When I spoke about the NHS App on the BBC Radio 4 programme You and Yours in January, the first question I was asked was ’Will it help our patients to avoid the frustrating 8am telephone scramble for an appointment?’ A golden question, but not an easy one to answer. The burden on general practice is growing and there is a real need to make sure that GP appointments are accessible to those who need them, when they need them. Part of the solution is in our hands. We can decide what proportion and type of appointments to make available to book through digital tools and when to release these appointments. The new GP contract commits us to making at least a quarter of our appointments available for booking online. Adoption of the new NHS App – and how effectively our patients use it to take control of their health – could be a big part of making this work well.
Our practice went live with the NHS App in September 2018 as part of the pilot, and we are learning that to unlock the potential of the app – all of our staff need to embrace it and we need to ensure that our patients understand how to use it to best effect.
We are learning that people need to:
- Understand the value of the symptom checker. Using NHS 111 Online and NHS.UK, the app provides clear information and advice and signposts people to the most appropriate service for help. While over time this might reduce the proportion of avoidable GP appointments as people make the right choice of where to go, its real power is its role in encouraging my reluctant patients experiencing worrying symptoms to see me sooner. Should I ignore blood in my pee…oh, symptom checker strongly suggests I make an appointment to see my GP…
- Know that the NHS App gives them choice in how to access NHS care and advice. It is not mandatory and all existing methods of contacting the practice will remain for those who don’t want to, or can’t use, an app. And moving more patients to digital channels like this to book appointments and order prescriptions will enable those who need to speak to us on the phone to get through more quickly.
- Be reassured that while the NHS App is new, digital access to GP services isn’t new. The NHS App is a convenient, safe and secure way to access NHS services, but we have been digitising primary care with electronic records, appointments bookings, electronic prescriptions and more over the last decade.
We were asked to send text messages to all patients promoting the NHS App and had some concerns about the level of enquiries this might generate from patients. We were actually surprised at how few patients contacted the practice with questions about it.
We’ve also learned that our staff need to understand:
- The sign-up process – registration is easy and a huge bonus for our practice as we found a lot of patients signed up to the app who had not been registered for other digital tools. But staff needed to be aware of the process so that they can support patients with the process where needed
- How to book an appointment
- How to cancel an appointment
- How renew their prescriptions
And the really tricky one: our patients, especially those with long term conditions, need to understand the benefits of having access to their medical record and test results through the app. This includes a conversation about when they might want to share their information with another health professional, for example during an appointment with a consultant at the hospital, and when to make an appointment.
We found that the app was well designed and enabled the majority of patients to walk through these processes easily on their own with no support needed from the practice. But we had good materials from the NHS App team to help us support those patients who did need that support and fed back to the team if there was a gap or opportunity to improve those guidelines.
Overall, we could immediately see the potential benefits of the NHS App and can see that this is the beginning of a very exciting journey for our practice and our patients.
Dr Ian Pawson is a GP partner at Brownlow Health in Liverpool, one of the first practices in the country to try the NHS App when it joined the pilot in September 2018