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GPs call for e-consultation ‘impact assessment’ amid ‘overwhelming’ demand


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The UK LMCs conference has voted in favour of a ‘full impact assessment’ into e-consultations amid reports that GP practices are ‘overwhelmed’ by patient demand.

The motion, which also called for further IT funding for practices, was carried in full.

It said that ‘conference calls on the BMA’s GP Committee to… conduct a full impact assessment of the effect of the roll out of uncapped instantly available e-consultations on the availability of more proven consultation models’. 

Proposing the motion, Dr Deborah White of Cleveland LMC said workload issues are being ‘exacerbated and made uncertain by inadequate IT and support for this’.

She added: ‘[E-consultations] may have brought flexibilities and safety during the pandemic but practices are now overwhelmed, affecting access for the most vulnerable and allowing 24/7 access for the most demanding.

‘The Monday morning flood brings dread. A local practice noted that some patients are submitting eConsults at a rate of one every day or so – this is not safe or sustainable.’

Speaking against the motion’s calls for direct SMS-based communication with patients to be commissioned nationally, Dr Hal Maxwell of Ayrshire and Arran LMC added that a ‘bottleneck’ in GP access can be ‘a good thing’.

He said: ‘Harsh as it sounds, a bottleneck for access to GPs, if managed well to weed out the urgent, is a good thing and gives us some measure of control over our workload.’

Part one of the motion, which called for fully and centrally funded remote consultation software to be integrated into practice IT systems, was backed by 100% of 228 voting delegates.

Responding to the motion, GPC IT policy lead Dr Anu Rao said she ‘absolutely agrees’ that e-consultation add-ins ‘should be fully funded’.

‘We hope that this will be reflected in the upcoming GP IT operating model’, she added. 

BMA GP executive committee IT lead Dr Dr Farah Jameel agreed that ‘there is a risk that instead of streamlining processes and reducing workload for practices – as the assumption seems to be – that opening up more routes of access via online consultations could have the opposite effect’.

And she added that ‘clearly more work needs to be done to understand the impact of this on practice workload, and in turn, patient access’.

She also warned that ‘while some patients will prefer this way of interacting with their practice, it must not leave others – including those without access to or competency with certain technology – behind’.

But she added that ‘if harnessed and used effectively’ e-consultation ‘can widen and improve access, especially in harder to reach groups of patients who are less likely to seek care’.

Last month, NHS England extended a temporary central deal which will ensure GP practices have continued access to AccuRx and other video consultation technology until the end of this year.

Meanwhile, the RCGP has warned against retaining the ‘total triage’ model of general practice beyond the Covid-19 pandemic, arguing that it may ‘exacerbate health inequalities’.

Motion in full

AGENDA COMMITTEE TO BE PROPOSED BY CLEVELAND: That conference welcomes the increased innovation and flexibility afforded by new digital ways of working but notes the ongoing lack of clarity regarding resourcing of these products and services and calls on GPC to: 

  • (i) ensure that IT system add-ins enabling integrated remote consultations must be fully funded by departments of health as a core part of the NHS IT offer to general practice PASSED
  • (ii) insist that departments of health commission nationally a service that allows direct SMS based communication with patients with the ability for them to reply, with attachments such as photos, to ensure that no structural inequalities are created around such a key method of patient engagement PASSED
  • (iii) ensure that national minimum standard for locum IT access is established and embedded in the IT procurement process PASSED
  • (iv) ensure that the roll out of digital models of access develop in parallel with work to reduce inequity in those not digitally enabled PASSED
  • (v) conduct a full impact assessment of the effect of the roll out of uncapped instantly available e-consultations on the availability of more proven consultation models. PASSED

Source: BMA

READERS' COMMENTS [4]

Patrufini Duffy 11 May, 2021 9:57 pm

Fre e-consult. Equals complaint. Equals no one’s coming to save you.

The Prime Minister 12 May, 2021 11:03 am

E-CONSULT DISADVANTAGES THE OLD, INFIRM, LEARNING DISABLED AND OTHER VULNERABLE GROUPS AND ADVANTAGES THE INTERNET SAVVY, HEALTH ANXIETY GROUP SO WE WILL END UP INCRESINGLY FOCUSING ON TRIVIAL SELF LIMITING CONDITIONS AT THE EXPENSE OF CANCER AND OTHER SERIOUS CONDITIONS….THE LAW OF UNINTENDED CONSEQUENCES……THE PROBLEM IS OUR LEADERS NOW MUST “MAN UP”, FORGET THE GONG IN THE QUEENS HONOURS AND MAKE AND I MEAN MAKE THE GOVERNMENT AND THE PUBLIC LISTEN…YES THAT MEANS 10 O’CLOCK NEWS AND A NATIONAL DEBATE……FOR F*** SAKE PLEASE SPEAK UP AND STOP WORRYING ABOUT OFFENDING PEOPLE……

James Cuthbertson 12 May, 2021 7:52 pm

Just like Amazon facilitates unnecessary and spontaneous purchases, so econsult allows people to consult endlessly about nonsense.

Nothing will ever control demand apart from making access to GP COST the patient something. It used to be time and the effort of arranging an appointment, now that is gone. And pleading 16 page letters will do nothing either.

John Graham Munro 12 May, 2021 9:05 pm

I recall a GP who moaned even if he had to see one extra patient during surgery—-I can’ imagine how he would react today