Telephone-first approach not a solution to GP workload, says study
The telephone-first approach is not a solution to patient demand and GP workload, according to a new study.
The method, whereby patients booking a GP appointment are initally phoned back on the same day by a GP, increases workload and does not suit all patients, the research found.
Researchers reported that although the average number of face-to-face consultations decreased by 38%, there was a 12-fold increase in telephone consultations and an estimated 8% increase in overall time GPs spent consulting.
The report, by Cambridge Centre for Health Services Research, compared 146 practices using the telephone-first approach to practices that were not using this method. The study’s authors surveyed 42 practice managers and 873 patients, all of whom recently had a telephone consultation with a GP.
The most common disadvantage of the system among practice managers' responses was 'increased/more intense workload for GPs and more stress'.
The survey also found that 44% of patient respondents said the method was either less convenient or made no difference to them.
Though some patients were positive about the convenience of the telephone-first approach, which reduced the need to come into the surgery, others said it was difficult for them to answer a GP's call if they were at work, and those whose first language was not English said the method was a problem.
The report said: 'It is clear from this and other studies that telephone consulting forms a useful part of the services that a practice offers to patients, and it is also clear from our results that a substantial amount of GPs’ workload and patients’ problems can be dealt with on the telephone. However, neither telephone triage nor the telephone-first approach evaluated here are a solution to meeting demand for care in general practice.'
RAND Europe's Dr Jennifer Newbould, one of the study's authors, said: 'We know in some cases that clinical commissioning groups have funded use of a telephone-first approach as a way to support struggling practices. However, our research suggests that practices without appropriate capacity and capability may struggle implementing the approach and this can have a very negative impact on staff morale.'
The study also analysed hospital utilisation data and concluded that telephone triage led to a 2% increase in hospital admissions, and there was no evidence in the report that the telephone-first method would reduce secondary costs.
Prof Martin Roland, who led the research, said: ‘Our study of a telephone-first approach shows that a number of issues can be resolved with use of telephone consultations in primary care, but the challenge of meeting patient demand remains a major issue for many general practices.’
Previous research warned that offering telephone appointments as standard ‘could increase GP workload.’
However, other studies have suggested that some patients prefer phone consultations over face-to-face appointments.