That déjà vu feeling
Dr David Hogg
I remember the frustration of reading this article in the BBC News back in 2014, when Scottish GPs were being criticised by Reform Scotland for not embracing online appointment booking and prescriptions.
The Scottish Government was quoted as saying ‘online services are currently available to all GP practices in Scotland’ and that it was 'continuing to work to promote and encourage practices to use these services’. As IT lead for our practice, my jaw dropped somewhat.
At the time this was inaccurate. On Arran we were keen to offer online services to our patients. So much so that we had specifically identified it in our IT strategy, and had held multiple meetings with our eHealth team about how to move this forward. I know that many of our members at the Rural GP Association of Scotland (RGPAS) were similarly enthusiastic.
But the problem was that no one in higher echelons seemed willing or able to allow us to switch the facility on. As a practice we were willing to take responsibility for the service - not least as the same system had been successfully rolled out in practices in England and seamless integration was offered. However, we were told that our local eHealth team had to approve all requests. ‘Regional governance’ and 'IP address security’ were cited as the reasons, which seemed reasonable enough - even if a frustrating hurdle towards better online patient access.
However, this was then superseded by the conclusion that in fact a Scotland-wide decision was required. I recall sitting next to a member of the national eHealth team at a conference later in the year. She sympathised with our frustrations over the delay, but promised that it was being looked at as a matter of urgency.
After two years of deliberating, we and other practices received an update. It was deemed that approval was too difficult for a nationwide decision. It would be up to each individual practice to appraise the IT governance required, and take the responsibility, which had previously been moved higher and higher in the mechanisms of the NHS.
So, back to where we started, but at least we were now able to get on with the process of preparing our system for online services. Earlier this year we enabled prescriptions, and just a few weeks ago we enabled online appointments.
So to read this article in the BBC News yesterday gives me a great sense of déjà vu. Once again, individual GP practices are being criticised for poor rollout of online services.
It’s so disappointing that the finger is being pointed at under-resourced GP practices with limited IT support. Some RGPAS members are even continuing to struggle on with Windows XP despite promises to upgrade. Many of them are actually very keen to innovate these services, but have been held back by centralised decision-making.
Our Government needs to be truthful in its response to articles like this. The article unfortunately omits the fact that GPs have been willing IT innovators from the outset, and blames practices for nationally dictated policy. This is somewhat disappointing.
Dr David Hogg is a GP on the Isle of Arran and Chair of the Rural GP Association of Scotland. He writes in a personal capacity. You can follow him on Twitter @davidrhogg