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GPs should refer patients to Skype outpatient appointments, says NHS England



GPs could soon be referring patients to outpatient appointments taking place via Skype, following calls from NHS England’s medical director.

Professor Stephen Powis said the ‘the time has come’ to use technology to reduce some of the 118m outpatient appointments every year, ‘many of which’ NHS England claimed are ‘unnecessary’.

Aside from using ‘Skype, apps and online tools’ to treat outpatients, another alternative route to make better use of patients time would be by having them seen ‘by specialists at the GP surgery’, said Professor Powis.

According to NHS England, this would mean ‘thousands’ of patients being ‘spared hospital visits, time off work and school while also saving the NHS millions’.

Professor Powis further suggested these new measures would form part of the NHS long-term plan, which is expected to be published later this month.

He said: ‘The outpatient system is older than the NHS and the time has come to grasp the nettle and use tech and other innovations to improve patients’ experience and care.

‘As part of the long-term plan for the NHS, it’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution and make the NHS more efficient.’

But Family Doctor Association chair Dr Peter Swinyard said: ‘There are few specialities in which a contemporaneous examination of the patient is not a useful part of the consultation.

‘There is a risk that this could just transfer secondary care work inappropriately to overstretched GPs – we want a consultant opinion and sometimes supervision of care where it is clearly the right place for care.’

Highlighting a number of NHS ‘case studies’ related to cutting outpatient appointments, NHS England mentioned a virtual renal e-clinic in Tower Hamlets in east London, via which GP can send questions on kidney patients direct to specialist consultants for a quick reply.

It also mentioned the telephone ‘hotline’ for GPs to get fast advice from neurology consultants in Cheshire and Merseyside, which NHS England recently claimed has saved £100,000 a year.

Professor Powis made his comments in the foreword of a new report by the Royal College of Physicians, published today.

Among the report’s key recommendations, the RCP suggests it is time hospitals were paid based on ‘clinical value, not units of physical interaction or activity’.

The report also noted that a reduction in referrals to outpatients by GPs has been ‘negated’ because of a rise in referrals from other consultants.

Taking a swipe at CCG measures to reduce referrals from primary care, as highlighted by Pulse’s ‘cash-for-cuts’ investigation, the report said: ‘Interventions to reduce new patient demand should be targeted at all referral sources.

‘They must not deter necessary referrals or damage professional working relationships.’