What is an online consultation?
Online consultations allow people to contact their GP practice without having to wait on the phone or take time to come into the practice.
Online consultations enable patients to use a secure online system to ask questions, report symptoms and upload photos. The practice then looks at the request and responds within a stated timeframe, signposting the patient to the right person, service or support. Currently, most practices use a questionnaire-based system, with their own staff delivering the service.
Some practices are also offering patients the option to have an appointment with a clinician via video (a video consultation), but this is distinct from an online consultation.
What support is available to implement online consultations?
We have developed an online consultations implementation toolkit, which provides a comprehensive range of ideas and options for different professionals at different points in the implementation journey. The purpose of the toolkit is to collate information and guidance on implementing online consultations in one place – such as measuring success, overcoming challenges and procurement.
To support the implementation toolkit, we have also publishing a range of case studies which highlight the challenges, solutions and implementation approach from a range of GP practices across England.
We are also developing evaluation standards to support the monitoring and impact of online consultations within primary care – this work will feed into the DPS specification refresh work.
Will there be funding for 2020/21?
Yes. There is a provisional agreement that additional funding of £15m per year will be provided for 2020/21, 2021/22 and 2022/23, to continue to support online consultations and the delivery of a digital first approach. Information on ongoing funding will be provided here as it becomes available.
What is the reporting process and what information will you be collecting about online consultations?
The GPFV monitoring survey contains six questions which relate to online consultations, and this information is collected quarterly. This gives an overall picture of how many practices have an online consultation system in place. The GPFV is completed by CCGs.
In addition to this, we are currently undertaking a piece of discovery work to understand what other information about online consultation is already being reported, its accuracy and where it is captured. Our aim to reduce the need for additional reporting by practices or CCGs by relying on information that is already being captured by both providers and suppliers. In the longer term we hope to provide access to a digital dashboard that will show how online consultations are being used and the impact these systems are having.
My practice triages all appointments before they are booked. Do we still have to make 25% of appointments available online as per the GP contract?
Practices should be working to provide a high quality digital offer to patients. Appointments that are available for direct booking by patients over the phone or in person should be made available for online booking. It is for practices to decide which appointments are appropriate for direct booking by patients, but at a minimum this will include appointments such as cervical screenings, immunisations, etc. For other appointments, where practices use a triage mechanism before an appointment is booked (e.g. via an online consultation system), we recommend that CCGs take this into account when assessing whether a practice is recognised as meeting the 25% target for online appointments in the GP Contract.
NHSX have published guidance for practices regarding offering 25% of appointments online.
Will online appointments not taken up by patients be released to other booking methods?
As always with appointments that have been made available to be booked by patients online, the practice has control over these and if a patient calls up or into the practice they can book them into an appointment that has been set for online booking.
Online appointments are usually available online and manually. Therefore, they are not usually released just for use by online users. The apps or web systems surface the appointments that are available from the clinical system.
Are there any exceptions to the GP Contract commitment for all practices to provide online consultations by April 2020?
No. The ambition is for all practices to be offering an online consultation service to their patients. However, not every practice necessarily needs to be looking at online consultations, as the service could be provided at a larger scale such as through an ‘eHub’. This may become increasingly appropriate as practices work collaboratively as a Primary Care Network (PCN). An eHub can provide remote triage and consultation to patients across a PCN or CCG. Some also provide face-to-face services when required or can redirect patients back to their practice where necessary.
An eHub could be set up as:
- A separate entity
- part of an Access hub
- Linked to an Urgent Treatment Centre (UTC)
- Linked to the 111 Clinical Advice Service (CAS)
How will the GP IT Futures framework and the Dynamic Purchasing System (DPS) framework align?
A refresh of the DPS framework specification is underway. This is to reflect the developments in online consultations that have taken place over recent years. As part of this work, we will also be looking to bring greater alignment between the DPS and the GPIT Futures Framework to give greater clarity to both suppliers and commissioners when purchasing primary care systems and setting up contracts.
When will the NHS App integrate with online consultation systems?
Work is underway with one of the online consultation suppliers to integrate their system with the NHS App as a First of Type. Once this is complete and tested, other online consultation products will also go through the integration process. The aim is that the online consultation systems with the most users (as of summer 2019) will be integrated with the NHS App during 2019/20, but all suppliers are encouraged to make contact with the NHS App team to discuss integration options.
NHS Digital have published guidance for suppliers about integrating with the NHS App.
What is the relationship between NHS England and NHSX?
Both the Primary Care team in NHS England and the Digital Primary Care team in NHSX are essential to supporting practices and primary care networks to put in place a digital first service. Both teams are working closely together and are running the work needed to support Digital First Primary Care as a single programme of work.