| GP Partnership | Health Care First |
| Location | Methley, Castleford, Ferrybridge, Airedale, Normanton, and nearby villages |
| Serving population | 32,000 |
Overview
In October 2023, the practice joined Phase C of the General Practice Improvement Programme (GPIP) and began moving towards the Modern General Practice model. The practice’s first step was a partial shift to total triage in December 2023. While this created some early improvements, it also exposed several difficulties. The removal of the call-back system, which staff had found inefficient, was unpopular with patients who valued its convenience. The introduction of digital booking links for routine appointments was not consistently used b
y patients, making demand harder to manage. In addition, the triage system initially applied only to urgent requests, meaning routine appointments were not always allocated appropriately, despite the efforts of the care navigation team.
To gather feedback and consider improvements, the practice organised a patient roadshow across its sites. This revealed concerns that the practice was becoming too large to manage effectively, that digital access through Patchs was cumbersome, and that continuity of care had declined. Patients also expressed a preference for in-person consultations at their local surgery and described confusion around appointment booking times.
Choosing a new approach 
In response, Health Care First chose to move towards a clinically led total triage model. Under this system, all appointment requests would be reviewed by a Clinical Assessment Team (CAT) made up of GPs, Advanced Nurse Practitioners, a Paediatric Nurse and a Practice Nurse. The aim was to prioritise patients with the greatest need, improve continuity of care, and ensure patients were seen by the most appropriate clinician. The practice also committed to moving away from Patchs and towards SystemConnect, which offered a more user-friendly experience for patients submitting online requests.
Partnering with Xytal
To ensure a smooth transition, Health Care First brought in Xytal to act both as a facilitator and as a critical friend to test and validate plans. Between December 2024 and March 2025, Xytal supported the practice in reviewing project plans, mapping key processes, capturing baseline data, and designing job standards and new rotas. Resources on continuity of care were shared with the team, and workshops were held to strengthen communication planning. A patient journey map was developed to clarify what patients could expect when contacting the surgery by phone, online, or in person
The Implementation
By March 2025 the practice was ready to launch. In the months leading up to this, the call-back system had been reintroduced and SystmConnect tested extensively. A series of digital roadshows and communications prepared patients for the changes, supported by video clips featuring clinicians explaining the new approach. Training sessions ensured staff were confident, and test days with the CAT allowed the new processes to bed in ahead of the official launch.
During the launch week, patients were informed about how the new system worked and encouraged to consider community services such as Pharmacy First where appropriate. To support the transition, the practice relaunched its website with SystmConnect easily accessible from the homepage, sent letters to housebound patients, and made in-person help available across its sites. Staff were supported by a rota of managers on-site and a virtual drop-in room on MS Teams.
Lessons Learnt
The first review meeting, held shortly after the launch, found that the Clinical Assessment Team was managing requests effectively and that the shorter consultation times had created additional appointment capacity each week. Patients who had initially self-assessed their needs incorrectly were being triaged to more appropriate care, improving safety and efficiency. Early feedback suggested that patients found SystmConnect easier to use than Patchs, while the updated website made navigation simpler.
There were also areas to improve. Some patients were confused by text messages that listed a practice site for telephone consultations, while processes for managing missed calls and follow-up bookings required refinement. Staff requested more training on SystmConnect, and the capacity of notes within the system needed to be increased in some areas, such as for mental health. Technical issues with the call-back system persisted, requiring escalation.
The Impact
Within the first month (March–April 2025):
- 9,287 SystmConnect requests were processed, with patient use steadily increasing.
- Appointment duration changes created +175 additional appointments each week.
- CAT processes improved clinical prioritisation and reduced duplication.
- Early patient feedback highlighted the ease of using SystmConnect.
- The redesigned website and digital support sessions helped patients transition more quickly.
In the first month after launch, Health Care First processed more than 9,200 SystmConnect requests. While many were submitted on behalf of patients by reception and call-handling teams, direct patient use is expected to increase as confidence grows. The change in appointment length from 15 to 12.5 minutes created around 175 additional appointments per week, increasing access for both urgent and routine care. The Clinical Assessment Team reported positive experiences with the new model, particularly in managing complexity and reducing duplication.
Although call volumes were harder to interpret due to technical issues, care navigators noted that longer calls were often the result of supporting patients to use SystmConnect for the first time. This time has already begun to reduce as staff and patients adapt to the system.
Next Steps
Health Care First is now focused on stabilising the call-back function to improve patient and staff confidence, while embedding SystmConnect more deeply into everyday practice. Plans are underway to integrate the tool within the NHS App, which will offer a further boost to patient adoption. A staff survey and appointment audit will provide further insights into the impact of the new system, and continuous monitoring will ensure the model continues to evolve to meet the needs of patients and the practice team.
