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Experts propose e-mails to cut face-to-face GP consultations

5% of consultations by e-mail could save 17 million face-to-face consultations

Adrian O'Dowd

Thursday, 23 July 2015

Experts have proposed that pilots are run to see if GPs communicating with patients vie e-mail is a viable way of reducing demand on GPs’ time.

GP leaders, however, have warned that such a “virtual” approach might actually increase workload so should be road-tested first.

A major new report commissioned by health secretary Jeremy Hunt and prepared by the Primary Care Workforce Commission set up by Health Education England, has been published containing many recommendations to improve general practice.

In The future of primary care: creating teams for tomorrow report, the authors say: “We also believe it will soon appear outdated that, unlike countries such as Denmark, patients and clinicians cannot routinely communicate by email.

“If 5% of GP consultations could be dealt with by e-mail, this would save 17 million face-to-face consultations a year.”

The authors admit, however, that they do not know to what extent e-mails from patients would generate additional demand.

They recommend that e-mail correspondence between GPs and patients should be piloted prior to becoming a routine part of NHS care.

They also suggest that e-mail correspondence and electronic messaging should become routine between GPs and hospital specialists, allowing both to seek advice and give guidance on patient care.

Although this would need “protected time” in the working day, there were significant potential cost savings in terms of reduced referrals to hospital.

Professor Maureen Baker, RCGP chair, responding to the technology proposals, said: “Whilst the use of technology in healthcare is often hailed as a wonder-solution to the capacity problems we face, we must not be blind to its limitations.

“Some technological advances are incredibly useful for both doctors and patients, but we are concerned that 'virtual' correspondence between GPs and our patients is unlikely to reduce workload and actually has the potential to increase it.

“We therefore support the Commission’s cautious approach to introducing e-mail correspondence as a matter of course and its recommendations for piloting to ensure that this doesn’t add to workload overall.”

The Commission was led by Professor Martin Roland, professor of health services research at University of Cambridge.

The report calls for greater collaboration across organisations and a broader range of staff involved in the delivery of healthcare, such as pharmacists, ‘physician associates’, and ‘medical assistants’.

“There are also opportunities to reduce the administrative burden on healthcare professionals,” says the report. “GPs currently spend 11% of their time on administration. If administrative staff (such as medical assistants) took on half of this work, this would be equivalent to 1,400 more full-time GPs in England.”

New approaches to the best use of administrative support roles should be piloted and evaluated, they said.

The RCGP’s chair Professor Baker welcomed much in the report, saying: “Professor Roland’s report could prove to be a valuable lifeline to help rescue general practice from years of neglect and under-investment and ensure that we can continue to deliver good and safe care to our patients well into the future.

“The report echoes much of what the college has been saying for a long time and we hope it will add grist to the mill in our campaign to increase funding for general practice and significantly boost the number of GPs.

“These will never be a substitute for GPs so any new roles, such as medical assistants, must be properly piloted and evaluated to ensure that they can add value to patient care in general practice.”

A spokesperson for Health Education England said it was now considering the report in detail and would respond by the autumn.

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