Why can you limit the number of requests patients can submit through PATCHS?
Ideally PATCHS should be unlimited and turned on 24 hours per day, 7 days per week. But from my own personal experience in my practice and through our research, we understand practices only have a certain number of staff to deal with patient requests, and a certain number of hours in the day to deal with them. This is a particular problem if staff members are off work unexpectedly e.g. for sickness. Having too many requests to deal with can increase staff stress and worsen the problem. That's why we've made it possible to limit the number of requests you receive each day, should you wish, to match the capacity you have, and to turn off PATCHS when you're closed.
Clinical vs non-clinical request limits
It is possible to choose whether to limit clinical or non-clinical requests in PATCHS.
- Clinical requests are New health problems, Ongoing health problems, and Other types of requests
- Non-clinical requests are Medication and Admin types of requests
You may wish to put a higher non-clinical request limit (or not limit at all) so that patients can still request medications when you're closed.
How to set request limits on PATCHS
Go to 'Edit practice' under your name in the top menu (if you work across multiple practices that use PATCHS this may appear as 'My practices' instead)...
To edit your practice's request limit settings go to 'Demand Management' using the tabs at the top of the page...
Edit the 'Maximum number of requests patients can submit throughout the day' fields to update the request limit settings for your practice.
You can split each day into a number of time periods (up to 6) by clicking the edit icon...
Choose the number of time periods you want the day to be divided into...
And confirm by clicking the change number of periods button.
You can also duplicate the daily request limit settings to one or more other days...
Choose the days you want to copy the current day's request limits to...
And confirm by clicking the Duplicate day button...
When a request limit field is left blank the number of requests (of the particular type) patients can submit in that time period is unlimited.
Click the 'Save changes' button at the bottom of the page to confirm the limits.
What standard messages do patients see when PATCHS limits have been reached?
Patients will always see a message stating that PATCHS is closed - either for clinical and/or clinical requests. For example:
If you tick the box 'If maximum requests limit is reached, show patients the next time PATCHS is available for requests', patients will be told when PATCHS is next open...
The patient will then be advised when PATCHS is next available for requests. For example...
The 'Help' link they see directs them to this article.
You can also create custom messages for patients when PATCHS limits have been reached.
How many requests should I limit PATCHS to?
This is entirely up to you and what you think you can cope with as a practice. However, if you want some advice on specific numbers, please read this article: How many PATCHS slots should we offer patients?
You may leave the rate limit blank in which case there will be no limit to the number of requests patients can submit. In my own experience with this approach, a list size of ~10k, and using PATCHS for Total Triage, we received roughly: 200 requests on Mondays, 150 on Tuesdays and Wednesdays, and 100 on Thursdays and Fridays.
An alternative approach for clinical requests may be to: 1) count how many clinicians you have working on PATCHS, 2) decide how many PATCHS requests you want each of them to receive, and 3) multiplying those numbers together. For example, if you have three GPs working on PATCHS, and you want them to receive 20 requests each, your clinical request limit would be 3x20 = 60. How many requests you want each clinician to receive is a personal choice, and dependent on the practice and individual clinician.
You can take a similar approach for non-clinical requests by working out how many staff members will be dealing with non-clinical requests. That may be non-clinicians such as receptionists, but it may include clinicians too.
Using the On/Off switches
An alternative to the request limiter settings, PATCHS requests can be switched off by using the On/off switches in the Unassigned inbox.
What happens if I use the 'Off' switch?
If you use the off switches in the Unassigned inbox you will override any schedule you have set. Patients won't be able to submit requests regardless of what you have put in the table. They also won't be able to see when PATCHS is next open for requests if you have chosen to display that information. So instead of seeing this:
They will instead see this (note there's no second sentence saying when PATCHS will next be open):
Don't tell patients to use PATCHS if it's reached capacity or turned off
This may sound obvious, but we've seen it happen! Clearly this doesn't provide a good service to patients and they will just get frustrated.
I don't want patients to submit requests when we're closed - when should I turn PATCHS off?
Patients have 30 minutes to write a PATCHS request before they get timed out. Therefore if you don't want to allow patients to submit requests when you are closed, you should switch off PATCHS at least 30 minutes before you close. You can see if a patient is still writing a request from warnings on the Unassigned inbox...