If you only get a chance to monitor a patient’s asthma once a year, it’s vital that you and they both get the most from your consultation time.
The high-impact actions identified in the NHS report “Making time in general practice” can make your appointments quicker and more efficient. They’ve already made appointments more productive for HCPs and patients – and we have the evidence to prove it.
Action 1: Active signposting – make attending an annual review the ‘new normal’
- If your practice displays a poster of how many missed appointments there were in a year/month, try swapping it for one with attendance rates instead. One practice did this, alongside other initiatives, and found it reduced DNA rates by 32%.
Action 2: New consultation types – try asthma reviews by phone to save time and money
- The latest evidence shows these are just as effective for patients with mild or well-controlled asthma who are unable or unwilling to attend an asthma review in person. Asking the three RCP questions over the phone counts towards QOF points too.
Action 3: Reduce DNAs by prompting and preparing patients ahead of time
- One of the commonest reasons for patients not attending their appointments is forgetfulness. Send motivational invitation letters 2-3 weeks ahead of annual asthma reviews, giving patients time to plan to attend. Include clear instructions on how to prepare, such as bringing their inhalers and any record of their symptoms (see Action 6). Download and use these templates for effective invite and missed appointment letters.
- Send low-cost text message reminders. One study found these reduced DNAs by 38%, and another showed that a text is just as effective as a phone call.
- Ensure patients record their next appointment in their diaries or smartphone before leaving.
Action 4: Make your workflows more productive by understanding your patients’ lives
- Timing annual reviews at convenient or symptomatic times can encourage patients to attend. For example, invite children during school holidays, and those with hay fever before pollen season starts. If a large number of your patients work office hours, consider evening or telephone reviews.
- Ask patients to bring answers to questions about asthma control to their review. Try including the three RCP questions or the Asthma Control Test in appointment letters or handing them out in asthma clinic waiting rooms. This will help save time and make the most of the review.
Action 5: Work in partnership to save time and prioritise those who need you the most
- Almost a fifth of GP appointments are taken up by people who don’t need them, so signpost patients to reputable information and support services. Asthma UK provides wide-ranging, Information Standard accredited advice through our nurse Helpline (0300 222 5800, open 9-5, Monday to Friday) and 24/7 at www.asthma.org.uk.
- Use personal written asthma action plans to cut emergency primary care appointments. Filling out a written asthma action with the patient has been found to reduce emergency appointments at GP surgeries by supporting self-management, as long as patients take a copy home. If your practice doesn’t have its own plan, you can use the one on the Asthma UK website, or integrated into EMIS Web.
Action 6: Support self-care and help patients feel more in control
- Ask patients to keep a diary or bring a video of their symptoms. Watching a video clip, or reviewing a calendar, is often faster than asking patients to remember all their symptoms – and it can help patients recall what triggered their symptoms. Videos are especially useful because symptoms might not be present on the day of the appointment.
Help us spread the word
These aren’t just ‘nice ideas’. They’ve produced real results for practices across the UK - and you can read the evidence to support each one here. If you know a colleague who’s short of time, please download and share these tips with them – especially if they’re not as clued up about asthma as you are. It’s a really quick way to reduce their stress and help them make the most of their time.
If you have a tip of your own that other busy healthcare professionals would benefit from hearing about, please do drop us a line on firstname.lastname@example.org.