Active Signposting – the Directory Dilemma

So Many Services, No Single Directory!

Our recent discussions with CCGs, GPs and their Practice Managers about the Active Signposting initiative have identified a relatively common dilemma concerning the creation of a comprehensive Service Directory. For Active Signposting to be effective, and for Receptionists to become the competent Care Navigators that make the program such a success, there is a need for a comprehensive Services Directory. The Care Navigator then uses the Services Directory to identify the contact details of the service or non-GP care giver that is most appropriate for the patient on the end of the phone.

So far so good you might think, and indeed it is, because there are plenty of contact details of services available throughout the Health system. The dilemma arises however, because although the NHS is very good at publishing contact details for the relevant services that may be needed by the Care Navigator, not all of them are in the same place. In fact very few of them are in one place –  the vast majority being scattered across a wide variety of information platforms, posters, leaflets, Care packs and websites owned by the Practice, the CCG, NHS England and by numerous voluntary, charity and community groups. Without the Services Directory, the Care Navigators cannot do their job, and there is a natural reluctance on the part of GPs and their practice Managers to start training Care Navigators if there is no Services Directory for them to use.

We have found there are two ways to address this challenge. The first one is to take advantage of the services of our medical researchers to create the Services Directory for the Practice – or more frequently for the Locality of geographically grouped Practices, where the bulk of services are likely to be common across the Locality.

The researcher accesses data from the multitude of online and offline sources to identify the contact details of those services likely to be signposted by the Care Navigators. The researcher then compiles them all into a single, interactive and hyperlinked Word document that can be made available across the Practice’s Management systems. Care Navigators then just need to click on the first letter of the service required, to be taken instantly to the relevant entry in the Directory. The Directory is formatted so that when the time comes to consider publishing the Directory online in Waiting Room kiosks and Practice websites, the process of doing so is quick and straightforward.

In practice, when commissioned as part of the Active Signposting package, the creation of the Services Directory can be carried out quickly enough to be available for use at the training workshop. This makes the roleplay exercises directly relevant to the situations the Care Navigators will experience when starting to signpost after the course.

The second way, and the route preferred by some of the more conservative of Practice partners, is to start with a relatively small number of referral areas, such as Pharmacy and musculoskeletal and a few clinics – and then build up the Signposting over time as GPs, Care Navigators and their patients become comfortable with the concept. The disadvantage to this approach is that whilst it is possible to store a few contact details on a scrap of paper or in a notebook under the keyboard, when the Practice wants to expand the services signposted, there is no Directory structure for them to build upon.

Over a relatively short space of time the Services Directory becomes an authoritative and hugely valuable guide to all of the services available to patients in the Practice catchment area. It is then a logical next step to make such a valuable resource available to the wider patient community. This is best achieved by taking the Directory online and linking to it from the Practice and CCG websites and making it available on electronic kiosks in Practice Waiting Rooms.

DNA Insight provides advice and training to GP Practices in Active Signposting, the Coding of Medical Correspondence and Reducing Missed Appointments, three of NHS England’s Ten High Impact Actions, designed to transform General Practice as part of the GP Forward View strategy. Contact us on 0800 978 8323 or read more at www.dnainsight.co.uk

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