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CAMHS won't see you now

Virtual GP plan needs reality check

General practice, like pretty much every other area of life, is going electronic.

General practice, like pretty much every other area of life, is going electronic.

IT systems are already used routinely for referrals and increasingly for prescribing, with the Summary Care Record on its way.

So it's perhaps unsurprising that the policy wonks at Connecting for Health have fingered the patient consultation as the latest area of general practice to be packaged for a virtual world. Pulse this week reveals plans for a new IT system for GPs, grandly named Communicator. It's a kind of Facebook for general practice, that will allow patients to converse online with their doctors without the inconvenience of having to attend the surgery.

Big things are expected of Communicator.

Dr Gillian Braunold, who is leading on the system at Connecting for Health, talks excitedly of its potential for QOF asthma reviews or even as an alternative way of extending surgery hours.

As an access initiative, it is bound to be popular at the Department of Health. GP technophiles are likely to be enthusiastic too and the system may also bring benefits for the mainstream of general practice, perhaps by cutting the need for face-to-face consultations.

But GPs are sufficiently scarred by the difficult recent history of Government IT - from the disastrous early problems surrounding Choose and Book to the myriad delays over the care record - to be wary.

Strict safeguards

And there is plenty to be wary about. The system will have to be watertight in its security and far more streamlined in its implementation than Choose and Book has ever been. Its use must remain voluntary and it must come with strict safeguards, to prevent patients taking advantage of it as a way of calling on GPs' time as and when they please.

And then there is a potential minefield of medicolegal problems, all of which must be identified and defused.

Take asthma reviews, for example. Doing them online might seem an attractive way of improving uptake among patients while easing practice workload - but then so did phone consultations, and that did not stop the QOF implementation group from barring their use.

Anyone who thinks virtual consultations can quickly and easily become a substitute for seeing a GP in person may have to take a step back into the real world.


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