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Digital consultations should be taught in GP trainee curriculum, says HEE

Exclusive: Digital consultations should be included in the GP trainee curriculum according to Health Education England’s head of primary care.

In an exclusive interview with Pulse, HEE's deputy medical director of primary and integrated care, Professor Simon Gregory, also said there was a concern around GPs working for digital providers not receving required training.

Professor Gregory said the RCGP curriculum does not distinguish between face-to-face consultations and other types, but added explicit reference to digital consultations 'most certainly need to be in the curriculum'.

When asked about the level of interest in the digital GP model - such as Babylon GP at Hand - among trainees, Professor Gregory said: 'If you go back to the RCGP curriculum, if you go to the first bit being a GP and the second the consultation, none of that says it has to be in a consulting room.

‘When I started out as a GP trainee, we weren’t taught about telephone consultations, many of the consultations are by telephone now.’

He added: 'Rather than focusing on any particular provider, what I would say is that this is a disruptive innovation - and the genie is out of the bottle on this one. I now do all my banking on the app on my iPhone..... It most certainly needs to be in the curriculum.'

However Professor Gregory also suggested that newly qualified GPs who begin their careers working via online consultations would lose out on the breadth of learning that takes place during the period straight after qualifying.

He said: ‘I recognise now that when I started as a GP, I wasn’t yet fully ready. It took me a few years. My worry would be that if people go straight into online consulting, they may not have the full grounding in being a GP.

‘I would hope that we would do that [digital consultations] more and more through it being one of the modalities we offer to our patients but we also have to need to be really careful.’

He continued: ‘I initially found it tricky doing telephone consultations because I thought, “I can’t see them, I want to, you know, pick up on that gut feeling of whether the person is saying one thing but their eyes and their body language are saying another”. 

‘I think there will be a place for digital, we’ve all got to offer some form of digital consultations under the new contract.’

Although patients will be offered digital consultations as part of NHS long-term plan’s promise, NHS England analysis has shown that patients at digital GP practices are three times more likely to return to their original practice than patients switching between traditional practices.

A recent Ipsos Mori evaluation of Babylon's NHS service said the features of the digital GP model are attracting GPs to work for Babylon GP at Hand and the NHS should look into it to ‘ease the recruitment crisis’.

However, while GP leaders have said the NHS 'has a lot to learn' from the model, they have criticised Babylon for cherry-picking younger, healthier patients and destabilising general practice.

Readers' comments (11)

  • Apparently having an out of data legionella check is a grave risk to providing GP services but not being able to physically examine a patient is absolutely fine!

    What a world we live in.....

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  • As GPs we do need to evolve.

    The 10 minutes face to face is becoming obsolete, not least because we can’t afford the infinite amounts of this, that patients demand.

    Some colleagues have embraced telephone and online consultations but others have buried their heads in the sand, siting “safety risks”.

    Unless we can evolve as a profession, we will be left behind...

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  • Prof Greg has got it together.
    GP trainees would benefit from practical training I.e. a professional consultation is a minimum £3-4 per minute (and fxxx the governments ‘global sum’ shite).

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  • The risks should not be understated. Body language is missed, colour can be different using different screens, IT problems cannot help spped up time not to mention not being able to examine patients makes one less likely to examine (one of the sources of complaints). GMC judges on "best care". This certainly is not best care, just trendy delaying tactics and triage and it does not save any time. What is does is increase your chances of being struck off and sued massively. Profits to the programmer and lawyers. Why would one want to rush and risk being screenshot or filmed and edited and be used against you?

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  • Clinical examination? Pffft.

    Like the good professor, I can confidently diagnose critical aortic stenosis by looking at the eyes,and the body language.(/s.)

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  • Cobblers

    IDGAF Aaaah! Landolfi's sign! That would be Aortic regurg.

    https://is.gd/TbKu9M

    (Warning Daily Mail)

    :-)

    Agree, online consultations save no time for the doctor and are marginally less risky than phone consults.

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  • Benn Gooch

    This is obviously a fairly niche area and nobody in their right mind is suggesting it's going to replace face to face consulting. There is a an appetite for more flexible access to a GP from a proportion of the population so getting to grips with meeting that need (I use the word advisedly) seems sensible.

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  • Why is more flexible access needed? Are your clinics sitting there with slots that patients cannot access? Mine certainly aren't - I'm fully booked all day, every day.

    The problem is not actually access, it's GP TIME. The choice, therefore, is whether I spend my 10 minutes with a patient in front of me or whether I spend it looking at the patient on a 5 inch screen.

    I know which I prefer, and I know which is safer. I also know what I'd pick for my own family.

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  • Well said JAM GP. The crucial thing is GP time and risk.
    I can already see the lawyers rubbing their hands in glee at all the new possible openings and opportunities to sue and the GMC ready to increase their fees for "more work", more rules and more regulation.

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  • "Unless we can evolve as a profession, we will be left behind..."
    left behind where? a world in which the Drs have been left behind is a world with no Drs, or am i missing something?

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