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Better IT can reduce face-to-face GP appointments 'by 30%', NHS England claims

Better technology will help GPs reduce their face-to-face appointments by up to 30%, the deputy medical director at NHS England has claimed.

Dr Mike Bewick, warned that it would be expensive, but the other main barrier to increased technology – the low usage by very elderly patients – could be rectified.

The comments come the day before the health secretary has announced a £240m fund to ‘empower local clinicians and health services to come together and find innovative solutions for their patients’.

Speaking at the ‘Federations – the final frontier’ event, organised by Newham CCG and the RCGP yesterday, Dr Bewick said that by increasing access to good advice online, we could ‘transform the landscape of primary care’.

He told delegates: ‘I estimate that you could reduce the appointments that you would do face to face by up to 30%.

‘It would cost a lot of money. But if patients had access to the right advice online for many of the conditions we treat – especially the long-term and minor conditions – I think we could transform the landscape of primary care by doing that one thing well.’

He said much of opposition to more technology came from the problems associated with Connecting for Health, the previous Government’s project to increase the use of IT in the NHS.

‘This albatross around our neck was Connecting for Health,’ he said. ‘Not everything in Connecting for Health was bad. There was a lot of good ideas. We have to embrace the technology. We are many years on now from when we devised CfH.

‘The internet is many years on and used by just about everyone except the very elderly. But most very elderly people have carers, most have grandchildren who will do it for them. We have to stop patronising those areas of society that we feel will be disadvantaged. We just need to make it possible for them.’

Readers' comments (9)

  • Harry Longman

    Dear Mike,
    We've shown time and again that face to face consults can be reduced by 30, 40 or even 50% through telephone consults, and it doesn't cost a lot of money - it costs less than the traditional model. Nor does it rely on swapping professional knowledge and the GP-patient relationship for an IT led algorithm (hello NHS111 again).
    I'm quoting evidence, not estimates or projections from untried, unbuilt IT systems. If there is evidence of such a system showing these effects and any wider outcomes, let's see it.

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  • I think most clinicians will recognise that better online advice will have nowhere near a 30% reduction in appointments. It just won't happen.

    Patients want contact with clinicians, and at least want advice in person (if not a listen to their chests with a stethoscope etc)

    As above, protocol led medicine like 111 has been an absolute failure.

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  • Face to face consultations are determined by availability. The use of alternatives will increase the overall number of consultations and increase workload, not decrease it.

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  • We operate Doctor First in our practice and are freed from all of the historical problems we use to have. We don't need this expensive technology we help all our patients and see 40% less than previously in a system where we didn't help as many. Using it over 2 years now and patients know they can call for 'little chats' or for info when they need it.

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  • We operate Dr First as well . The demand out there is the demand out there. Our previous system just kept it invisible to doctors. As well as a fall in necessary face to face appointments our D.N.A. rate has dropped by two thirds. Online booking of triage slots may take the pressure of our phones and receptionists some more and reduce phone answering times.

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  • We also have been a DrFirst Practice for about 18 months and it has massively improved both access, continuity of care and has reduced unnecessary face to face consultations. We have seen an increase in capacity of over 25% as a result. It requires good reparation and training but is well worth the effort and has allowed us to manage our practice better and keep costs from spiralling. A reduction in A+E attendances has happened even for our practice who were very accessible before we changed. Spend precious resources instead on rewarding practice who improve care and access like ours instead of expensive technology.

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  • Drachula

    I really wonder whose agenda this is. I heard this chap talk. He admitted that the evidence was not there to support telemedicine but that he was "sure that it would prove beneficial if we did it better and on a larger scale", or words to that effect.
    I suggest that Dr Bewick, who was telling us of his real GP credentials, should do what we all have to do and go with the evidence . Or £millions more are wasted when the health economy has a "£30-50b" challenge.

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  • While not wanting to libel anyone, the persistence of this telehealth mantra concerns me hugely. Which telehealth company has the ear of the government or member of parliament that allows them to peddle goods with no known worth?

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  • Harry,

    Happy to arrange a demo of the system for you, it has been around for 15 years now, so it is not untried or unbuilt. A series of short videos (5 mins each) are available here for you to look at, or you can contact me to arrange a demo.
    http://www.youtube.com/watch?v=xZxFM_qv6O4
    http://www.youtube.com/watch?v=zQdsE335AaU
    http://www.youtube.com/watch?v=VwRTdWjynag
    http://www.youtube.com/watch?v=LMJ53vIDUgw
    http://www.youtube.com/watch?v=j8eMFxwbxzQ
    http://www.youtube.com/watch?v=FQbZPOR9nPA

    Mike.waite@plain.co.uk

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