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GPs buried under trusts' workload dump

GPs asked to save £1m by skyping pensioners in care homes

GPs in the Midlands will be asked to consult with elderly people in nursing homes via video link, in a bid by commissioners to save £1m.

NHS Stoke-on-Trent CCG and NHS North Staffordshire CCG are investing £272,000 to set up a video consultation system across 17 practices and 10 nursing homes.

The funding, which the CCG has sourced via the Government's GP infrastructure scheme the Estates and Technology Transformation Fund (ETTF), will mostly be spent on buying the necessary technology.

This will include computer tablets, to connect patients with mental health and palliative care staff, community pharmacists and geriatricians through the CCGs’ telehealth system and health management apps, the CCGs said.

They added that some money would be left over to spend on providing initial training, and ongoing support, for patients and clinicians.

The two CCGs, which are splitting the investment equally, are targeting the £1m cost saving over the next four years by cutting the number of unnecessary GP visits and hospital attendances.

Dr Anil Sonnathi, a GP in Stoke on Trent and the clinical lead for the project, said that in addition to GPs skyping patients directly, the technology would enable GPs to discuss patients in a multidisciplinary team with mental health, social care and palliative care experts without having to attend a meeting.

He said this was 'a much more effective use of GP resources and time' because 'they're not physically attending those multidisciplinary meetings but they are in their practices where they can actually be viewing the patients records'.

Dr Sonnathi said the scheme was also in line with plans outlined in last year's GP Forward View, to reduce pressure of GP time and resources.

He said: 'One of the things about the GP Forward View was that to make sure that GPs time is much more efficiently used and one of the things they suggested was the use of technology to communicate. And this will tick the relevant boxes.'

Dr Sonnathi said the project team has identified the participating nursing homes based on A&E admission rates and has contacted nearby practices about taking part.

The team is also in talks with the LMC about rolling out the project on a wider scale when it has been evaluated.

Dave Sanzeri, head of commissioning at NHS Stoke-on-Trent CCG and NHS North Staffordshire CCG, said the funding will allow the them to ‘harness the benefits of modern technology to provide better healthcare’.

He said: ‘Using this technology can improve health outcomes for patients and residents in care homes by offering their carers speedy access to extended expert primary care support, giving our patients effective care from integrated health teams.’

It follows a pilot initiative in Stafford nursing homes, in which an iPad and a pulse oximeter were mounted on a trolley, that found Skype consultations meant that GPs only needed to be called out 50% of the time.

Both projects form part of NHS England's ‘Making Technology Enabled Care Services (TECS) a Reality in Elderly Care’ scheme, which was launched two years ago and aims to provide healthcare remotely to people with long-term conditions in an effort to improve patient access and save money.

The Government's plans for IT to save general practice

The focus on IT projects to save time and money has continued to feature heavily in Government plans, with the health secretary announcing in February last year that £4.2bn would be ring-fenced for IT projects over the next four years. This included £750m for digital primary care, medicines, social care digitalisation and digital urgent and emergency care.

Meanwhile, in May last year, NHS England committed to allocating £173m to CCGs for improving IT services in primary care in 16/17.

The £1bn Estates and Technology Transformation Fund was first announced the 2014 Autumn Budget, although at the time it appeared to be focused on much-needed upgrades to GP premises.

But Pulse investigation later found that only 5% (£48m) of the fund has been spent on premises so far, while £201m was quietly spent on supporting other projects, such as seven-day GP access and putting pharmacists in GP practices.

Readers' comments (26)

  • our ccg is planning this as well where team of people will skype patient and arrange gp visits.
    more and more people involved in seeing old people more work for gp's as with this age group no one want to take risk.
    visits are free . spend your own car expenses and deal with complicated cases.not patients fault.
    IT IS TIME GP'S ARE PAID FOR HOME VISITS FOR ALL PATIENTS.

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  • How educated managers can propose such inepsies??!!
    Is it to get rid sooner of old people?? Are we in a civilized country ??

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  • On the positive side, it may save an occasional GP visit.

    On the negative side...

    1. increasing access opportunities will increase demand, as nursing home staff decide to 'just Skype the doctor and get her to look at it' for every little thing. This increase in demand on GP services will not be funded.
    2. I can see where the cost increase is, but I can't see where cost savings are to be made. Presumably the CCGs hope this will keep patients out of hospital, but exactly how (unless it is because nursing homes will be reporting back every little issue in the hope that occasionally something more major is picked up early)?
    3. video consultations are clinically riskier than face to face consultations especially in complex patients, and may attract higher indemnity costs, borne not by CCGs but by GPs. 'failure to visit' is a common complaint and often turns into a performance issue, I doubt 'I had a peek at her through an iphone camera' will be considered a reasonable alternative assessment by the GMC

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  • David Banner

    Ho Ho, very funny Pulse, but it's only 30th March, the 1st April is 2 days away yet.

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  • It will cost 1million and create extra work/ visits - completely unsafe.
    Which moron came up with this?
    You couldn't make it up !

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  • If it takes as long as facetiming my parents then they'd better put a whole session aside per call

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  • I didn't realise I could ascultate via Skype. Wonders never cease.

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  • We cannot even get video links to work reliably between hospitals and educated professionals. These links will go down in months and the equipment left to gather dust!

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  • IT people would have booming business in setting up this. Wish I would have been computer engineer setting up computer with big contract money. Biggest leach on NHS is IT.

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  • You know that telltale UTI aroma as you walk into the room?

    You know that smile when you hold their hand and reassure them?

    You know that vital bit of information that you pick up from the nurse as you're walking to the room

    You know all those subliminal clues that trigger your spider-sense and tell you this one is the ill one?

    It doesn't work over the internet

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