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CAMHS won't see you now

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)

  • Loving the positivity on here.

    The comments are almost identical to those when the telephone consultation made its way into medicine in the late 1870’s: “As if the Telegraph and the Post Office did not sufficiently invade and molest our leisure, it is now proposed to medical men that they should become subscribers to the Telephone Company, and so lay themselves open to communications from all quarters and at all times. It must be admitted that this would have its conveniences. The only fear we have is that when people can open up a conversation with you for a penny, they will be apt to abuse the privilege; and that to have a dozen telephonic consultations in one day, or conversations that might be thought to supersede a consultation, would be a doubtful addition to one͛s advantage or repose”

    Sounds familiar doesn’t it?
    Did primary care fall into the abyss. Nope. Is it going to with Online consultations. Nope.
    Medicine never stands still or goes backwards and those who think it won’t change are kidding themselves.
    I for one will push forward with any new way if it is what patients and clinicians need. Those who say otherwise, well, we will see you when you get there. Maybe a little late and grumpy.. much like in the 19th century....

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  • Thin end of the (rapidly expanding) wedge. Once we start to talk about "an eConsult", how long will it be before we refer to a face-to-face "consult"?
    The nounisation of verbs is poisonous and should be stopped immediately. Ditto the verbisation of nouns.
    And don't even get me started on "June 18" cf "June the 18th"!!!!!

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  • Re all those accusing people against this of being luddites- technology has its place but how much will be lost by not interacting with and forming relationships with patients. Who knows! Whilst netflix has replaced blockbuster without much harm been done (apart from my sentimental recollection of the thrill of choosing videos off the shelf on friday night -I digress) this might have more consequence. Personally for me it will just make the job so crap that I'll choose another career

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  • God help us if this is the future of primary care! As I progress into my dotage I wish to have face-to-face consultations with a real, live GP. It looks like I'll have to go private to ensure that.

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  • How very sad that General Practice has been changed to be like working in a call centre

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