Another week, another specification thumps onto the floor in front of my inbox. NHS Blithering CCG* has copied down the questions from the last lot, added the requirement to integrate with local place-based cloud-enabled remote home visits by Longstay (Vietnam) NHS Telecare plc, and there, ta-da, is the blueprint for online consultations.
As I read through the same tired wishlist, my heart sinks. Must have:
- red flags (unsafe and cut patient use by around 60%)
- symptom checkers to divert patients away (unsafe and patients hate them)
- ability to book GP appointment (wastes GP time as 70% of patients don’t need a face to face)
It goes on, and of course we aren’t going to rewrite our software to meet this specification and thereby ensure it doesn’t work. What’s missing from the list are many of the features which really do matter to patients and GPs, let alone any serious understanding of the journey of change which is much more expensive to deliver than software.
If the CCG has decided on a tick box procurement process, we’ve put ourselves at a serious disadvantage. We run a permanent policy of not lying about evidence, rather presenting the raw data and letting the customers talk about the outcomes. Worse still, we don’t promise the moon unless we have clear technical and economic means of reaching the moon. Overall disastrous.
So I’m going to ask you a genuine question, if you’re in an English CCG, or a GP affected by the DPS procurement process through the ringfenced £45m online consultations fund, set up by Arvind Madan, former eCONsult chief executive: should we pull out of the DPS?
CCGs can still procure askmyGP or any competing product via G-Cloud 10, and draw on the same £45m fund. We are fully compliant on patient safety, information governance, security and so on. But our product development is driven by the simple question “what works?” rather than “what is specified?”.
It’s a philosophy that has enabled orders of magnitude greater usage and value for patients and GPs.
What those tick boxes and essay writing competitions can never ask is whether it will do this. Copied to me yesterday by Dr Barry Sullman, writing to another GP and he’s delighted to share:
“AskmyGP is a revolutionary system, that has transformed my work/life balance. It is now normal for me to have breakfast, and tea with my family. It has also transformed care at the surgery, empowering patients, and creating efficient SAME DAY care.
But I don’t want to talk hyperbole. I want you to come and see this on a live system, where you can see this really happening. I have recovered the cost of the system in 3 months, and I will continue to recover the cost many times over indefinitely until I retire. Let me show you the math when you visit.
This is the future – and doctors need this sorely as do patients.”
So what do we do? Advice welcome or if you like put it in public and comment online.
PS Wales and Scotland do not suffer the same procurement blight as England and they are pulling ahead, as are English GPs investing in their own businesses for the return Barry mentions above.
*Blithering and its staff are an unregistered trademark of the great @jtweeterson, used without permission. The genuine article is here.