- Posted Monday May 11, 2020
A recent webinar from NHS England stated that 95% of practices are now set up to offer virtual consultations as a result of Coronavirus in the UK, compared to only 5% before the onset of the virus. They went on to discuss how this incredible “turbocharged change” may well affect Primary Care after the pandemic is over.
Virtual Consultations have been explored as a way of improving the Service Model for Primary Care for around 20 years. Due to limitations in technology and limited research into general practice, the idea of using virtual consultations wasn’t expected to have a significant impact for a further few years, with the NHS Long Term Plan looking at 2023/24 as a target. However, coronavirus has forced the change - what would have taken 6-18 months to implement has been pushed through in a matter of weeks.
Is this likely to last after the pandemic is over?
Practices are currently, on average, dealing with 50% of consultations on the phones, 40% through direct messaging,7% are attending practices and 3% are using video consultations, but that number is growing fast (NHS England).
This is a huge change compared to the usual way of working and by no means likely to last in its current form, but it is likely to trigger longer lasting change, as most practices now have the technology and skill to be able to utilise virtual consultations.
There is a real opportunity to move to a more streamlined triage way of working, with patients having to fill in online forms to request an appointment, being able to have a virtual appointment and consequently saving sufficient time, for both patients and clinicians.
What are the benefits?
With NHS England’s “Total Digital Triage” model, patients would be able to fill in their history at home, saving time in the appointment and allowing clinicians to spend more time with their patients. Phone lines would be freed up for urgent queries as well as those patients unable to use the online system.
Video Consultations and Direct Messaging - Patients will not necessarily have to disrupt their working days, being able to attend appointments from home. Clinicians can manage an increasing demand for appointments more effectively. Great for routine check-ups, reducing disruption for the patient. This would be good for those times where there is a trade-off between visiting the doctor and staying at home.
Change of Work flow - Not only could this new way of working be better for the majority of patients, it could also lead to a more flexible way of working for clinicians and practice staff. This could include the opportunity to work from home and flexible work hours.
What are the drawbacks?
Of course there are always going to be times where a face-to-face appointment is needed. There are some patients, such as the elderly, that will not be able to access an online triage system or attend virtual consultations, as well as many situations where a virtual consultation is suitable, such as where a physical examination is needed.
Patients need to trust in the security and confidentiality of the systems to allow virtual consultations to be effective. This is something likely to happen over time, but there will be some concerns that will need clear guidance, such as recording sessions.
Furthermore, although technology is far more predictable and reliable nowadays, there is a risk that a poor connection could impact the professionalism of a consultation or impact the clinician/patient relationship.
Overall, we will have to see what happens in the aftermath of Covid-19, but it certainly is possible that the Model of General Practice may fundamentally change forever.
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