The healthcare lottery: Supporting GPs in a more direct route to care

Dr Murray Ellender, a GP and chief executive of eConsult, looks more closely at the role digital triage solutions will play in our recovery from the COVID-19 pandemic

As a practicing GP, I know all too well the pain, stress, and frustration caused by the 8am phone call appointment lottery.

All too often we hear of patients having to call dozens of times to reach a GP receptionist, if they are even fortunate enough to get through among the flood of other callers trying to make an appointment.

And the likelihood of speaking to someone has, in recent times, been compared with the chance of winning the lottery.

This comparison is no surprise.

According to recently-commissioned research, there is, on average, one GP per 2,308 people in England - far lower than the OECD average, which stands at around 3.5 doctors per 1,000 people.

This is a trend that needs to be reversed.

Dr Murray Ellender

Recent British Medical Association (BMA) analysis found that the number of fully-qualified, full-time GPs has dropped by more than 1,800 versus 2015 levels, with the number of GP partners falling by 918 between June 2020 and July 2021.

The 8am phone call lottery is, consequently, as predictable as it is worrying.

And it is a situation that is placing increased stress on everybody, from patients, to GPs, receptionists, and other healthcare professionals.

For example, according to our latest research, we found that 20% of patients self referred to A&E as they ran out of patience when trying to book a GP appointment.

Digital triage will enable surgeries and hospitals to give appropriate appointments to those most in need, helping to ensure everyone receives the right help in a way that means that more patients can be successfully treated

But, at a time when frontline health services are battling to overcome the array of challenges built up during the pandemic – including staff absences, capacity constraints, and a growing backlog of appointments – never has it been more important for GP surgeries to operate as effectively as possible.

Enter digital triage

One of the ways we can reduce the strain on our key workers is by implementing technology that helps us to provide the correct services to as many patients as possible.

Digital triage is one tool practices can adopt to support in ensuring those who need face-to-face time with a GP are prioritised.

Digital triage tools enable patients who are able to to visit their GP surgery’s website and use Q&A-based triage tools to receive personalised help and advice.

In some respects, it is a digital substitute to phoning a practice or walking in to speak to a receptionist.

And the information provided online allows the surgery to decide how quickly a patient needs their help and which healthcare professional is best placed to cater to their individual needs, be it a doctor, nurse, or another member of staff.

This way, patients can find out if they actually require a GP appointment or whether their concern could be managed remotely, either by visiting a local pharmacy or through taking a simple remedy, such as a dose of paracetamol or ibuprofen.

In terms of the bigger picture, this serves as means for phone lines to remain open for those without access to the internet or in most-urgent need of a face-to-face consultation.

How it works

Digital triage it is not a digital service which simply serves as an extra channel through which GP receptionists handle frustrated patients.

The system is intended to provide, what we refer to, as a digital front door to enable safer access to services, something that can, ultimately, help to save lives.

We often cite the example of a 23-year-old man who used our service after being placed into a queue of 15 patients trying to get through to his surgery’s reception desk on the phone.

He was suffering from a severe headache, something he had not felt before.

Lacking the time to wait on hold, he went onto the online triage and was immediately told to go A&E, where he was treated for a subarachnoid hemorrhage.

Without the instant digital advice to seek emergency help, this patient could well have died.

Fit for purpose

Put simply, the more efficiently practices triage demand, the more patients they can see, and the more quickly sick patients can be treated – whether face to face, or online.

At a time when frontline health services are battling to overcome the array of challenges built up during the pandemic – including staff absences, capacity constraints, and a growing backlog of appointments – never has it been more important for GP surgeries to operate as effectively as possible

This means transitioning all triage activity online to free up practice staff and ensure requests are handled both quickly and efficiently.

Of course, in the minority of cases where people cannot access digital services, telephone access should still be made available.

Digital triage will enable surgeries and hospitals to give appropriate appointments to those most in need, helping to ensure everyone receives the right help in a way that means that more patients can be successfully treated.

But it will require GPs to embrace change.

As a profession, we must accept that the added pressures and demand brought about by the pandemic are here to stay.

And the events of the past 18 months have highlighted the need for technology to underpin our services.

For me, switching to digital triage represents a logical first step.

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