Digital First Primary Care

Digital technology is transforming how patients and health professionals interact. As a result, NHS England is supporting primary care to move towards a digital first approach, where patients can easily access the advice, support and treatment they need using digital and online tools. ​These tools need to be integrated to provide a streamlined experience for patients, and quickly and easily direct them to the right digital or in-person service. ​

In practical terms, this means patients should be able to use online tools to access all primary care services, such as receiving advice, booking and cancelling appointments, having a consultation with a healthcare professional, receiving a referral and obtaining a prescription.

NHS England is developing a programme of work to support practices and primary care networks (PCNs)  to move towards providing Digital First services. For more information please contact england.digitalfirstprimarycare@nhs.net

Online consultations

GP practices are increasingly offering more online access to services, including the option to have an online consultation. Online consultation systems allow patients to contact their GP practice without having to wait on the phone or take time out to come into the practice, and they form an important part of Digital First Primary Care. Online consultations enable patients to ask questions, report symptoms and upload photos. The practice then looks at the request and responds within a stated timeframe, connecting the patient to the right person, service or support. Currently, most practices who have implemented online consultations use a questionnaire-based system, with their own staff then looking at requests from patients and delivering the service in response. However, there are also opportunities to manage online consultations at a larger scale, for example across primary care networks or via a hub model. Some practices are also offering patients the option to have an appointment with a clinician via video (a video consultation).

Research has been commissioned to understand the impact of online consultations on general practice. However, evidence to date and case study findings show that where online consultations are implemented as part of a comprehensive primary care service, they enhance the experience of care for patients and support general practice in managing time and workloads, improving both access and sustainability.

A simplified patient journey

Commitments

The NHS Long Term Plan commits that every patient will have the right to be offered digital-first primary care by 2023-24.

To achieve this commitment, the GP Contract has set out a number of digital primary care requirements, including:

  • all practices will ensure at least 25% of appointments are available for online booking. Practices that are encouraging utilisation of online consultations and offering non-triage* appointments online, i.e. those which are currently available for direct booking by patients on the phone or in person, will be recognised as working towards the 25% target. A quality framework is being developed by NHS England and NHSX to support practices with online appointments.
    *non-triage appointments could be cervical screening, health checks, travel vaccinations, flu vaccinations, etc.
  • all patients will have the right to online consultations by April 2020 and video consultation by April 2021.