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GPs buried under trusts' workload dump

Digital services will help ease GP shortages, says Simon Stevens

The greater use of technology to deliver GP services will encourage part-time GPs to take on extra services and will help mitigate the effects of the 'inverse care law', the NHS England chief executive has claimed.

Speaking yesterday at the NHS Confederation conference in Manchester, Simon Stevens suggested the use of digital services in surgeries could help address workforce issues, especially in the most affected areas.

He also claimed that it would help deprived areas, who - according to the inverse care law - are in greater need of more healthcare resources, but are less likely to receive them.

Last month, figures published by NHS Digital showed that the number of fully-qualified GPs in England has fallen by 441 over the past year, from 29,138 in March 2018 to 28,697 in March this year

Mr Stevens said there is 'some evidence' that digital GP services can encourage part-time GPs to do more sessions.

He said: 'We’ve got to think creatively about whether some of these new digital models of care delivery, for example in digital general practice, are actually a way of increasing the number of flexible sessions that part-time GPs are willing to work.

'There is some evidence that that is the case. That has to be one of the tests as we expand this model if we really can get more sessions worked on a flexible basis through these digital methods of delivery and target those on parts of the country. Where there are particular GP shortages this could be a way of dealing with the inverse care law. We’ll be consulting on proposals in that respect next week.'

Mr Stevens also confirmed that NHS England will consult on the rules around out-of-area registration and 'digital-first primary care. from next week. 

GP practices have been able to register new patients who live outside their practice area - without any obligation to offer home visits - since 2015.

Babylon Health has used this opportunity to attract more patients living outside its catchment area and offer digital consultations, which in turns has prompted NHS England to review the rules around out-of-area registration. 

The GP contract states that out-of-area arrangements 'were originally set up to allow a relatively small number of patients to choose to register with a practice in a more convenient location than their home address'. But it adds that those rules 'were not designed with digital registration in mind, and they need to be revisited'.

A recent independent report, commissioned by Hammersmith and Fulham CCG and conducted by Ipsos Mori, revealed that GP at Hand patients are younger and healthier than those who use traditional primary care services but are higher users of primary care.

GP leaders have long criticised the GP at Hand model, saying practices do not 'cherry-pick young' young, fit and healthy patients and are left with patients with a higher workload.

Earlier this year, health secretary Matt Hancock told Pulse that there must be a 'genuine level playing field' for GP practices competing with Babylon GP at Hand and that rules have to change to ensure they 'work fairly for everyone'.

Readers' comments (23)

  • Love to see the indemnity issues on these Tele-consults.
    I am assuming the USA/Australia/Canada (anybody let's face it, who are ahead of us) have good reasons for not pushing this agenda.
    I really worry the political agenda is to try and make all consults virtual and all consulters (n)octors.
    Can't express how dangerous this is. My scariest pickups (the really life saving ones in kids/parents/ etc) are usually a caught clinical sign which would be completely missed on a screen.
    I don't worry so much for the docs (we will always get work).
    We must get the message out- that this is terrible 3rd class and potentially life-threatening and lethal option for our patients.
    This is not the NHS.

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  • Scrap or radically change appraisal revalidation and cqc and fix the pensions. Had this been done I would not be retiring in 3 Months at 54. Once i`ve gone, revalidation and paperwork will stop me coming back.

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  • Dear All,
    Palpably nonsensical and countered by the evidence. Even the ex head NHSE IT leader, Dr Arvind Madan admitted his own digital first product had not solved his workload problems. As the Babylon experience has shown, if you lower the threshold for access to a thing it will be accessed more, doubly so if its free.
    As to the new workforce, yes it could help but it could also end up with warehouses full of zero hours contracted GPs gazing at screens and not generating the wisdom and experience that comes from face to face interaction.
    Regards
    Paul C

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  • What a foolish idea.

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  • Its not better, its just that were desperately looking for answers that don't involve improving the terms and conditions of being a GP and then pretending that whatever harebrained scheme we come up with has evidence for it. Totally pathetic

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  • No it won't.

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  • demographic time bomb coming in my area. Baby boomers going to get ill in next 10 years. Need home visits/admissions/terminal care. Boots on ground needed not suits in warehouses.

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  • If I tried a dangerous experiment on people without their consent should I not not be referred to the GMC?

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  • LOL. Bablylon alredy in canada BTW gluedtodesk and the powers that be selling digital consulting software to GPs
    there they will see as positive as thats their outlook generally positive

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  • Vinci Ho

    Miss you , Harvey Dent , where have you been hiding ?
    Why am I not surprised what you said ? Your boss Robocop has finally put himself together to focus on his job after the disappointment of Tory leadership contest . He was the lone gunman in promoting GP at Hand . Of course , he needs your voice to back him up .
    Now , while the general outlook is MojoBojo will become your new Big Boss (and of course , he would NOT give you £350 million a week to spend) , you still have a chance to reunite with your old boss called Agent Hunt as the new PM . They all like to hear what they want you to say , good boy !😁

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