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I’m Robert Varnam, a GP in inner city Manchester and Director of General Practice Development at NHS England. I’m passionate about providing great personal care for patients and helping others across primary care do their job better.

I’m genuinely excited about the launch of the General Practice Forward View’s £45 million fund to support more GP practices in offering online consultations for their patients. This is a major step in NHS England’s work to empower patients and clinicians through digital technology, and is expected to release time for clinicians and improve patient experience. The fund was announced as part of the General Practice Forward View in April 2016 and is being allocated in 2017/18, 2018/19 and 2019/20.

I am hopeful that, over the three years of the fund, every practice in England will want to try online consultations. As other digital healthcare channels are developed, we also have the opportunity to provide a simpler and more seamless experience for patients, and to provide more personalised support for them to manage their own health. In many respects, the NHS is catching up with the technology assistance we’re used to receiving in other parts of our lives, and it’s good to be part of that.

The basic principle is simple: patients use an app or the practice’s website to send a query to the practice. This might be details of a new medical problem, an update on their progress or a query about their care. The practice receives the information and responds accordingly. Often, this will avoid the patient having to take time out to come to the surgery in person. In other cases, they will still need to speak with or see a member of the team, but the issue can often be addressed more quickly because the patient has already provided information.

I first saw online consultations in general practice about four years ago, and they have come a long way already. The market is evolving rapidly, as is the range of functionality provided by systems. Most now signpost to information for patients as well as providing a channel for communicating with the practice. There is also a growing focus on supporting communication about ongoing care as well as new queries.

As three wise women once sang, it ain’t what you do it’s the way that you do it – and it’s clear this applies to online consultations as much as anything else. As with other innovations in healthcare, knowing what you could do to improve care is only the first step in realising that potential. The way in which practices implement online consultations is a major determinant of how much they and their patients benefit.

Specifically, it’s important to look at how patients are encouraged to use the new channel and how staff respond to online contacts.

  • Marketing to patients is essential. If patients do not know about the new channel, understand the benefits for them and have confidence in the response they’ll receive, experience shows that uptake will be low. Thankfully, simple things are effective, such as ensuring there is a large link to online consultation portal displayed prominently on the practice’s website. Recommendations from staff are also very important.
  • Staff sometimes need support to make the best use of an online consultation system. In particular, at first, some regard it as little more than an alternative route for booking face to face consultations. With a modest amount of encouragement and experience, clinicians and clerical staff come to appreciate that some online contacts can be resolved easily without forcing the patient to come to the practice.

NHS England is therefore providing support as well as money. Regional Patient Online teams will be on hand to advise support CCGs and practices in making the best use of this new communications channel. Free webinars and Time for Care workshops will also help clinicians and practice managers learn more about the success factors and plan their own approach to engaging patients and supporting staff. New marketing resources and support will help engage patients and ensure they are aware of the benefits for them. A national commercial and procurement hub will provide advice and support for CCGs as they procure systems on behalf of their practices.

More information about this initiative is available at www.england.nhs.uk/gp/gpfv/redesign/gpdp/consultation-systems/

Experts from the procurement hub will be hosting a series of webinars for commissioners, federations and practices, to introduce the principles for good practice and answer questions. Webinar details, dates and times will be published at www.england.nhs.uk/events/upcoming-events/upcoming-webinars/

 

 

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