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NHS England looking at helping patients to ‘switch GP provider’ online

Patients could be given the facility to switch their GP practice online under new plans to expand online access to GP services from NHS England.

The plans were revealed in papers being presented to the NHS England board meeting this week that aim to give patients the ‘ability to transact directly with the NHS’.

The paper looks at progress on digitising patient communications with GPs, a major aim for NHS England in 2014/15, including switching GP practices.

But the plans have been described as ‘bonkers’ by GP leaders.

The paper also reveals that after major concerns were raised by the RCGP and the BMA over plans to give patients access to their records online by March 2015, NHS England is looking at introducing a ‘time delay’ so GPs can manage how ‘certain test results are communicated’ in patient records.

The NHS England board paper says: ‘This commitment has been included in the 2014/15 GP contract and work is currently underway to define in detail what the “GP record” will constitute, for example how much historical data is meaningful and whether there is a time delay to allow a GP to “manage” how the impact of certain test results are communicated.’

The paper adds that as well as records access, they want to go further to digitise communications with GPs.

It says: ‘The aim is also to give people the ability to transact directly with the NHS using technologies that allow them to book and rearrange appointments, order repeat prescriptions, track the progress of test results, contact their GP or hospital electronically with a query, provide electronic feedback and even switch GP provider.’

Dr Kambiz Boomla, former chair of City and East London LMC and a GP in Tower Hamlets, London said letting patients change practice online was ‘bonkers’.

He said: ‘Where do I start? You’d have to get permission from the practice you’re changing to before you registered and I just can´t imagine how the practicalities of that would work. And then what would happen about arranging new patient checks? Then there´s the IT implementation.

‘And shouldn’t something like this be negotiated between the GPC and NHS England in any case? The whole practice boundary thing is a disaster and this could be even worse.’

Access to patient records and the abolition of practice boundaries will both be included in the new GP contract from April.

Dr Marie Louise Irvine, a GP in New Cross, London warned that the idea of switching GPs online could pose problems with transfer of medical records:

She said: ‘I’d need that to be explored and clarified. If a patient transfers and then decides to change again on a whim before their records have been switched, you could end up with records constantly in transit.

’In my practice we already have a very high turnover of patients and it can already be a problem as patients don´t understand that their records may not always follow them automatically.’

Readers' comments (7)

  • Can I switch patients to another practice!

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  • And who is going to ensure the patient actually is the person behind the computer? How will they ensure this isn't abused - we already have small group of drug addicts GP hopping to try and get benzos and opiates. And how will the cost be shared amongst CCGs - if a patient hopped to neigbouring CCG who offers a different service (e.g. barriatric surgery) then hopped back to old CCG's practice for remainder of the year once the op is done, who pays for the bill?

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  • To be honest we're not too fussed about this.

    Most of the patients who want to hop GPs all of the time are the ones with issues that no-one can resolve (GP or Secondary care) and of course the usual heart sinks. We also have many patients that act unreasonably (urgent appointment in 50 mins is not good enough, I'm going to A+E even though I'll wait longer etc), kick up a fuss about problems beyond our control, leave and then realise that the grass isn't greener and that, actually, we were doing very well with the limited resourced we had.

    Of course, there is a group of genuine patients who either have poor service from their GPs or for other reasons don't like their surgeries - nothing wrong in making it easy to switch for this group. We are totally at capacity with patients and these changes won't alter this.

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  • Vinci Ho

    (1) This is really about 'pressing the button without the need to think about too much '. So convenient , so 21st century . So what is the problem with that ?
    (2) Computer/Internet is probably the greatest invention of early 21st century(well , end of 20th ) . But like every matter in this life , there are advantages/greatness as well as disadvantages/weaknesses. Face to face communications have been sacrificed by no brainer blogging, texting and on line chatting . My wife is complaining of me spending that much time on my bloody I Phone 5 than talking to her and my daughter.( Not saying that is not good for a selfish me! Ha Ha Ha).Clearly it has become a 'syndrome ' . We all come across young people spending > 15-20 hours on Internet everyday. Forget about exercise.There are reasons why computer geeks have become so fashionable. Have you watched the TV show 'The Big Bang Theory'?
    (3) Problem with full access and 'transparency' on reading raw data/information (hence medical record in this argument ) is lack of complete understanding of scientific/medical/professional jargons from the reader . Yes, you can argue that it is important to have more rather than no question so as to seek more information . But it is no good for somebody worrying about cancer to read a long winding CT scan report with numerous measurements although the conclusion might be no abnormality over all .
    (3) There has to be a happy balance to strike somewhere . Not like this . These bureaucrats / politicians are clearly trying to please a crowd . The subsequent gregarious impression of ' this is the way forward' will generate more and more questions . Questions generate more demands . Are they prepared to answer these demands in reality ? No. Because they will not invest to tackle the root of the problem.
    (4) Remember Pendleton's book on consultation skills? Sooner or later , all our trainee GPs will have to spend most times on computer dealing with questions from 'virtual' patients on preset programmes. All the tasks during consultation and sharing of decision according to Pendleton will be thrown out of window .
    (5)Furthermore , medical records are the property of Scretary of the State(correct me if I am wrong in legal terms). They are not really 'possessions' of patients. Professional opinions and patients' precise account of their problems co-exist NOT merely about what somebody 'likes' to see on the computer screen .
    (6)Virtual reality can never be the same as Reality Actua . Thou shall not be fooled by bureaucrats with virtual solution,running away from their real responsibilities.
    (7) Once a politician , always a politician . Once a bureaucrat , always a bureaucrat (inspired by George Orwell on dishonesty and cowardice)

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  • To be honest I think this is another preparation for primary care privatization.

    Don't like you GP? Come to Virgin Health Care with a click of a button. Sure the demographic might skew the patient population with young, intellectual computer literate (i.e. those less likely to need health care) and leave ordinary but that's great for business right?

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  • This has gone bonkers …be able to contact GP's via e-mail … so who is going to answer the queries etc?

    Change GP's on line, whenever a patient doesn't get what they want, they will change GP's. See the new patient in practice, know nothing about them, for some reason the records haven't arrived and they are demanding medication of one sort or another … disaster!

    Access to medical records … so what if the patient doesn't agree with the content and then wants to sue the GP? What if there are records from a time the patient was very unwell,how upsetting can it be to read disturbing reports, especially around mental health?

    Appointments … how many slots will be lost to patients who just want to query the content of their records?They may need explanations of clinical jargon, test results etc. all of this takes time.

    Trust in our GP … anyone that has a good relationship with their GP should not need access to records, the GP should be keep the patient informed at each session. Although I have nothing to fear, I have complete faith in my GP and want him to manage my care. I am sure looking back over my recent medical history, there are things on record that might upset me, no matter how level headed one may be, and feel accessing medical records is opening up a can of worms fro anyone doing that.

    Testing ground … does NHS England put these ideas out to test the water?

    If they want to do something really positive and increase access to appointments, lets have a written rule re DNA's so that these patients can and will be removed from lists for wasting time. So many appointments are lost, hundreds per month, because patients are just too lazy to cancel! Practices should have a right to remove these patients and mark their records in such a way that ensures that their next GP is made aware they are a 'non attender'!

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  • part of Hunt's master plan for privatization. So obvious but no one seems to be able to halt this? where is our voice?

    recent poll in guardian?86 odd percent patients do not want to pay a tenner to see a GP! around 90 percent are happy with their current GP care in previous Polls. There is no mandate for this government to privatise health care but they are ploughing on regardless like GOVE with education (who is a loon). Ego ego ego

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