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GPs go forth

Professor Field's 'super practice' moves 80% of patient contacts out of surgery

A super practice that counts the chief inspector of general practice among its partners has moved to having 80% of their patient contact via telephone or online.

The chief executive of Modality - where Professor Steve Field is a partner in Birmingham - told delegates at a King’s Fund conference on today that it has developed its digital offering, including producing a smartphone app.

The practice is one of NHS England's 'new models of care' that provides primary and secondary care to 100,000 patients, and was awarded investment from the Prime Minister’s Challenge Fund.

Dr Naresh Rati, who is also a GP in Birmingham, said they started looking at changing access two and a half years ago. He said: 'We are all ruled by our smartphones but yet fewer than 1% of our patients were interacting with us digitally. We thought this could not be right.

'Now, two and a half years on, about 20% of our patients access Modality services digitally. And if you include telephone, that increases to 80%. So over 80% of our interactions with our patients are out of a consulting room, out of a GP surgery.'

But Dr Rati was keen to stress that this was not about reducing access to patients, who can still book face-to-face appointments with GPs, but expanding it.

He said: 'For us this isn’t about restricting choice of access to patients. It is about giving patients more choice. So they can book in the traditional way and see a GP or other clinician, or they can talk to us by phone, Skype and through the website.'

But he said Modality has learned that patients don't want to access appointments on Sundays - something health secretary Jeremy Hunt had admitted himself.

He said: 'Modality has been open seven days a week for the last 2.5 years now and patients want access but they don’t want it at weekends. Sunday afternoons particularly they don’t want it, Saturday mornings they don’t want it, but we are open seven days a week.

'But what they do want is convenient access at times that are right for them - that is instant access.'

Speaking also about the new care models, which will have over 30,000 patients each and operate to new voluntary contracts, Dr Rati said super practices had a responsibility to 'step up' and help solve problems faced in the NHS,.

For Modality, that had included sending GPs to work in A&E for free.

He said: 'As a lot of acute trusts did, it imploded one weekend over Christmas and I got a call Friday afternoon and we put our GPs in A&E that weekend, for free. It is that sort of stuff that you’ve just got to kind of say that is your responsibility as a large GP organisation.'


Readers' comments (42)

  • anyone with access to a New Scientist magazine would perhaps be interested to see this months cartoon on the back pages which seems to be a logical prediction of increasingly digitalised medicine...

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  • It's not super, just very, very big.

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  • We did this. By increasing your total number of patient contacts by about 50% you can increase the % dealt with without being seen in person.

    This is not the same a 80% reduction in patients dealt with in person though!

    Result - headache for staff and we have moved away from this level of access.

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  • Everyone rates quality over quantity. If we are only looking as things we can measure i.e. patient contacts rather than reassurance and trust patients receive form GP services also, then the public are going to be the poorer for it.

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  • Not sure patients like it: 2* average rating for most of the practices in Modality on nhs choices and many in worst category in various parts of national patient survey. Not sure this is a practice model that I would want to aspire to

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  • "All ruled by our smart-phones....". Says it all.

    GPs are generally well known for being sh~t at clinical examination (hand on heart when did the readers of this actually do a proper full CNS exam including using a tuning fork and red-pin when indicated, rather than ignoring the issue at hand or making a crappy referral displaying no attempt at a diagnosis?); this is another nail in the coffin which is primary care medicine. I wonder how indemnity fees will become affected by this trend.

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  • Took Early Retirement

    Anon 9.02- please go forth and micturate. It is NOT a GP's job to do a full neuro exam in a ten minute slot. It IS the GP's job to decide, "Is this a problem which needs the attention of a Neurologist?" (And in that case WHICH one, as I memorably, just before I retired, referred a relatively young woman, whom I thought, correctly as it turned out, had atypical PD, only to be told- "Dr X doesn't do PD".)
    Personally, I used a tuning fork a lot, but this was to see whether a person had conductive deafness vs sensorineural.

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  • Have you seen NHS choices for these practices - it is very poor - I have family in those practices and they hate the system!!! Across all age groups - you can't get to see a GP without speaking to someone who can call anytime of the day and if you miss the call then you are stuck

    There has also been a massive investment in these schemes -'what is the guarantee the funding will continue

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  • Reading this BS makes me want to weep.

    I want to travel to 5 star holidays to the Maldives but I don't as I need to live within my means.

    Of course patients want instant access at all times of the day - doesn't mean they should be entitled to receive it if the country doesn't have the means to pay for it.

    And all the while, the elderly time bomb is ticking away but no-one is planning for this because if they don't have an i phone they don't exist.

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  • Glasspool 10.08.

    Your response typifies the clock-watching nature of many GPs who essentially act as a triage service. The lack of intellectual curiosity you display towards the art of medicine reaffirms how awfully sad General Practise is today.

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