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GP e-consultation forms should be accessible round the clock, says NHSE

e-consultation forms

GP practices should not limit access to e-consultation forms at evenings and weekends because it will be less convenient for patients and reduce patient satisfaction, updated guidance from NHS England states.

The latest standard operating procedure said all GP practices must offer patients the option of online access and patients should be able to make online requests at any time, NHS England said.

‘Any time patient access to online tools does not mean that practices are expected to respond to these requests outside of core hours, and switching off online consultation systems out of hours is likely to be less convenient for patients and reduce patient satisfaction,’ the SOP states.

GPs should ‘inform their CCG’ before switching off online consultation systems out of hours and consider whether additional support may be available, the SOP states.

It follows reports that GP practices wanting to turn off e-consultation forms at weekends and evenings are facing ‘resistance’ from their digital provider and CCGs.

Online platform eConsult has ‘delayed’ some practices’ requests for more than a month, directing them to their CCG for permission to turn off access out of hours, grassroots organisation GP Survival told Pulse.

The updated NHS England guidance also states that practice receptions should be open to patients to ensure that those without easy access to phones or online services are not disadvantaged when accessing the GP.

But physical access to practices should be consistent with infection prevention and control guidance.

It notes that changes in access to general practice may disproportionately impact some patient groups and should be mitigated as far as possible.

Previously the BMA has said it is ‘aware that there have been a growing number of concerns relating to NHSE/I guidance suggesting, and local commissioners requiring, practices to maintain online consultations and remote triage systems’.

In a GP bulletin, it confirmed that practices have no contractual duty to leave any form of online provision accessible out of their contracted hours, although it has been agreed as part of the 2019 GP contract that it will ‘eventually’ become contractual for practices to offer online consultations during core hours.

At the moment it is for practices to determine how best to use online consultation systems, it advised.

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Darren Tymens 20 May, 2021 5:13 pm

This is madness.
The SOP is guidance and practices should feel free to ignore it.
The contract regulations have not been published – so this isn’t a contractual requirement until they are – probably in October. Until then, it is not a breach to switch it off.
When they are published, it is likely to be a politically toxic car-crash of epic proportions as practices are forced to implement it.
The only research done into how this affects demand suggests it increases it by an average of 30% – much of which is trivial, but all of which will need to be processed by staff.
There are anecdotal reports of up to 3000 EConsults waiting on a Monday morning: many of which are such clinical gems as ‘how much fruit is in a portion?’, and ‘my cholesterol has gone from 2.2 to 2.3 – should I panic?’.
I am tempted to suggest we should simply give NHSE what it wants – but put every online consultation into an existing consultation slot (without creating more, because we have already established that we provide reasonable access). This will allow NHSE to understand the extra workload involved – and suddenly the wait to see every GP will stretch into months. The resulting press outrage will dwarf the recent headlines. NHSE will then have to reconsider their approach and decide if online access is really worthwhile – and if so they will have to actually fund the staff to deliver it rather than just dump it on us unfunded.
The contract makes provision for reasonable demand – and not unreasonable demand driven purely by consumer preference.
In chasing after the approval of the press, NHSE are about to collapse the boat.

Michael Crow 20 May, 2021 5:32 pm

Many years ago I was the medical director and co-founder of an out of hours Co-Op. Before IP telephony we wondered how we could limit the demand to match our capacity and be resilient. We had telephone lines coming into the building from each end of the road so that if one end was dug up the other would work and we ensured that the total number of lines coming in to the call centre was limited to the number of call handlers and matched the doctors we had on duty. By creating the “bottleneck” and manipulating it we were able to meet the NQRs and provide a timely service. If you open up every single method of access 24 hours a day it will swamp capacity and encourage completely inappropriate requests of General Practice. We have already sacrificed continuity on the altar of access. This will not benefit either and General Practice will be finished. I can retire but I won’t be able to access my own GP in my dotage.

Patrufini Duffy 20 May, 2021 5:59 pm

EConsult – co-founder = Arvind Madan.
Full stop.

Michael Mullineux 20 May, 2021 7:29 pm

E-consults were ‘sold’ to us as part of available appointments, not extra capacity. The solution is simple: each e-consult counts as an apointment and if these use all appointment capacity, tough …

Robert James Andrew Mackenzie Koefman 21 May, 2021 10:21 am

I think GPC/LMC need to vote on this as well to suspend econsult until able to switch off weekends etc

Barry Moyse 21 May, 2021 10:42 am

Was always bound to be “another lane on the motorway” as some of us always said. A local smallish practice of 3-4 colleagues had 200 AskMyGPs between 0700-1030 on a recent Monday and they do limit access time. It cannot be another bolt on extra – something has to give. That said, as a patient last year it was good to get my consultation in at 3am on a Sunday when I had L3 nerve pain for the first time – my worst ever pain – I’m never ill. Then I had to keep down grading my pain score from a realistic 8 to a frankly untrue 6 before it let me proceed without sending me to the ED. Which would have created more work!

terry sullivan 21 May, 2021 11:30 am

say no

Patrufini Duffy 21 May, 2021 2:02 pm

Embed it deep in your website.

Mr Marvellous 24 May, 2021 11:59 am

BBOLMC have said in their release from last week that practices don’t have to offer this at all – it was going to be but never was written into the GMS contract.

Sure they’ll all it shortly but why do it if you don’t have to…?

James Weems 24 May, 2021 9:05 pm

Only when we can have 24/7 access to NHSE and secondary care.

David Jarvis 26 May, 2021 12:25 pm

Have you ever thought if every GP emailed one of these grandees pontificating about this on the same day how they would feel. And then of course chase up for a reply a couple of days later and so on until a satisfactory response. Just saying.

Ali Hossein ESTEKIbardeh 27 May, 2021 12:58 am

Pay for it and then you can get it 24/7. If NHSE has amnesia problems then I should remind them that we paid each over 12k to NOT participate in any activities after 6:30 pm.
Pay us back 12k + inflation rate over 17 years + additional administration cost = 18000k per gp and then I will switch the econsult 24/7.
If you don’t pay then keep quiet and no hot air please!