Online consultations 'can free up an hour' of GPs' time each day

Some practices are freeing up around an hour of their GPs' time each day by embracing online consultations, NHS England's head of general practice development has said.

Dr Robert Varnam, NHS England head of general practice development (Photo: Pete Hill)

Around 3m people in England currently have access to online consultations and practices using them can improve access for patients and relieve pressure on appointments, Dr Robert Varnam told the EHI Live conference in Birmingham this week.

Earlier this week NHS England released details of how CCGs could access £45m of funding to help roll out online consultations to practices in their area. The funding covers a three-year period and forms part of the extra money made available to general practice via the GP Forward View.

Dr Varnam - a GP in Greater Manchester - said the fund was aiming ‘to make it easier for any practice who wants to, to use this channel. We’re not mandating it, we’re not forcing it, it’s an offer.’

The money will be allocated to CCGs on a per capita basis and equates to approximately 80p per patient over three years.

Read more: How can practices access funding for online consultations?

Dr Varnam said that online consultations were not necessarily video consultation, but about providing patients with the option of using online as the first point of contact with the practice.

‘Online consultations are in some regards a really simple idea,’ he explained. ‘You offer online as the first point of contact. So instead of a default option "I’m sick and I need help I phone the practice", what we’re offering is "click first", whether it looks like an app or a webpage.

Impact of online consultations

‘We’re finding out a lot about the impact. What’s interesting is that the impacts are in more than one area. They are about improving access for patients and the convenience. They are about improving patient empowerment, by providing better information and better signposting. They do seem to relieve pressure on practices and particularly GP appointments.’

‘[The funding] is not requiring [practices] to use video consultations,’ he added. ‘But, if you want to use the money for that, you can. The evidence to date is that video consulting between professionals is great, but that most patients don’t really want it.’

CCGs will be expected to submit plans to NHS England that will have to be approved before funding is released.

NHS England guidance says that it hopes the majority of practices in England will benefit from the fund over the three-year period. It says that in most areas it expects online consultation systems will be undertaken ‘at scale across STP footprints’. Pilots looking at how online consultations can link with urgent care services, including out-of-hours, will also be running in 2017/18.

Research published earlier this year suggested that online consultations could drive up GP workload, and that the benefits of more appointments carried out in this way were unclear.

But Dr Varnam said that GP practices could realise the benefits of online consultations very quickly.

‘Very often in the NHS, we’re used to ambitious programmes of change taking an achingly long time to have an effect. This is an example of something very, very different. We’re finding time and again that when GP practices switch on an online consultation solution and start encouraging large numbers of patients to use it the impact can be very big, very quickly.’

However, he said for the systems to be a success just ‘switching it on’ wasn’t enough.

‘You’ve got to make it really obvious to patients, you have to encourage people and train up all of your staff to remind patients and to sell it to patients,’ he said. ‘You have to change some ways of working so that when a patient leaves the room you don’t say "come back and see me in a month", but maybe "send me a message in a month".’

Dr Varnam said that NHS England will be providing resources to support patient uptake, including marketing materials to help patients feel confident in contacting their practices in this way.

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