A win-win-win for once

Three easy actions to implement measures to transform the experience of General Practice for the whole Practice Community

With the pressures on general practice seemingly increasing every day, and the political heat around waiting times rising, what simple measures can we take that will have a real impact on waiting times, whilst at the same time reducing the stress and pressure on our staff and clinicians?

The answer can be found in the Ten High Impact Actions identified by NHS England in the GP Forward View strategy as having potential to transform General Practice.  These actions have not been thrown together arbitrarily, they’re there because they’ve been found to work and to deliver real, quantifiable results.

Whilst all ten actions have potential to release capacity, there are three that can significantly transform the experience of general practice for the entire stakeholder community. When applied together they create a remarkable synergistic effect,  but even as individual measures they can make a huge difference.

So what are these three measures and how can they help?  They are Active Signposting, Coding of Medical Correspondence and the Reduction of Missed Appointments – and their impact can be transformative.

Taken individually, Active Signposting can reduce the number of GP consultations by up to 26%, simply by redirecting those avoidable and unnecessary consultations to more appropriate health professionals; simple behavioural techniques can reduce Missed Appointments by up to 30%; and Coding of Medical Correspondence can reduce the amount of paperwork that needs to be seen by the GP by up to 80%, freeing up to 45 minutes of GP time each day. When all three are implemented in a coordinated manner it is easy to see the beneficial impact on all stakeholders that could be achieved across a busy and overstretched practice. 

The key stakeholders in a GP practice are the GPs, the practice staff and the patients that the practice serves. Each of the three measures above address the concerns of all three stakeholders, creating a Win-Win-Win situation that can dramatically improve the experience of each stakeholder, reduce stress and improve job satisfaction.

For the practice stakeholders, benefits include:


  • GP time is freed up from unnecessary paperwork – coding is more efficient and thorough.
  • GPs no longer take consultations where the patient could more appropriately be helped by other clinicians within the practice, or by externally based health professionals.
  • Time saved from reducing unscheduled missed appointments can either be saved up and used to provide GPs with scheduled comfort, admin and coffee breaks, or used to reduce patient waiting times.


  • Reception staff,  up-skilled as Care Navigators, enjoy greater job satisfaction as they help patients secure earlier appointments with the most appropriate health professional for their needs.
  • Non-GP, practice based clinicians see patients relevant to their special skills, earlier in the patient journey, improving outcomes and patient satisfaction.
  • Receptionist self-esteem is improved, ‘tricky’ calls are eliminated, stress levels are reduced and job satisfaction increased.
  • The time wasting management effort and stress involved in overbooking needed to accommodate DNAs is largely eliminated.


  • Patients receive earlier appointments with the most appropriate health professional. Choice is increased.
  • Care Navigation leads to higher patient satisfaction scores.
  • Late running appointments due to overbooking are reduced, improving satisfaction.

With ring-fenced funding provided by NHS England to implement Active Signposting and Coding for the next four years, there is no major financial barrier to adoption either. Where practices are grouped in federations, neighbourhoods or localities, training can be shared across the group and conducted centrally to allow teams from several practices to take part at a time that suits their shift patterns.

The three actions mentioned above are not a silver bullet to cure all the ills of general practice, but when the addition of two words to the conversation between the receptionist and patient can reduce missed appointments by 15%, they do have the potential to significantly transform the experience of the entire practice community. The result is a Win-Win-Win for all concerned.

Nick Sharples is the founder of DNA Insight, a GP training consultancy that focuses exclusively on providing training to GP practices in support of the GP Forward View Strategy. Courses are available in the three High Impact Actions of Active Signposting, Coding of Medical Correspondence and the Reduction of Missed Appointments.
Nick draws on a background in Stakeholder Communications, Customer Engagement, Marketing and Behavioural Psychology to deliver Programmes that help Practices to engage more effectively with their patient communities across all touch points. This in turn enables the practice to exploit the full potential and benefits of the High Impact Actions and achieve a Win-Win outcome for the entire practice stakeholder community. Find out more: www.dnainsight.co.uk 


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