The appointment, the consultation and the record

How a GP day runs in commvita: booking and attendance, the consultation where the record actually gets written, prescribing and EPS, the online triage queue, records moving between practices, and the enhanced services money counted as you go.

1 The morning surgery

A GP day starts as a list. Who is coming in, when, what for, and who didn’t turn up. commvita holds slots and appointments as two different things: the slot is the capacity, the appointment is the person in it.

Every row carries the reason it was booked for, so the clinician opening the record already knows why. Marking someone attended or DNA is one click from the list, and it writes to the appointment itself, so there’s no separate register for somebody to reconcile later.

2 The consultation, and where the record gets written

The consultation is where a GP edits the record. It opens with the person’s context alongside it, takes the presenting complaint, and carries a red-flag check through to the end.

Notice what the list tracks. Twelve consultations this week, an average of fourteen minutes, four still in draft. A draft is a real state here, not a lost tab — a GP interrupted at 11:20 comes back and hits Resume, and the half-written note is where they left it. Red flags are counted for the day, so a supervising partner can see whether anything came up.

What the GP writes lands on the record itself. The problem list, the medication, the observation and the coded outcome all go to the same person the Whole Person Record reads from, which is why a note written in the surgery at half nine is on the community nurse’s screen at two.

3 Prescribing, and what happens to the script

Prescriptions carry a type, a status and an EPS reference, and the status is the real one — draft, signed, sent, with the dispenser, dispensed, cancelled.

A controlled drug is marked as one and carries its schedule. A drug outside the local formulary gets flagged instead of quietly issued, so the conversation happens before the patient is at the counter. Two scripts are sitting awaiting sign-off, which is a queue somebody owns.

4 The consultations that arrive without an appointment

Online consultation takes a patient’s own description of the problem and puts it in a triage queue with an urgency on it, for a GP to assign and action.

Some of these never need an appointment. A repeat prescription request gets actioned and closed. Chest tightness on exertion doesn’t — it sits at the top marked urgent until somebody picks it up. The queue is the safety net: nothing is “in the inbox”, everything has a state and an owner.

5 The record arriving, and the record leaving

When a patient moves practice the whole record has to move with them. GP2GP does it electronically, and commvita tracks both directions.

Two completed, one pending, one failed. The failed one is on the screen, not buried in a log nobody reads, because a failed record transfer is a patient whose history hasn’t arrived at their new practice. The page also carries a transfer quality score and a safety notice tab, which is where the known hazards of electronic record transfer are written down.

6 The contract, counted as you go

Enhanced services are how a lot of general practice actually gets paid. Each one has a target, a rate and a running count.

Flu vaccination: 2,641 of 2,840 done, at £10.06 an item, which is £26,571 claimed of £28,570 claimable. The SMI physical health check: 118 of 142. Three services are behind, and the dashboard says which, in September, while there is still time to do something about it. A practice finding that out in March has lost the money and the health checks both.

7 Data leaving the practice

GP data flows out to the national extraction service, and that flow needs governing.

The ingest screen shows which practices are feeding, how many patients are pseudonymised, how old the last refresh is against its target, and whether pseudonymisation is on for each feed. It carries its own information governance and consent tab. A GP practice signing up to a data flow should be able to see the flow, and this is where it is.

Where it lives in commvita