Thursday, 3 September 2020

Patient Led Service?

KEEP CALM AND PUT PATIENTS FIRST Poster | CODY | Keep Calm-o-Matic

The Times reported recently that online appointments are to become the new normal for GPs.

Now I don't know about anyone else, but the health service seems to have gone to the dogs as a result of the coronavirus epidemic - cancer patients are not being treated, thousands of essential operations have been put on hold, dental services have ground to a halt and now face-to-face consultations with GPs are to become a thing of the past.

Doesn't sound much like a 'patient led' service to me.

 




CORONAVIRUS
Coronavirus in Scotland: Online appointments to be the new normal for GPs

Leading doctors said that the use of technology for remote check-ups has accelerated “five years in five months” - Photo ALAMY

By Helen Puttick - The Times

GP appointments by phone and video will become the new normal in Scotland after the pandemic triggered a “cultural shift” in healthcare.

When Covid-19 hit in March surgeries rapidly moved all their consultations to phone lines and the internet, only seeing patients in practices if essential to control the spread of the disease.

Leading doctors said that the use of technology for remote check-ups has accelerated “five years in five months”.

GP leaders now say that they expect appointment systems to include a greater mix of telephone, web and face-to-face appointments for the foreseeable future.

Before the pandemic there had been a tentative exploration of Skype-style consultations in Scotland, including a pilot involving Edinburgh University and 150 Lothian patients. However, the British Medical Association’s Scottish GPs committee had expressed concern that this approach could be more risky for patients and hampered by technical glitches.

The BMA and the Royal College of General Practioners in Scotland now say that telephone and video appointments will continue, although care will need to be taken to ensure patients can still build a relationship with their surgery and are seen in person when necessary.

Carey Lunan, chairwoman of the RCGP in Scotland, said: “I cannot imagine there will be any practices who will decide to completely get rid of telephone and video consultation even when the pandemic goes away.

“We have seen the benefit of having increased flexibility. It is not for everyone, but for some people it is much better: for people who are working, for people who struggle to get out of the house, for people who have kids and difficulty with childcare and do not want them running around the consulting room. I think we will have to remain flexible and remember the folk we have to work for.”

She said that remote consultations worked well when doctors already knew the patient, but could be more difficult if patients struggled to articulate their problems or spoke English as a second language.

Video quality varied, she said, meaning that emailing pictures of skin lesions and rashes tended to work better than assessing them live on camera.

Andrew Buist, chairman of the BMA’s Scottish GPs committee, said: “We have stepped forward in use of information technology five years in five months, but not everything works, and we are still working out what is the best balance between face-to-face, telephone and using [the video consulting service] Near Me.”

He said that some GPs did not want a job where they sat in front of a computer, rather than patients. However, he added: “I think it is here to stay. It will reduce a little bit as Covid becomes less of a problem, but it has certainly had a major lift-off because of necessity and that might change again as the broadband gets better and the hardware becomes more widely available. My typical day in three years’ time compared with three years ago will have a mixture of telephone, video and face-to-face. That will be the new normal.”

Dr Lunan and Dr Buist pointed out that online appointments did not save GP time, and could take longer if technical issues affected the call quality. Dr Lunan also noted that GPs could assess patients just by walking with them from their waiting room to the consulting room, noting if they limped or were breathless, something that was not possible via video.

Dr Lunan also warned that technical departments in health boards that supported practices when technology failed were under enormous pressure and needed significantly more staff. She said: “When IT is not working well, we need to speak to someone quickly to get it fixed. We cannot be on hold for 30 minutes when our whole system is based on being slick.”

The Scottish government has been contacted for comment.