Call centres urged for GP appointments

GP appointment booking could be centralised in future with national or regional call centres used instead of local practice lines, a report commissioned by the Department of Health recommends.

The review of NHS back office functions by the NHS Confederation’s Foundation Trust Network suggests the health service could save £616m by reviewing back office functions and switching to shared services. It recommends all organisations should move to do so as quickly as possible.

On GP appointment booking, the report says back office functions for GP practices offer “significant potential” for savings.

It adds: “The majority of GP practices have dedicated administrative support teams, often undertaking identical tasks, including the organisation and booking of patient appointments. This system should be radically re-engineered.”

The report says a move towards regional and national GP appointment centres could generate “substantial efficiency gains” and recommends that the DH commissions work to evaluate how such a move might be made and report back by September 2011.

However, the DH said it had no plans to follow the recommendations to introduce national call centres for GP call handling.

A DH spokesperson told EHI Primary Care: "This independent report, produced by the NHS for the NHS, sets out a number of proposals for how NHS organisations could choose to improve and streamline back office functions.

"This is just one of those. Any savings the NHS makes in back office costs will be reinvested into frontline patient care.

"In line with our reforms, it is entirely up to the local NHS to decide how to provide the best possible services for their local communities.”

Dr Richard Vautrey, deputy chairman of the BMA’s GP committee, criticised the proposal.

He told EHI Primary Care: "This completely misunderstands how general practice works.

"The idea that staff with every GP surgery just answer the phone is misguided. The person answering the phone is also carrying out administrative tasks and meeting and greeting patients."

The 74 page report , QUIPP national workstream, back office efficiency and management optimisation, concludes that all sectors of the health service including foundation trusts, other NHS trusts and primary care trusts could save money by switching to shared services and simplifying services.

The report found that the NHS spends £2.8 billion a year on back office functions and said a benchmarking exercise involving the majority of NHS organisations had shown that if organisations spending above average reduced their spending to the average the NHS would save a minimum of £616m.

It said greater savings of up to £1 billion could be made over three to five years following the adoption of shared services.

Tony Spotswood, chief executive of Royal Bournemouth and Christchurch Hospitals who led the review, said all trusts needed to benchmark their performance and redefine what they do.

He added: “There is genuine scope to redirect funds to front line services through the standardisation, simplification and sharing of back office functions.”

The review looked at streamlining finance, human resources, IM&T, procurement, estates management, governance and risk and payroll function. IT was the service most likely to have been outsourced or run from a shared service already.

The report also contains a series of indicators which the project group suggested could be used to measure the efficiency of back office functions. On IT these include indicators such as the cost per helpdesk call, acquisition cost per workstation and cost per medical record processed.

The review says PCTs as a sector have the greatest potential for saving with back office costs accounting for 9% of their total spend compared to 3% for providers.

It says management cost savings achieved by PCTs and strategic health authorities should be consolidated into the management allowances for GP commissioners with cash-limited allocations for GP consortia.

The report provides guidance to NHS organisations on different models for shared service operations and on how to approach a move towards shared services.

In a foreword to the report Jim Easton, national director for improvement and efficiency at the DH, said the evidence based for shared services was “overwhelming”.

He added: “It is critical that the NHS uses its scale to leverage greater efficiency. Closer collaboration of provider organisations allied to a granular examination of how to take cost out and reduce low-value-adding transactions will be essential.”

He said GP consortia would also need to consider how they could come together to provide shared back office services effectively.