Research and Technology

23.11.17

NHS £45m online GP service ‘not a silver bullet’ despite central pressure

Plans to introduce an online consultation system for GPs may not fix workload and waiting time issues in the way the government is hoping, it has been argued.

Research, funded by the National Institute for Health Research (NIHR), has suggested there is not enough evidence to say the system will have a positive impact, despite NHS England offering a £45m fund to encourage practitioners to adopt the service.

‘eConsult’ was piloted in 36 GP practices in Bristol, North Somerset and South Gloucestershire, but research by the University of Bristol found that it was only being used by two in every 1,000 patients.

A total of 38% of the online consultations led to a face-to-face contact, with another 32% leading to a phone consultation.

The company has confirmed that it will take this research into account to improve its services.

Dr Jeremy Horwood, of NIHR CLAHRC West and the university’s Centre for Academic Primary Care, said the study had some important lessons that must be taken on board.

“While our study focused on a particular system in a regional GP consortium, there are lessons here for any GP practice considering moving to an electronic consultation system,” he commented.

“There is a central government drive to move to these systems. However, our research shows that they need to be carefully implemented and effectively marketed to yield the benefits that politicians are hoping for.

“Online consultations may have value for some patients, such as straightforward medical enquiries, but they cannot replace face-to-face consultations in situations which are more complex.”

In response to the research, Murray Ellender, chief executive of eConsult, accepted that online consultations may not be a silver bullet, but experience shows “they could be a significant part of the solution, and have evolved a long way since this study was carried out.”

“It is encouraging to note from the evaluation that more than six in 10 online consultations did not require a face-to-face consultation, and quantifiable feedback from patients indicates they value having this option,” added Ellender.

“eConsult now supports more than 350 practices and we are gaining expertise and knowledge all the time, and using this to improve our offer. We welcome studies such as this, from which we learn and evolve.”

Despite concerns, the service has reduced the number of consultations that GPs have to deal with in the pilot areas.

The research concluded that the online consultation was not an “immediate solution” but could offer improved access for some patients, especially if the system could be improved.

Last year, a report from the Nuffield Trust offered similar warnings about future patient consultation technology.

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