Last month, I, alongside several colleagues, launched a new digital service that makes NHS GPs available to people – initially in London – 24 hours a day, 7 days a week via their mobile phones.
GP at Hand harnesses technology to cut down the wait for a routine GP appointment from the current average of around two weeks to just a matter of minutes via video consultation. Face-to-face appointments are available on the same day or next if needed. Like any other NHS service, it’s free and means patients can see a GP when and where they want.
There has been a lot of heated debate about this new service. This is good; we should discuss it. However, where there are myths or misinterpretations out there, my colleagues and I will try to dispel them.
Critics claim the app will destabilise other practices. But most patients are happy with the practice they are at, and where people do move practices, the funding formula caters for this already. Primary care funding is not perfect, but a lot of thought has gone into matching payment to practice workload, and it will continue to evolve. NHS England should look closely at how patients react to our service, independently evaluating the outcomes, and we welcome its willingness to do so.
Let’s all learn from the real-world results, and worry a bit less about whether individual GPs like or loathe the service, because, well-intentioned or not, it is all too easy for the voice of our profession to drown out that of the patient.
It is fundamental to the doctor-patient relationship that we all respect people’s right to choose the GP practice that works best for them. If people want to join GP at Hand, that’s great. If they wish to stay with their current GP, that’s fine too. And if other GPs choose to innovate using new technology, so much the better.
If there’s one thing I’ve learned as a GP, it’s that the patients I see every day are the ones who knows best about their own lives. The health service belongs to the people, as the NHS Constitution rightly says.
GP at Hand is available to everyone living within our initial eligibility area: no exclusions, no restrictions, no cherry-picking. From pilots of the service in Essex and west London, we found it is popular with a broad range of patients, including elderly people – who find it difficult to get to a surgery – and families with young children.
It is patronising to suggest older people can’t benefit from this technology. Recent ONS figures show the proportion of older people using the internet to keep in touch with family members has doubled over the last six years. These figures also reveal women over 75 showed the greatest increase in internet use of any demographic group.
The benefits of being able to see a GP quickly on your phone from the comfort of your home can be felt just as much by older people as they can be by younger, busy workers.
NHS England has vetted our service, and provided us with some examples of conditions where, to be prudent, it feels it would be sensible for a patient to seek advice before registering for a digital-first service. These include people with complex mental health conditions, those requiring end of life care and people with drug dependence, among others. Our team is on hand to provide such advice.
In the cases where an individual’s health needs mean they are not suitable for a digital-first service, they can register at any traditional practice. For the vast majority of patients, old or young, our service is an appropriate method of GP care.
Harnessing technology and digital innovation is critical to the future of our NHS. We have an ageing population and the NHS is under ever increasing pressure, with finite resources to deal with demand. GPs are coming under increasing strain too. GP registrations are up 10% in London alone. And that has knock-on effects, such as people going to A&E when their problem could have been dealt with by a GP.
If, as the government says, it wants to deliver a seven-day-a-week NHS, we have to start making use of the benefits and efficiencies technology can bring, as almost every other industry has. It’s the only way we’ll be able to continue meeting the ever increasing demand on our NHS while continuing to deliver first class care.
In a world where we can FaceTime friends and relatives half way around the world, it makes sense to be able to have a video consultation with a doctor within minutes, rather than waiting weeks for an appointment. It means problems can be tackled early on, rather than being allowed to get worse while people wait to see a doctor.
We live in a country populated by people with a wide variety of needs and preferences for how they live their lives. The NHS will flourish by providing care that respects these differences, and above all recognises patients’ right to choose what works for them.
- Dr Mobasher Butt is a partner at GP at Hand and a former adviser to the chief medical officer for England
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