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GPs contractually required to ‘offer and promote’ remote consultations

GP list cleansing temporarily paused until February

GPs are now contractually required to ‘offer and promote’ remote consultations during core hours, new NHS England guidance has confirmed.

Under changes to the GMS contract enacted in October, practices should ‘offer and promote’ online and video consultation tools, plus other electronic communication methods.

The requirement to offer and promote remote consultations during routine hours was agreed as part of the five-year contract announced in 2019.

However, amid a row earlier in the year over whether practices should be allowed to switch off online consultation software out of hours to manage demand, it emerged that the requirement to offer online consultations even within hours was never actually implemented into the contract.

In a bulletin to practices in May, the BMA said that offering and promoting online consultations would ‘eventually’ become a contractual requirement within core hours.

The new guidance, published as a draft on the FutureNHS platform last month, has confirmed that this has now happened, and from October all practices have been contractually required to ‘offer and promote’ to their patients:

  • An online consultation tool;
  • A video consultation tool;
  • A secure electronic communications method; and
  • An online online facility to provide and update personal or contact information.

However, all these should be offered ‘alongside rather than as a replacement for other access and communication methods’ such as face-to-face contact, it said.

Practices must also signpost patients to their online consultation tool and the NHS symptom checker on their website or any other online presence such as on social media, it added.

The requirements of the new guidance

The online consultation tool must as a ‘minimum’ allow patients to ‘make contact’ with their practice online to seek health advice, describe their symptoms, ask a question, follow up on a previous issue or make a clinical or administrative request. 

It will be up to ‘practices and commissioners to determine’ how far ‘beyond the minimum’ the online tool should be used – for example, allowing patients to send photos.

The tool must be offered and promoted during core hours, but practices may ‘choose’ to make it available out of hours too to provide a ‘more consistent experience’ for patients.

However, the NHS England guidance added that practices ‘are not expected to respond to queries received via the online tool outside core practice hours’, in the same way they deal with blood tests, but there should be ‘clear communication with patients’ around response times. It adds that an ‘appropriate response may simply be an acknowledgement that the online consultation request is being reviewed’.

Practices should respond to patient contacts made via the tool ‘based on clinical judgement and in a way that is appropriate for the patient’s needs’, rather than necessarily also via the tool.

Video consultations ‘should be available and promoted but they are not mandated in any specific circumstance’.

‘Secure electronic communications’ should be used where they will ‘increase convenience’ for both the practice and patient.

Data on the use of online consultation tools and video consultations must be reported to NHS England ‘in anonymised form’, either by the software provider or by the practice itself.

NHS England said the aim of online consultation tools is to ‘provide benefits to practices in managing and prioritising their workload’ as well as giving patients greater choice and flexibility.

There is no ‘one-size-fits-all’ model and practices should ‘co-design’ this with patients and staff, it added.

The guidance recognised practices will need ‘time and support’ to do this and said funding is available to ICSs to support practices and PCNs in implementing the changes.

It comes as GP leaders last month voted for the ‘removal of all mandates and incentives regarding online consultations’, including 2021/22 PCN DES targets, at the England LMCs conference.

And GPs and practice staff are to be surveyed as part of an NHS England-commissioned independent evaluation of remote GP consultations.

This comes amid an ongoing row over face-to-face appointments and access to general practice, most recently seeing the BMA’s indicative ballot of GP practices revealing more than half are willing to opt out of the PCN DES in revolt against NHS England’s access plan.

Meanwhile, Pulse revealed this week that the CQC has outlined its framework for unannounced inspections into patient access at GP practices, with the first inspection taking place last week.

READERS' COMMENTS [8]

Patrufini Duffy 7 December, 2021 11:41 am

Any other tools you want?
__A home on your sofa drunk tool, an on holiday tool, and a while you have brunch tool? Tools are only as good as the quality of item you are trying to fix. Otherwise you just create hypothetical trivial work, which the NHS is superb at.

David Banner 7 December, 2021 1:15 pm

If anyone really needed confirmation of NHSE incompetence, this clinches it.
-GP appointments are already oversaturated, we can agree on that at least
– if you increase F2F, you must reduce virtual
– conversely, if you increase virtual, you must decrease F2F
– NHSE issues diktats to increase F2F one month, then increase virtual the next
– given that there is no cavalry charge of new GPs on the horizon, you can only conclude that NHSE seem to think we can increase both F2F and virtual on current resources.
– in which case, they are simply not fit for purpose. Either give us the resources or do us all a favour and shut the **** up.

Reply moderated
Grant Jonathan Ingrams 7 December, 2021 1:19 pm

Not contractually required until a Contract Change Notice has been issued … Not seen that one yet, so no change required yet …

Reply moderated
Doc Getmeout 7 December, 2021 2:05 pm

Is this non face to face contacts, a U turn after all that distress caused to GPs/BMA from Mr SJ and his friends at Daily Mail !!!!!!!!!!!!

Reply moderated
Michael Mullineux 7 December, 2021 4:45 pm

Another to add to the litany of the considered consistent messaging we have come to expect from NHSE….

Reply moderated
William John Lockley 7 December, 2021 5:03 pm

How long will it be before NHSE realise that trying to force GPs to use particular tools won’t work? If a specific tool /approach /technique is worthwhile, it won’t take long for GPs to work out the importance of using it.
The corollary to this is – if a tool is worthwhile, you don’t need to force people to use it. If it isn’t worthwhile, don’t bother promoting it because you’ll just look stupid.
The best method? Provide a tool, and make it clear that its use is within the regulations. Then sit back and watch…
The whole thing will unfold automatically before your very eyes, providing a definitive answer relatively quickly (or at the very least, providing a clear guide as to what else needs to be done before that tool can be used properly). Obvious, really.

Northern Trainer 7 December, 2021 8:04 pm

Who are these people? I do not have the words. Really – why are we letting such obviously unqualified inexperienced folk determine anything?
Where are our profession’s leaders? Please please let me see you stand up and represent us and our patients properly! Now.

Just Your Average Joe 12 December, 2021 8:23 pm

Been there, tried it, and it was less useful than telephone triage and telephone consults.

Just took longer, and led to yet another path to contact your GP – but reminds me of getting a new telephone system with 10 phone lines, where you are only given funding to employ 3 reception staff to answer the phone, leaving 7 ringing off the hook.

Until they are willing to fund General practice properly and increase medical school places and allied professionals to massively increase staffing, you will not get the extra 7 phone lines answered in a functional and timely manner, and it will just lead to more staff quitting with burn out.

Stop increasing access, without addressing patient demands 1st.