THE appointment system at Ramsey Health Centre, meant that any patient walking in the door was usually seen by a doctor within an hour. But not everyone was happy, and the practice was determined to do better. Good is not perfect, says Dr Simon Brown.

TAKING YOUR CALL: Administrator Caroline Brown.

THE appointment system at Ramsey Health Centre, meant that any patient walking in the door was usually seen by a doctor within an hour. But not everyone was happy, and the practice was determined to do better.

"Good is not perfect," says Dr Simon Brown.

"We found we were slightly limited - not everybody needed to be seen immediately that same day, but they still had to take time off work to attend.

Others needed to be seen again perhaps a few weeks later.

"The answer was quite simple. We asked our patients what they wanted," said practice manager Len Moore.

"Our recent patient survey was very clear on three points.

"Our patients would prefer to see the same doctor each time when possible.

"Ideally they would like to be able to choose their doctor and, despite the Government target of access within 48-hours, they were quite happy to wait a week before being seen for less urgent problems if it suited their lives better."

Dr Martin Glover said: "It makes sense but how do you match that to people's busy lives? How do you ensure you can fit it around those who work?

"At the same time can you make sure that the most vulnerable groups (children and the elderly) are not ignored?"

Senior partner, Professor David Haslam, CBE, a doctor with years of experience as a leader in UK health care, said: "We talked to leading GPs across the country. Together we shared ideas of how to help patients and it came down to being flexible."

Dr Luke Twelves said: "We have been partly doing this for many years without realising it. The best ideas are often the most simple.

"One phone call and it is sorted. For some problems, that is all that is needed - forms, some types of sick notes, basic advice, or test results.

"For these people it's a real waste of time to have to come in to the practice. With others we can tell very quickly that they do need to come in, and how urgent that is.

"Once or twice the most difficult part was convincing the patient they really did need to come to the practice."

One strategy has been to increase the number of people at the practice. An addition to the nursing team is Nurse Ann-Marie Flaherty.

There are also two more women doctors, Lynda Brown and Karen Hales.

This is an important step. For some problems you may wish to see a female doctor and we can now offer this choice every day. In addition, the expansion of staff has enabled us to provide additional services to our elderly patients in nursing homes and those with serious or terminal illness.

This system will take a little time to settle but I believe it will offer better access to all our patients when they need it.

Medical emergencies will always be seen. Like anything new, we will watch how it works and adapt it to people's needs.

How will we know? Well, it has worked extremely well elsewhere, but above all, our patients will tell us and help us shape it for their benefit.