E-consultations – evidence and fear
You can’t have failed to notice that everyone’s talking about e-consultations and whatever the evidence (or lack of it), the GP Forward View fund is forcing the pace.
Evidence. It’s the key battleground because if £45m is going to be spent the public needs to be assured that it’s value for money (more particularly, the NAO).
But the public. as we measure their actions and views with askmyGP, are saying something very important: we like this more and more. This week feedback includes: “Happy with the quick response.” (f 62), “good, easy, fast” (f 56), “System very easy to use, I will use this again” (m62).
You know my skepticism of anecdotes, but they do illustrate the trend, which is 60% now saying this is a better system.
The common theme is easy and fast, and it’s those practices who understand this that are reaping the benefits. The fact is, patients have to be begged to use a new online channel, they don’t all rush at it, and only bother the GP when they’ve tried Googling for self help (75% in the latest survey).
Those that fear their patients are missing out. “This is a great way to avoid an unnecessary doctor’s appointment.” (f 43), and I really love this one, (m 77), “Both parties benefit by sometimes not needing a surgery visit”.
Pure genius. Patient-centred care means it’s a joint decision on how best to help, not a barrier for patients to overcome.
Harry Longman
PS Not just for data nerds, it’s astonishing to see how over the last 20 months askmyGP use on smartphone has shot from only 22% to 48%, as PC use has shrunk.
- Published in Comment
How does GP practice list size affect patient satisfaction?
This poster was presented at the European Forum for Primary Care annual conference, in Riga, Latvia, September 2016.
The data source is all English GP practices by list size, and the GPPES survey data for the same practices.
A clear relationship was found between the top score “Very good” and practice list size by band. Note that the critical distinction is between the score “Very good” and “Good”. The often used tactic of combining the top two scores makes the relationship disappear. However, given that 85% of respondents gave the top two, which is typical of surveys where most people are “nice” unless they have a particular complaint to make, I submit that the difference is useful.
- Published in Evidence
So what is an e-consultation?
Well I was right about the bombardment of doom ceasing for just one day. They are at it again, and NHS England’s £2.4 bn GP Forward View is “not nearly enough, not the right stuff and not soon enough.” Never mind, it is what it is.
Though not one of the 1700 words Shakespeare coined, “e-consultation” is centre stage and the thing that is going to transform general practice for a mere £45m. However, with no definition of what it means, I’d like to propose one, starting from the basics.
In our context, a consultation is a personal interaction between patient and clinician in order to provide medical help.
Where traditionally they have all been face to face, remote consultations can take place by telephone, video or digitally. (Letter would also fit the definition but I’ll assume there is little call for this. Even faxes are being smashed in the new modernisated NHS).
E-consultations are therefore a subtype of remote, and to hone the idea let’s look at what falls outside:
- not simply booking an appointment online (no interaction)
- not NHS 111 (even if it is digitised, only an algorithm, not patient-clinician)
- not Skype or other video, as like telephone these are synchronous means, patient and clinician present at the same time.
- not symptom checkers (not personal)
Therefore I propose:
An e-consultation is a personal interaction between patient and clinician initiated by digital means.
All very dry, and I think Shakespeare would have put it in plainer English along the lines of:
The patient seeks help from their GP online.
It’s much more fun to have a go.
You can try an askmyGP demo as a patient:
I’m interested in your views on the definitions and demos – please comment below
Harry Longman
- Published in Comment
Thurmaston features in Pulse: how we saved £90k per year
Dr Kam Singh explains how the practice saved recruitment costs using a precursor to askmyGP.
- Published in News
They don’t want you to read this
3:30 on Tuesday a practice manager tells me, “I’ve got GPs wandering around, wondering what to do. We’ve run out of patients”. Me: “Get them cleaning windows.” It was day 2 of launch.
Last week a receptionist at a practice 3 months in told me “it’s really quiet today” – we often hear the same, and no surprise, as there are some busy days and some quiet days if you’re close to patient demand.
Yesterday a Liverpool GP explains to me how they’d saved £50k as a practice in GP costs, enabled by their demand led system now going 4 years.
So why aren’t you seeing this all over the industry press? You know it doesn’t fit the narrative, #GPinCrisis and the rest. It doesn’t suit the interests of RCGP, BMA, NHS England or even the secretary of state.
Money and power need continual crisis.
GPs and their patients need something rather different, a way of working which is compassionate, sustainable and professionally satisfying.
Hunting down good news has a long history. Sorry if your child got the short straw and had to play King Herod this year, but take heart, the Wise Men got the better of him.
Regards
Harry Longman
07939 148618
Founder, Chief Executive, GP Access Ltd
PS You must read @jtweeterson’s NHS Networks, a record year for trends “BMA’s Clinical Time Lost to BMA Workload Surveys survey” is the mark of genius.
PPS Did you get one of the emails sent to top GPs yesterday? Businesswoman and GP Clare Gerada writes, “As a leading member of the GP community, I hope you don’t mind in me blatantly promoting Web-GP (now known as e-Consult) an on-line GP consultation platform that myself and my partners developed.”
Some partners too, with businessman and civil servant Dr Arvind Madan now directing NHS England’s primary care. She continues,
“As part of the GPFV, NHSE has announced funding to stimulate the uptake of online consultation services over the course of the next 3 years”. That’s the ring-fenced £45m.
I’m sure you’re aware of the debate over our askmyGP and their webGP/eConsult. Competition on quality, service and evidence is greatly to be encouraged. Taking on the medico-political establishment was not part of our product planning, but hey ho, if that’s what it takes we look forward to it.
Do write to me about your experiences if you’re one of the 300 practices they claim to use eConsult.