down - it's easy to forget something you had thought of earlier during that brief time you have with your clinician. It's OK to bring a bit of paper with some questions.
‍
Might it help to send an eConsult in beforehand? These are quite good at asking lots of questions to find the pertinent information for the clinician, sometimes asking about things you might not think are important or relevant. And you can take your time doing it beforehand when there's no rush.

Are you wearing appropriate clothing? For example if you're coming in about a knee problem, skinny jeans are no good! If you will need a blood pressure reading, wear something with short sleeves.

Has something come up? Not going to make it? Are you feeling better? If you don't need the appointment any more, please let us know. Even if it's a short time before the appointment we can often fill cancellation slots with other people who need to be seen, and we'd far rather do that than see them go to waste.

Travel

3.5% of ALL road travel in England relates to NHS activity (patients, visitors, staff & suppliers). It is 14% of the NHS's carbon footprint, and the NHS generates 4-5% of the UK's entire emissions (for comparison air travel makes up 5.9%). Specifically, air pollution is linked to conditions like heart disease, stroke and lung cancer, contributing to around 36,000 deaths annually.

Here are a few things to think about when it comes to travelling to the surgery:

Do you actually need to come to surgery?

• If the appointment is to discuss ongoing treatment, or is for a problem that won't require a hands-on examination by the doctor or nurse, could you have your appointment by video call or telephone? All the doctors and nurses have cameras and microphones to allow video calls. See our page here for more information.
• Savings to be made: greenhouse emissions, air particulate pollution, your fuel and your time travelling and parking
• It is safer for you as you don't risk catching transmissible diseases such as COVID, flu etc. in the waiting room

What's the best way to get here, for you and the planet?

• If you need to come in, can you run, walk or cycle here? Not only will this eliminate emissions, save fuel and avoid the stress of finding parking, it's also better for you and improves your health!
• If you can't get here yourself, can you use public transport? Bus route 167 (the Garston - Grassendale circular) stops just a few metres from the practice doors.
• Could you use an electric scooter as part of the city's trial?

When you arrive

Face coverings

Unfortunately, due to a resurgence in COVID cases we are back to wearing face coverings in healthcare settings. This protects vulnerable patients who may be in the surgery, and also reduces the risk of staff having to be absent through self-isolation.

Checking in

If you are able to, please check yourself in using the touchscreen in the waiting room. This reduces queues at the desk and speeds up the process. The screen is located immediately on your left upon entering the waiting room. If you've never used it before, please just ask the staff member at the desk, they will be happy to walk you through it so that you're confident to use it in future. Don't forget to wash your hands with the gel before and after using it!

Being called through

Unfortunately we have had problems with our call screen for some time, and we are still waiting for this to be fixed - this means that the staff are calling patients through themselves. Please keep an ear out for your name. If you're hard of hearing, please let the receptionist know on arrival and they will let your clinician know.

In your appointment

Time

Usually, unless specifically requested otherwise, you will have a single appointment. The doctor is allocated 15 minutes for an appointment slot. In this time, and if this is a new problem, your doctor will have to:

• Call, greet and seat you
• Allow you to explain what the problem is
• Ask further questions to narrow down what it might be, and listen to your responses
• Explain what examination they need to do, and ask you to undress accordingly, if necessary
• Perform the examination
• Explain their findings, what they think this means in the context of the other information gathered and what the diagnosis may be
• Explain the proposed futher investigations or treatment
• Answer your questions about that
• Arrange the next steps which may be investigations, a prescription or a referral (e.g. request a test, and print the forms; create a prescription and issue it to a chemist; connect to the e-Referral System, select a service, request the appointment, print out or email you the details)
• Agree a follow-up plan with you, if necessary
• Ensure we have explored relevant health promotion with you - weight, smoking, alcohol, physical activity etc.
• Type all of that up in the medical record

As you can see, that's a lot to get through in 10-15 minutes! This is the reason why we ask that you only bring one problem to your appointment. Time is tight as it is, but if you bring two problems, then we only have 7.5 minutes for each, three problems gives us 5 minutes each and so on. Although it is understandable that some people think it is being helpful to "save their problems" for a single appointment, it usually isn't. If you have multiple things to discuss, please come back and see us another time so that we can give each issue the attention it requires.

What to ask

The doctors are really keen for patients to be engaged in their healthcare, and to be as involved as possible in the decision making process. We support the Choosing Wisely initiative from the Academy of Medical Royal Colleges. This is from their website:

Shared decision making

The focus of Choosing Wisely UK is now about shared decision making using BRAN to encourage patients get the best from conversations with their healthcare professional by asking four questions.

1. What are the Benefits?
2. What are the Risks?
3. What are the Alternatives?
4. What if I do Nothing?

This is a collaborative process in which doctors and healthcare professionals work together with patients to select tests, treatments and care management or support packages, based on clinical evidence and patients’ informed preferences and values. It explicitly acknowledges the fact that there is usually more than one way to treat a problem, including ‘no treatment’ and patients may require help to weigh up the benefits and risks of the options in order to determine the best choice for them.

There is good evidence that shared decision making benefits patients, improving the quality and appropriateness of clinical decision making.

You can dowload their patient information leaflet here.

At the end of the consultation

Research has repeatedly shown that patients forget much of what they are told by their GP as soon as they leave the surgery - between 40% and 80% according to one study, which also found almost half of the information they do recall is incorrect. If you think it would be helpful, ask the doctor to write down a summary of the points covered, plan of action and next steps.