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GPs set to miss online appointments target amid IT concerns

A Scottish Government target for 90% of GP surgeries to be offering online appointment systems by the end of 2017 will be missed, a report has warned.

Research carried out by think tank Reform Scotland found that most health boards were falling short of the goal.

Information collected from health boards also indicate that ‘many GP practices have the ability to offer these services, but choose not to’, the report said.

The Scottish Government published its eHealth strategy in 2015, in which it encouraged all practices in Scotland to offer repeat prescribing and appointment booking as online services, Reform Scotland said.

Responses from health boards showed a wide variation, with 78% of Borders practices offering online booking compared with no practices in Shetland and 26% of Highlands practices.

For online repeat prescribing Borders and Tayside had more than 90% of practices offering the service, compared with 55% in the Western Isles and 29% in Highlands.

The Reform Scotland report also said patients have ‘little choice over who and where their GP is’.

Alison Payne, research director at Reform Scotland said while surveys suggest the public often praise the care they receive from GPs, there can be frustrations with the difficulty in accessing that care

‘The Scottish Government and the Royal College of General Practitioners have recognised the benefit of offering more services, such as repeat prescriptions and booking appointments, online.

‘Yet it is clear from these figures that too few people can benefit from these services.’

She added: ‘There are significant differences in digital access arrangements across Scotland’s GP practices – differences where the practice size or location are irrelevant.

‘However, despite these differences, patients have little choice over who and where their GP is. By giving people greater choice over their GP surgery this will give them much greater influence over the way services are developed.’

But Dr Miles Mack, chair of RCGP Scotland said that for many GPs in rural areas the IT systems were simply not up to scratch and broadband could be very slow or non-existent.

‘We have an inverse connectivity law in Scotland so the areas that could do with better connectivity are rural areas where GPs and other members of the healthcare team need the availability of inter-professional decision support and good links for data sharing and we are not seeing that in any way.’

Dr Mack, who is a GP in the Highlands, said for many practices it was about priorities and they needed to focus on improving IT to support face-to-face patient care.

He said: ‘A third of Scotland’s population is rural. Many rural practices are lucky if they get 1Mb per second broadband and much connectivity is purely voice only.

‘3G is a rarity and 4G is almost unheard of.’

When GPs in the Highlands are still having to input lab results manually from hospital reports, they have other IT problems that are more pressing, Dr Mack said.

‘We have had recurrent setbacks trying to get functionality into the IT systems,’ he added.

A Scottish Government spokesman said an additional £500m a year will be invested by 2021/22 to transform primary care in the NHS in Scotland. He said: ‘Investing in new systems means GPs will be able to access and record medical information more quickly, giving them more time to spend with patients during consultations.’

Dr Alan McDevitt, GPC Scotland chair, said the BMA was currently in discussions with the Scottish Government about how to support GP practices in providing online services to patients

‘Enabling patients to access services such as appointment booking online can be more efficient for patients and for practice staff, but can be a challenge for practices to introduce in the face of rising costs,’ he said.