The Covid-19 pandemic has clearly shown us that we must dial into new methods of primary care and with the increase in general practice activity now is surely the time to act.
Spending on general practice has increased for the past six years, but GPs are having to work harder as demand for care increases. General practice has managed these higher workloads by becoming more efficient but decreasing continuity of care and lengthening waits for appointments suggest that these new working practices have not been enough to keep up with demand.
The funding outlined in the NHS long-term plan and the 2019 GP contract should be enough to allow GPs to meet rising demand over the next four years but is unlikely to be enough to achieve all of the improvements in access to and expansion of services outlined in the NHS long-term plan.
As we all know the population is growing larger and older. At the same time, the NHS is directing more people to general practice. The fragmented data available suggests that this combination has seen GPs’ workloads increase considerably. The most common activity in general practice is consultations where patients book appointments with GPs, nurses, physician associates or physiotherapists and NHS Digital estimated that there were 332m consultations in England in the year ending in April 2019.
The majority of GP appointments often end with a prescription for medicines that are then dispensed from community pharmacies. It has been estimated that prescriptions dispensed in the community increased by 18.6% between 2010 and 2017, from 0.9bn to 1.1bn. Most prescriptions that GPs issue do not require an appointment and it is thought that 70–80% of prescriptions are issued ‘on repeat’ – where a prescription that has been issued to a patient previously is signed off by a GP without an appointment although this still requires time on the part of GPs.
Some of GPs’ increased workload is down to changes in other parts of the health system. The NHS has increasingly encouraged people to use NHS 111 in order to ease demand on the 999 service. In 2014/15, the first full year the service was accessible to the whole of England, there were 12.9m calls to NHS 111. By 2018/19, this had risen to 16.8m which was an increase of 30.3%.
With the increased volume of 111 calls, it has been reported that the number of people recommended by operators to speak to or attend primary care has increased from 6.5m to 7.7m between 2014/15 and 2018/19. The Nuffield Trust, a health think tank, estimates that the number of people NHS 111 diverted from A&E to general practice increased from 875,235 to 1,258,176 between winter 2013/14 and winter 2015/16.
GPs are conducting more and more remote consultations which are typically quicker and cheaper than meeting patients in person. The share of consultations by telephone increased from 5% (2012) to 9.3% (2018).
Online consultations increased at a much slower rate, from 0% in 2016 to 0.1% in 2018. Between November 2017 and November 2018 there were 40.8m telephone consultations and 1.4m online consultations so It is quite clear that remote consultations are becoming more and more popular but online seems to be experiencing a much slower uptake.
With the introduction of virtual appointments, it is clear that they are extremely efficient and supporting GPs massively in managing the daily struggle with increased activity, but it is clear and understandable that some patients will still need face to face appointments.
It was around this time last year that GP surgeries all over the country went from bustling waiting rooms to conducting most of their consultations via telephone and video, almost overnight. For the last few years there has been a big push to give primary care the digital upgrade it so desperately needs, but in all honesty, no one expected it to happen like this and so quickly hence perhaps why the uptake with online has been smaller than telephone consultations.
A GP recently reported that there have been scenarios where online consultations have proved to be a perfect solution to the current climate with numerous examples of why they need to stay. The GP described a situation where a gentleman gave him a low-down of his blood pressure readings over two weeks which was enough to make it clear that it was time for him to trial an additional blood pressure lowering medication. In total in took 6 minutes from starting the consultation to electronically prescribing the medication which saved a trip to the surgery and gave the GP ore time to focus on more complex cases.
There was also a young woman whose acne had become quite bad during recent months and she was able to showcase them over the call. The GP was able to prescribe a medication that she had used to good effect a few years earlier. Again, this took a matter of minutes to resolve.
As the pressure continues to grow within the NHS to step up the pace of digital transformation especially with digital dictation, speech recognition and transcription, eClinic Manager from SpeechWrite delivers an integrated virtual clinic app that will enable GPs to carry outpatient appointments virtually and securely via smartphones, tablets and desktop computers to support GPs in delivering patient care in these turbulent times.
With a real focus on virtual clinics, eClinic Manager from SpeechWrite will enable doctors to carry out much-needed patient appointments online meaning thousands of medical appointments which continue to be cancelled due to COVID-19 can continue with some form of normality. Medical users will simply convert their normal face to face consultations into virtual consultations with software that is fully compliant with data protection and protected health information restrictions.
SpeechWrite eClininc Manager can help alleviate some of the stress on appointments whilst delivering patients with a familiar yet easy to use tool without the need to install or download any applications by simply using a link in an email or SMS that will direct them to a virtual waiting room before joining their consultation at the click of a button.
Clinicians will be able to work in teams with doctors being able to see who is in the virtual waiting room and following a consultation, they will be able to complete a digital template and dictate notes that can be saved and shared in their usual way.
We believe that eClinic Manager will offer relief to our greatly appreciated NHS staff whilst at the same time assisting patients in need.
eClininc Manager’s key features include:
- Provide timely and appropriate access to care
- Lower you overall cost of care
- Increase your capacity
- Enhance your operational efficiency
- Integrated clinician experience
- Multiple people on call such as clinicians, patient and their guardian, interpreter or support worker
- Increased patient satisfaction
- Reduce hospital admissions
- Can be used as a stand-alone tool meaning you do not need to have dictation systems for it to work
What’s more, SpeechWrite are offering a FREE trial so you can find out for yourself how eClinic Manager can revolutionise the way you provide care.
As with many parts of our health service, this pandemic has shown us that necessity is the mother of invention when it comes to bringing primary care into the 21st century. There is no doubt that virtual appointments are here to stay so the only question left is are you ready to give it a go and take our FREE trial on?