The drivers for an online system
“With ever increasing demand we knew we needed to be more efficient”, practice manager Trev Kerr said. “We needed a system that worked for everyone – staff and patients – which also made the most of modern digital technology.” They chose an online consultation system, supplied by AccuRx.
How the online system works
The system enables patients to request care by completing a secure online form on the practice’s website and, since 2022, via the NHS App. Once received, the surgery team assess the request and decide who should respond – be it a GP, practice nurse or another healthcare professional – and whether they invite the patient for a face-to-face appointment, contact them by phone or video call, send a text or online message. All care requests, however they are received, are triaged in this way. “We met our original aim of improving efficiency and supported phone and video consultation when appropriate, rather than having people come in for appointments,” said Trev.
Engagement and awareness
Ahead of launch, the practice held team discussion and training sessions to help them understand how to use the new system. They told patients about the changes and also used posters, a reception ‘check-in’ screen and text messages. A key priority was to ensure that all patients would continue to receive an inclusive and equitable service. To support this, the reception team received training to help patients to understand how the new system worked and its benefits. Patients without internet access or who preferred not to go online were supported to continue using the phone or to visit in person.
A GP’s point of view
Dr Emamoke Ubogu, a GP at Swan Medical Practice said patient feedback had been positive and that the reception team now rarely received complaints about the difficulty of getting appointments. “Many patients feed back to us that the online system is wonderful, and the ability to send their GP photos or other information digitally has saved them trips to the practice.” He added: “Patients who are still uncomfortable with using online technology or who have difficulty accessing the internet can still telephone us or visit in person, if that’s what they prefer. Our reception team is happy to help and can escalate any health issues to the GP team. “We try to explain to patients how the triage and appointment system works and usually even those who were initially resistant are quite happy. We ensure patients understand that it’s not always necessary to see a GP or have a face-to-face appointment and also that we are never closed to in-person consultations and have never shut our doors.”
The challenges
The practice opted to change their whole system in one go. Following “go live” they continued to support staff to learn and embed the new processes for several weeks. Having the backing of the entire practice team prior to go live was important, said Dr Ubogu. “Pre-pandemic, some of our team struggled with confidence in IT, so this was a big shift and there were some challenges in the new way of working. However, we were given training on the processes at the beginning. As the lead, I can offer training and we now have other staff who are able to train new starters.”
The benefits and next steps
The link to the online form helps to manage demand, and it offers more options than just a GP appointment – for example, patients can request contact with the practice’s nurse, primary care network paramedic, physiotherapist or pharmacist. Patients can also request prescriptions or blood pressure checks and further options are being developed. Following the implementation of the new online system, the practice’s ‘did not attend’ rate fell significantly, from an average of about 100 a month before the change to only 30 in January/February 2022.
The practice team continues to support people who are less digitally able or who do not have access to the internet to use the online form. Once an appointment is booked, patients with a mobile receive a text or phone call as confirmation. Despite the system change and the pandemic, patient satisfaction with the practice in the 2021 GP Patient Survey remained high at 80%. Work to further improve access continues, for example addressing the challenges of how to manage forms where the information provided isn’t easy to understand due to language barriers. The form is also being amended to include an option to book an appointment with an interpreter. Visit our website for more information on implementing online consultations in general practice.