Monthly Archives: August 2023

Can video ease pressure on primary care?

Can video ease pressure on primary care?

While video consultation provision was accelerated by the Covid Pandemic it’s fair to say that take up has not been as widespread as expected by those championing online expansion.

In this blog we look at whether video consultations can become an essential part of the primary care toolkit or will be relegated to niche healthcare roles.

Blog hero image: Can video ease pressure on primary care?

The UK primary healthcare industry faces numerous challenges, including increasing patient demand, limited resources and the need for improved access to healthcare services. These challenges have highlighted the urgency for innovative solutions that can optimise healthcare delivery while maintaining quality care.

Video consultations development was fast-tracked as it was seen as one of the ways to interact with patients while minimising physical contact during the pandemic.

What was being seen as an optional extra became a key part of online services offered by Silicon Practice and others.

However, while video seems to have found a place in urgent care settings its takeup has slipped back in general practice.

Clinicians in control

Silicon Practice provides a secure and user-friendly platform for video consultations. With robust privacy measures in place, patients and healthcare professionals can connect virtually, ensuring confidentiality and maintaining the trust between providers and patients.

From the very start, video consultation sessions were developed by Silicon Practice to keep the clinician in full control.

Sessions can be scheduled online, with notifications sent to patients online or by SMS, or happen on demand – directly in response to a patient message received through our advanced dashboard or when the clinician is on a telephone call to a patient.

Patients are messaged to remind them of a forthcoming video appointment and if the clinician is running late they can notify the patient in the online ‘waiting room’ without having to begin the consultation.

The Silicon Practice dashboard itself can be tailored to each practice’s requirements. Staff work hard to make sure customers are satisfied with how their site works at its launch and practices have the flexibility to alter their site and dashboard’s functionality as needs change.

Can phone calls do the heavy lifting?

It’s fair to say that takeup of video consultations has not been as great as politicians and the public might have expected.

While fewer than 1% of UK general practice consultations occur by video that still means that around a million video consultations could be being provided each year (based on 300m general practice patient consultations annually).

Although the perception can be that video consultations are being offered as a replacement for face-to-face consultations they can, in fact, be a useful way of seeing patient reaction or a way of picking up on their behaviour which might speed up the decision on which course of action to take next.

It has also been reported that patients with mental health issues have been able to have a video consultation when they would have been anxious about leaving home.

It may be that easy phone communication acts as an unintended barrier to greater video consultation uptake.

Clinicians have reported that phone conversations provide much of the information they need on which to base a medical decision – even if that often means scheduling a face-to-face consultation.

And talking a patient through a self examination as part of a video call means a lot of detailed instructions and being able to examine the patient personally is usually considered easier, quicker and more likely to result in an accurate assessment by clinicians.

Urgent care medics lead the way

There may be lessons to be learned from the fact that a focus group study earlier this year found that urgent care GPs were keener about the technology, using video it more frequently than ‘in-hours’ GPs.

Urgent care GPs found that their anxieties about using video were overcome by training and, once they were confident, the technology had a range of benefits. These included during the initial assessment, allowing better rapport and trust between clinician and patient.

Video was found to have value in a wide range of conditions, including in identifying safeguarding issues, and was also useful for bringing others into the consultation and helped maximise resources.

‘In-hours’ GPs identified a range of problems, and generally being less confident treating patients without seeing them face-to-face compared with those in urgent care.

Where video proves most effective is in supporting decision making, for example being able to see how distressed a patient is which may not be as apparent from a phone conversation.

One in-hours female GP told the study: ‘I find some people can sound really awful on the phone, but when you look at them on the video you can see instantly … they’re actually all right and vice versa.’ 

Beware of two-tier system

While rural areas would seem to be ideal places for video consultations, potentially saving on long journeys for the patient or clinician, there are concerns that this could lead to a two-tier system.

Poorer families may not have the access to broadband which the more affluent may take for granted and GPs also reported those with larger homes had wi-fi blackspots.

The focus group study also found a wide split in use across the age ranges – some elderly patients, used to speaking to relatives online, were adept while others struggled to use video.

However, poor takeup by some GPs and barriers in day-to-day use doesn’t mean that the potential of video consultations has vanished. It may be a case that we are still only just starting to explore the potential of video.

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Functionality has been increased by Silicon Practice to allow group calls, which could prove invaluable for clinicians needing to have a translator involved in a consultation, a trusted third party or to bring in another clinician for advice.

Video has been used to link with nursing home staff to discuss patients, to at least partially replace visits and for statutory functions such as issuing death certificates, and this could be an area where the technology increasingly comes into its own.

Conclusion: Video’s flexible future

There are many reasons why video consultation uptake continues to be slow.

However, it is still a relatively new technology. A certain amount of resistance from patients and clinicians is inevitable but additional training would seem to be one way of making better use of the equipment which so many people now have at their fingertips.

If those barriers can be overcome, and demand for video in primary care expands, you can be certain that Silicon Practice will be ready.

Contact us to find out more about Foundation with, or without, video functionality. Follow us on socials.

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Written by Bruno Clements

Teamwork needed to prevent nightmare NHS queues

Teamwork needed to tackle nightmare queues for NHS doctors

NHS queues of nearly five million patients each month in England for a doctor’s appointment have put general practice back in the headlines.

The Government has already stated its  ‘expectation’ that all those who need a GP appointment can get one within two weeks.

Urgent appointments, meanwhile, should be on the same day, the Government said in its Autumn Statement of November 2022. 

However, breaking down what is, or isn’t, being achieved already, and how to reduce NHS queues, isn’t easy.

The Royal College of GPs says 85% of appointments happen within two weeks with nearly half on the same day.

It says the Government’s wait time target isn’t a fair measure if those appointments which take longer than two weeks are for routine matters.

Prof Kamila Hawthorne, who chairs the Royal College of GPs, says that GPs and their staff are working hard and issues around delayed appointments are due to “decades of underfunding and poor resource planning.”

While the major parties and professional bodies seek to lay blame, patients may be more pragmatic and wonder if their practice is being run as efficiently as possible.

About 122 million GP appointments were booked in 2021/22, according to NHS England, and around 6.4% were missed – that’s around 7.8m appointments a year or 650,000 a month.

Earlier this year the NHS asked hospitals to ensure they are sending appointment reminders, to improve processes for cancelling or rebooking appointments, and considering remote appointments.

As Sir James Mackey, NHS National Director of Elective Recovery, says: “With NHS staff delivering more than two million outpatient appointments every week, and outpatients making up more than 80% of the overall waiting list, this drive to reduce missed appointments has the potential to make a huge difference in freeing up capacity and helping us deliver for patients.”

Technology can make a difference

Many if not all those initiatives can be used in primary care as well, with technology provided by Silicon Practice and others can help GP surgeries to step up to the challenge.

Silicon Practice sites have always prominently featured multiple ways in which patients can cancel appointments and contact their practice.

Home page of Foundation website: Teamwork needed to tackle nightmare queues for NHS doctors

Not only can appointment reminders be sent by SMS, but text messages and emails can also be used to flag up availability so that patients who are prepared to be ‘on standby’ can be notified quickly when appointments become free.

NHS England has recently established benchmarks for making sure patients find online healthcare provision, including appointment changes, easy to navigate and interact with.

Foundation sites are expected to achieve a 98% rating of the top NHS benchmark at launch and can be part of your strategy for reducing missed appointments.

Appointment scheduling efficiency will differ widely from geographical area to area, by PCN and, indeed, from surgery to surgery.

Increasing the use of video and phone consultations can reduce unnecessary visits to a surgery. Websites, such as those provided by Silicon Practice, can give patients control of recording blood pressure readings online and completing other healthcare assessments and reviews at times convenient to them

Streamlining administrative tasks and reducing paperwork can bring benefits and will be one aspect of the approach which has to be adopted across the UK if the situation is to improve.

Cash injections increasingly unlikely for NHS  

Politics and how public funding is allocated is an inescapable part of the situation patients and NHS staff find themselves in.

In simplistic terms, increasing funding can help surgeries hire more staff, expand their facilities and invest in technology, which could lead to more efficient and timely care.

This can’t be untangled from the need to recruit and train more medical professionals, as well as training and supporting existing GPs, in many cases attempting to stem the flow of those into early retirement.

However, a massive boost in funding looks increasingly unlikely during the present cost of living crisis.

Offering GP services outside normal working hours, during evenings and weekends, has been seen as a way of distributing patient appointments more evenly and expanding the roles of nurses, nurse practitioners and other healthcare professionals can free up appointments for GPs to see more complex cases.

Cooperation not conflict will help patients and clinicians

The NHS was created 75 years ago by a political party and, sadly, healthcare is always going to be a political football. Arguments on how much should be spent and on what are never going to cease. 

In some cases, approaches will be tried and won’t work or, possibly more worrying, just be judged too costly to provide at the end of a trial period.

As website providers, we see this happening around the country, and a one-size-fits-all approach is unlikely to work.

An evolving multifaceted approach is perhaps the key, as well as getting the message across to patients that they themselves have a part to play by keeping appointments and cancelling when unable to attend.

Learning lessons from successes and failures across Britain will be paramount if resources are to be used effectively.

Contact us to find out about Foundation. You can follow Silicon Practice on Linkedin.

Silicon Practice logo: Teamwork needed to tackle nightmare queues for NHS doctors

Written by Bruno Clements