One in six GP practices carry out 'email consultations' with patients, poll suggests

One in six GP partners say doctors at their practice carry out some patient consultations by email, a GPonline survey has found.

Almost all practices offer telephone consultations (96%), although less than 2% of 265 GP partners responding to the poll said their practice offered video or group consultations.

NHS England's '10 high impact actions' - proposals meant to release time in general practice - include a call for practices to 'introduce new communication methods for some consultations, such as phone and email, improving continuity and convenience for the patient, and reducing clinical contact time'.

The GPonline survey findings show that significant numbers of practices are offering consultations options beyond face-to-face visits.

More than a quarter of GPs said more than one in five contacts with patients at their practice were carried out via telephone consultations.

GP consultations

Among the 17% of respondents who said their practice offered email consultations, the vast majority said email accounted for less than 5% of contact with patients.

But GPs warned that alternative consultation techniques were not suitable in many cases and that technology was holding back wider adoption of some methods.

Wessex LMCs chief executive Dr Nigel Watson said that practices 'do far more by phone than we used to'. He said video consultations were largely not being implemented because practices were not set up to use it easily.

'As a business we have looked at video consultations and the broadband speed is just not adequate in many places. So that's not widespread.'

He said the finding that a significant proportion of practices offer video consultations was interesting, although he added that it 'depends what you understand by email consultation'.

Clinical systems

'Clinical systems allow you to email patients with results, or if they are in your notes and you have an email address you can send them a message – that might be considered an email consultation,' Dr Watson said.

'Some patients will email – and we engage in dialogue. Most GPs do that for selected patients. Most GPs wouldn’t want their NHS email address to go out to all patients but I know quite a few GPs – I would sometimes give it to people needing end of life care, or some patients with a long-term condition and they can report results back to you.'

He said this process often took place 'with a barrier between you and the patients' because patients emailed a practice address from which emails were forwarded on to the individual GP.

Dr Watson predicted that group, video, email and telephone consultations would continue to spread over the coming years as technology improved and evidence grew around the potential benefits.

'There is some evidence that group consultations for diabetics are quite a useful way of managing people. People can have blood test results, come into meeting with a facilitator, a diabetes nurse, and a GP could come in to answer questions - you could get through 12 patients in an hour. It has been looked at for respiratory disease too – it won’t take over all work, but we have looked at it.

For people with similar levels of disease – you could do education support for example in groups and that could add value to consultations.

'It all will slowly increase,' he said. 'I still think it will take a long time to replace face-to-face – there is so much you pick up in nuances of body language. Telephone consultation has been described as essentially doing it blind, and with an email consultation you are blind and deaf. It works for some patients at some times, but it doesn’t replace face-to-face.'

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