Let me put my cards on the table from the outset. I don’t believe that anything in this world is perfect. Every system has its flaws and that is something that we must accept. The problems start to occur when humans try to make a system better. It is normal human behaviour to try to improve things, but most of the time we cannot guess the consequences.
Let’s take GP appointment booking as an example. When a patient calls up to make an appointment, there are only so many available that day, which often book up within minutes of the phone line opening. You have to allow patients with non-urgent problems, to book an appointment for another day. The problem is that if you do that you reduce the number of appointments for another day. There is also anecdotal evidence to say that the further ahead the booking is made, the more likely it is that the patient won’t turn up.
A common reaction to this is to limit the way advance appointments are offered to patients so that there are enough appointments available on the day. This is further complicated when GPs need to arrange follow-up appointments, reducing the availability more so. Each call to the surgery then gets longer as the system is explained to an increasingly frustrated and often scared patient. This makes it harder for patients to get through on the phone, causing yet another area of complaint. Patients are often advised to call back another day to see if there any appointments available then. All this does is double the amount of staff resources needed to book an appointment, as well as being pretty irritating to the patient.
Are your eyes glazing over yet? Mine did when I went through this with a Surgery last month. Because the fact is, everybody gets to see the GP or talk to them on the phone eventually. But every time the system is tweaked, all that happens is that we make it harder to provide the service.
My Surgery? Well, I called them yesterday, after the morning rush settled down. I was offered either a phone call, an appointment later on in the week or I could come in and wait for an open slot, if I felt it was urgent that I saw a doctor that day. One phone call and it was sorted. I received options to resolve the issue, instead of telling me what I couldn’t have, providing me with an efficient service.
The trick is to design a system that is simple and flexible enough to deal with anomalies. But not to tweak the system to deal with rare occurrences. Because eventually, you will end up with a system that doesn’t deal with daily events, just anomalies.