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Gold, incentives and meh

Leading superpractice plans to phase out unnecessary face-to-face consultations

Exclusive A leading superpractice - which counts NHS England's primary care lead among its GP partners - is planning to only offer patients face-to-face appointments where necessary, with the remainder to be dealt with via its eConsult online system.

As part of the plans, the Hurley Group in attempting to double the number of GPs employed to do online consultations over the next six months.

The eConsult system allows patients to submit their symptoms to a GP electronically, as well as offering around the clock NHS self-help information, signposting to services, and a symptom checker.

The Hurley Group’s eConsult team said its recruitment campaign comes as more GPs are needed to manage the growing number of online patient contacts, which has doubled in the last year.

The expansion also aims to incentivise GPs to stay working at the 100,000-patient practice instead of leaving to join private online GP consultation companies, it told Pulse.

The superpractice, whose partners include NHS England primary care director Dr Arvind Madan and former RCGP chair Professor Clare Gerada, developed eConsult in 2013, with 12 GPs now consulting patients through the system.

Dr Murray Ellender, GP partner at The Hurley Group and co-founder of eConsult, told Pulse: ‘Ideally, over the next six months, I’d like to double the size of that team – that’s the plan – and start to take more and more stuff online.’

Dr Ellender said the long-term plan is to only see patients in person where necessary.

He said: ‘Then we will only see the patients we need to see face-to-face, face-to-face. Often then, we can give them longer. If we take enough patients online, it frees up time in practice.’ 

He added that, last month, the practice saw 1,158 online consults and avoided 695 face-to-face appointments across 14 of the Hurley Group’s practices.

He also said the ‘volume of online consults doubled in the past year, hence the need to expand the eHub team’.

This comes after Pulse revealed that e-consultations are resolving ‘40-60%’ of patient ailments without a face-to-face GP appointment.

However, several studies have been released in recent months, calling into question the safety on online consultations and disputing that it lessens GP workload.

But Dr Ellender added that the GPs hired to work in the eHub ‘can work from home’, which he said is ‘good for recruitment and retention’.

He said: ‘We don’t start that at the beginning. We get them working in the hub first.

‘We train them up and make sure they’re confident and comfortable but then there is the option for the GPs that have been doing it for a little while to do shifts from home.’ 

He added that the profession is losing GPs to private online companies 'because they offer something different'.

He said: ‘So this is us trying to retain those GPs within the NHS by offering them a similar sort of package.

‘They can work as part of a team, they can work remotely, they can potentially work from home but keep them within the NHS. So it’s for us to protect ourselves against that loss into those providers.’

NHS England offers practices funding to run eConsult through the £45m GP online consultation systems fund. However, Dr Madan previously told Pulse that he was ‘no longer involved’ with eConsult after taking up his position with NHS England in 2015.

Readers' comments (35)

  • I sense many missed cancers!

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  • The Hurley Group aren't leading me anywhere.

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  • Why not outsource it to India? Even more cheaper?

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  • Grammar.
    Even cheaper, or more cheap.
    Not 'even more cheaper'.

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  • What is the defence union fee to cover online. Online means you are subjected to technological limitations. The colour display from the screen, the dropping of wi-fi connections, time wasted connecting, speaker sound variation(prices from £10 to thousands depending on accuracy) and microphone problems One is at higher risk of being recorded, edited out of contex and used against you. The only good thing is not picking up infections from patients but otherwise it is a risky and time wasting venture making others rich at your expense and clinical risk. If I am an expert witness I would easily tear it apart challenging the heat, redness of a septic knee missed, the colour settings at that time etc and go for gross negligence manslaughter if the patient dies as one is not giving "best care" face to face.

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  • Leading? Super?...... Really?

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  • What about the last minute,about to leave,"while I'm here doctor".
    Sometimes what's the real problem then comes out.
    Sometimes it's potentially serious.
    Wait until the 1st e consulting GP is getting sued, then it won't the future of general practise anymore.
    Perhaps after 35 years of general practise I'm getting too cynical for these brave new world ideas.

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  • Sounds brilliant.
    What could possibly go wrong?

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  • I remember deciding to do general practice in medical school. On placement in North Wales at a 3 partnered practice. They knew every patient by name and every member of staff at the care home. 11-11.30 was a tea break before visits- banter, discussing tricky patients, divvying up the visits and, amazingly, choosing to add visits for vulnerable elderly they though might just need popping in on. They couldn't remember a complaint. If that kind of general practice cant exist any more its a shame but I wont spend my day on the medical equivalent of face time to people demanding antibiotics- life's too short.

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  • Just relocate the Hub to a third world country? Even cheaper.
    Barriers to care for the most vulnerable. It’s not about the patients it’s about the service and money.

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