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E-consultations resolve ‘40-60%’ of GP consultations without attendance

Exclusive E-consultations are resolving '40-60%' of patient ailments without having to schedule a face-to-face GP appointment, NHS England has said.

GPs using the online consultation systems have said there is ‘no doubt’ that practices are more efficient after implementing e-consultations.

However, GP leaders said the fund should have been delayed ‘until it could demonstrate that all suppliers were safe for patients to use’.

This comes as NHS England has said they are ‘on track’ to spend the £45m GP online consultation systems fund.

The fund, which was announced as part of NHS England’s GP Forward View in 2016, was launched in 2017 when eConsult, which allows patients to submit their symptoms electronically, was first trialled in 33 practices in Hull and East Riding.

NHS England told Pulse: ‘The £45m fund is split over three years. 2017/18 is the first year of the fund and we are on track to spend the allocation.

‘In early adopter practices, 40-60% of consultations are resolved without the patient needing to attend in person.’

Dr Karl Graham, a GP partner at Hedge End Medical Centre in Southampton, started using eConsult before it was launched as part of the national fund.

eConsult allows patients to submit their symptoms to a GP electronically and receive a response in one to two working days, which Dr Graham said is ‘key’.

He told Pulse: ‘It gives you a better understanding of what the patient needed and that allows you to manage that more effectively, which may mean it’s a briefer telephone conversation or that no telephone conversation is needed at all.

‘It may mean that a face-to-face consultation is needed but that that is a much more informed face-to-face consultation and a more efficient use of time.’

He said: ‘There’s no doubt that we’re more efficient than we were, by using this tool.’

According to data collected through eConsult for his practice, 1,303 patients visited eConsult in March, with 858 submitting symptoms to the GPs, which avoided 520 face-to-face appointments.

He added that 73% of these patients said they did not have to contact their GP or any other service for that problem in the same week, ‘so that’s really reassuring as it suggests we’re not just fobbing people off for a few days to do something else’. 

Dr Chandra Kanneganti, GP Forward View lead for the BMA’s GP Committee, said: ‘Before the online consultation fund was launched, on advice from the GP committee and the joint BMA-RCGP IT committee (JGPIT), the BMA requested that NHS Digital delay the fund until it could demonstrate that all suppliers were safe for patients to use.

‘A JGPIT evaluation of existing suppliers used by CCGs and practices revealed significant shortcomings and did not comply with basic safety and governance requirements.'

He added that the GPC ‘are working with NHS Digital to develop a dynamic purchasing system that will ensure suppliers are safe for GPs and patients to use, and comply with existing regulations’. 

What the research says

In March a study from Imperial College revealed there is limited evidence that GP video consultations are safe, effective or improve patient access to primary care, adding that their use could result in a rise in antibiotic prescribing.

Another study in the BJGP said consulting via telephone, email, e-consultation systems, or internet video ‘may well increase rather than decrease GP workload’ and have been implemented without clear rationale.

Researchers studying the impact of the eConsult system specifically found that GP practices experienced ‘no improvements’ to their workload.

Meanwhile, in London CCGs ditched plans to use Babylon Health’s ‘symptom checker’ app to triage patients after patients said they would ‘manipulate’ the system to book GP appointments.

Readers' comments (17)

  • Make a business plan that will be heavily financed from government resources, then choose an opinion (regardless of how evidence free) to support your activity. Then storm ahead to the piggy bank (might even consider off-shore).

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  • This does not magic up capacity,a 10 minute e consult is the same as a 10 minute face to face consult.I know which one is more medico-legally robust and its not the remote one.Get apps to do this.

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  • Do they not appreciate that this is likely to lower threshold for consults as patients start to use it for anything and everything, swamping resources and leaving us with an ever expanding (if invisible) workload which must have an impact on care provision? Is it just me?

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  • I don't understand....four studies seem to point out the needlessness and pitfalls of econsultation but NHSE ignores this and gives us anecdotal evidence from one doctor that this is a magical solution appointment issues.

    It looks like the die has been cast since the government decided on this implementation and we may well cry to heavens but nothing will change.
    With data to be shared with social care welcome to a pool of 'practitioners' ticking of the emails as it happens in customer service centres.

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  • Oh dear. This will not end well. Those of us experienced in OOHs know full well the symptoms given to NHS111 or whatever do not always mirror the problem. But hey, why should experience and research (look it up) ever be part of government backed ideas?

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  • If 40-60% ailments are resolved with an e-consultation without the need to book a face to face appt, then looking at it statistically, this means that 40-60% are not resolved and do need a face to face appt booking.Given that they will already have had a 10minute e-consultation, they will then need a face to face 10 minute appointment arranging.
    In other words, approx half of all patients undertaking e-consultations will require 2 x 10 minute appointments to resolve their issue. Could someone please explain to me how this is going to reduce our workload?

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  • It will increase it without an increase in workforce,oops GP workforce degrading quite quickly,we are doomed!

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  • Dear All,
    The question, is not whether the on-line system resolved what % of contacts without seeing a GP, is what % of those contacted would otherwise not have contacted the service.
    So you can have an "if you think you need to see a GP wait 2 days for an appointment system". Some wait some do not.
    Alternatively you can have an on-line "send me your symptoms and i'll advise whether you need to see me" system.
    The conversion rate of one is greater than the other.
    Which is the better system?
    what is your bias?
    Who are your masters?
    what is the evidence?
    is the evidence evidence?
    If you lower the threshold for access overall throughput does not diminish.
    Paul C

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  • My all telephone triage ends with "ring reception to make urgent appointment to see GP". If there is no appointment that's not my problem as Locum.I assume same would happen to e consultation- make appointment to see GP to discuss referral examination etc.

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  • AlanAlmond

    This stuff is driven by lobbyists not medicine

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