GPs embrace virtual consultations to navigate Covid-19 outbreak

The digital unit of the health service NHSX has reported that the majority of GPs across England have adopted video consultations and other digital services as a means to continue to operate through the Covid-19 coronavirus outbreak.

Over 75% of all practices used video to see patients in the third week of April 2020, with more than 50,000 people having access to doctors remotely. This compares to under 10% uptake of video across GPs prior to the pandemic, according to NHSX.

According to the chief digital officer (CDO) at NHSX, Tara Donnelly, the roll-out – which has happened at “an incredible pace” – has also meant the vast majority of people have had access to healthcare, from midwives to physiotherapists, for the first time in this way.

“The overwhelming feedback is positive from staff and patients, who are impressed at the value a virtual face-to face meeting provides over a phone call, and how effective it is for maintaining social isolation and reducing environmental impact,” she said in a blog post.

The virtual set-up has also meant that self-isolating clinicians could work remotely, something that would have been “hard to imagine” until recently, she added. Prior to the pandemic, uptake of video had been limited, with suppliers offering services but few practices adopting them.

“It is amazing that up and down the country, staff across the NHS are thinking so innovatively about how to make remote care work as well as possible,” said Donnelly. “Despite the global pandemic, the NHS keeps going – albeit in very new ways.”

In March 2020, NHSX started working with NHS England and NHS Improvement in a deployment of video consultation systems in GP practices across the country. For a while, it was acceptable for practices that didn’t have remote consultation technology to use video-conferencing tools such as Skype, WhatsApp and Facetime as a short-term measure.

However, according to Donnelly, nearly all GP practices in England now have a video consultation provider sourced from the Dynamic Purchase Service Framework or the Digital Care Services Framework (DCS, also known as GPIT Futures).

One NHS organisation that has recently rolled out video appointments is Walsall Healthcare NHS Trust, which has implemented IMImobile’s eClinic video consultation software. On its first day of use, the system enabled 23 urgent cancer patients to be triaged in their own homes, while nine cancer cases were identified.

Walsall now has 40 clinicians using the service, which is perceived to be transforming patient care. “The clinicians are able to tailor the consultation to patient’s needs, which has resulted in improved clinician satisfaction, and hopefully will result in improved patient satisfaction as well,” said Muhammad Javed, consultant paediatrician and chief clinical information officer at Walsall Healthcare NHS Trust.

“The clinicians feel that the ability to provide clear instructions to the patient by in-consultation text chat and transferring information leaflets using the file transfer facility makes this consultation mode safer,” he said. “The ability to share the screen to show the patients their X-rays, for example, has also proved to be invaluable.”

Commenting on the use of digital technologies in the NHS as part of the response to the pandemic, NHSX’s Donnelly noted that Microsoft Teams is available to all NHS and care staff, and that there have been more than 160,000 activated user accounts across the health service, 348,000 calls held and more than 4.7 million chat messages.

In addition, the CDO noted that NHS trusts and clinical commissioning groups are working on a number of remote systems to support their operation in the pandemic, in areas such as digital outpatient booking systems, patient portals and other routes to get results and home-based testing, remote care platforms for physical and mental health, and using devices to connect patients such as the Portal devices by Facebook, which are being piloted in the healthcare system.

Efforts are being made around providing NHS staff with computers and virtual private network (VPN) tools so they can work from home, according to Donnelly, as well as driving remote learning, with programmes such as Health Education England’s e-Learning for Healthcare, which has made a Covid-19 e-learning programme available to all health and care professionals in the UK.

Other updates provided by the CDO relate to identity verification service NHS login, which has more than a million registered users and is now used in a number of digital health products provided by Co-op Health, eConsult, eRedbook, eRS, Evergreen Life, Leeds Helm, Airmid-TPP, Patients Know Best, Substrakt, AccuRx, Echo (by Lloyds Pharmacy) and Shaping Cloud, with others to come.