What are online consultations?
Online consultation systems do not necessarily involve video consultations. NHS England describes online consultations systems as:
‘Using a mobile app or online portal, patients can tell the practice about their query or problem, and receive a reply, prescription, call back or other kind of appointment. They can also access information about symptoms and treatment, supporting greater use of self care.
‘Many enable the patient to access information about symptoms, conditions and treatments, and connect to self help options. They free up time for GPs, allowing them to spend more time managing complex needs. Some issues are resolved by the patient themselves, or by another member of the practice team. Others are managed by the GP entirely remotely, with about a third of online consultations being followed up with a face-to-face consultation.’
NHS England says that the ultimate ambition is to create an integrated digital experience that enables patients to access appropriate services based on their needs.
How can practices access the funding?
Practices will not be able to access the funding directly. The money will be allocated to CCGs on a weighted capitation basis after the CCG’s plan for how it will use the funding has been signed off by NHS England.
Practices can see how much funding has been allocated to their CCG here.
NHS England says that CCGs will procure licenses for systems on behalf of their practices and that in most areas it expects this will be undertaken ‘at scale across STP footprints’. It also says that CCGs are ‘strongly encouraged to liaise with practices and the LMC in agreeing the plan to use this fund’.
Ongoing funding after the first year will depend on evidence of uptake by practices and whether local systems have benefited patients.
Are all practices now expected to undertake online consultations?
No. NHS England says that every practice in England is eligible to access support from this new funding, but participation is optional. However it says that it hopes the majority of practices will benefit from the fund over the three-year period and that it expects all CCGs to submit plans to gain their share of the money.
What will the funding pay for?
The fund is to be used towards the 'costs of providing patients with the facility to conduct a clinical consultation with their GP practice online', NHS England says.
Online systems must allow patients to access their practice via a web browser, mobile app or both for free. Patient queries should be transmitted securely to the practice and be imported into the practice’s clinical system easily. Video consultations are not essential, although CCGs can include this in their system if they wish to.
The CCG will purchase licences on behalf of their practices on a per-patient basis. The funding can be used towards the cost of the service, software and to support the introduction of the systems, for example staff training and patient engagement programmes.
Where systems are already in place, the funding can be used to increase take-up by patients or to derive further benefits from online consultations.
In some areas these schemes may link with urgent care services and out-of-hours and NHS England will be running pilots on such initiatives in 2017/18.
What support will be available to practices that decide to undertake online consultations?
CCGs are expected to provide detail of how they intend to support practices to make best use of online consultations systems as part of the plans they submit to NHS England.
NHS England’s head of primary care development Dr Robert Varnam has said that NHS England’s Patient Online team will be providing resources to support patient uptake, including marketing materials to help patients feel confident in contacting their practices in this way.
He also said the team would provide CCGs with support on designing the processes around implementing online consultations and training for staff.
What else will CCGs be expected to include in their plans?
CCG plans will need to explain how online consultations will be promoted to patients and explain how practices’ PPGs will be involved with planning and rolling out the system.
CCGs are also expected to explain:
- Whether they are planning to provide additional funding to support online consultations, how the funding will work alongside other funding aimed at improving access and how they will ensure the scheme continues after the initial three years.
- How funding will be aligned with wider CCG and STP plans for IT, self care, improving access and integrated urgent and emergency care.
- Details of how many practices are currently using online consultations and how many will want to make use of the systems.
- How funding will be distributed to practices and whether the funding will have more impact if it is phased, rather than spread out among every practice every year.
- How the CCG plans to monitor uptake, feedback and the success of the initiative.
Where can I find out more information?
NHS England has a comprehensive online resource providing information about the GP online consultation fund here. Details of NHS England webinars taking place this month can be found here.