Introduction

Excerpted from, and with acknowledgement to GPonline, HERE.

The last 18 months have seen GP surgeries face profound challenges as doctors and their teams have adapted to the Covid pandemic’s restrictions on them and their patients. As face-to-face contact reduced, phone-based consultations became a critical way of keeping communication channels open – a fundamental change of approach that seemed to arrive virtually overnight.

It is nearly two years since the onset of the pandemic. Yet, GPs and the government are far from developing a workable method for increasing in-person appointments. As a result, the phone remains critical to the provision of GP services. Many doctors and patients alike have discovered that Telemedicine is an effective alternative to visiting the surgery in person, albeit only for some conditions and situations. Phone-based consultation is not a new thing. First offered in the UK back in the early 1990s, they emerged to provide people in more remote locations with better access to vital advice and care. Advances in the technology infrastructure and services available to GPs have helped improve the quality and effectiveness of remote consultations and enabled surgeries to be more agile in delivering their services to their patients.

Picture Attribution: Doctor attending by teleconsultation, 17 July 2020, by Ceibos (Author), file licensed under the Creative Commons Attribution-Share Alike 4.0 International license.

Cloud telephony users can work remotely or in the surgery using the same app on their mobile device or laptop to make and receive calls. For many GPs, nurses and support staff, this has become key to their ability to safeguard their own and their patients’ health while continuing to work as nearly normal as possible.

The most effective modern telephony services also integrate with EMIS and other clinical systems, reducing admin time to find and update patient records. EMIS Group Plc is a major provider of healthcare software, information technology and related services in the UK.

With remote consultations likely to remain a critical permanent option for many GPs and patients, virtual consultations and triaging have reached a tipping point during the COVID-19 crisis.

The future beckons with Telemedicine set to play a central role in the delivery of healthcare. As Healthcare2U says, Telemedicine is real and is dramatically changing how consumers receive healthcare. Initially developed more than 40 years ago to help alleviate a shortage of physicians in rural areas, Telemedicine has grown into a valuable part of healthcare delivery.

GP online consultations under the NHS
© Crown copyright to the following information is duly acknowledged.

NHS say that most GP surgeries now offer online and video consultations. The system can save you time waiting for a face-to-face appointment and means you do not need to go into a GP surgery. There have been changes to GP appointments because of coronavirus (COVID-19). Appointments can take place by phone or video call or by a pre-arranged visit to your GP surgery to see your GP.

Health services you can access online
If you are registered with a GP surgery, you can access some health services online. You may be able to:

• Contact your GP for advice and support.
• Order repeat prescriptions.
• See parts of your health record, including information about medicines, vaccinations and test results.
• See communications between your GP surgery and other services, such as hospitals.
• Book, check or cancel appointments with a GP, nurse or other healthcare professionals.

Coronavirus update on GP appointments
There have been changes to GP appointments because of coronavirus (COVID-19):

• GP appointments are likely to be by phone or video call.
• If you need to contact a GP, do not go to the surgery in person. Instead, visit your GP surgery website, use an online service or call the surgery.

Online consultations
Most GP surgeries offer online consultations with a GP. This is where you fill in an online form or speak to someone online about a health issue. You can use your smartphone, tablet or computer to have an online consultation.

Once you have answered the questions in the online form, you will get a text or email confirming your online consultation is complete and giving you advice about what to do next. If your GP surgery needs to get in touch with you, they may suggest a phone or video consultation.

To see if your GP surgery does online consultations, check your GP surgery’s website. You can Find your GP surgery to get their website details.

Video consultations
Most GP surgeries can offer a video consultation, which is very similar to a face-to-face appointment. You speak to a doctor using the video camera in your smartphone, tablet or computer. If you need to have a video call, you will get a text or email from your GP surgery with a date and time. Find out more about how to have a video call HERE.

To have a video consultation, you will need:

• A smartphone, tablet or computer that allows video calling – remember to make sure your microphone and camera are switched on.
• An internet connection.
• A well-lit, quiet and private space so the GP can see you clearly.

Using an Online Doctor
Digital GP and prescription services are on the rise. But are they suitable and reliable? With some patients waiting weeks to see a GP, it’s no surprise that consulting a ‘digital doctor’ has soared in popularity. There are currently two main ways to access remote care from your home: through e-visits with your GP (if available) or by consultation via an online-only service. An article on Wales Online says research suggests the number of people searching for online GP and prescription services almost doubled between 2014-2018, and a recent poll by digital healthcare service DoctorCareAnywhere.com found that 68% of British adults would be happy to use alternatives to in-person GP appointments.

Picture Credit: “online doctor appointment” by bastamanography is licensed under CC BY-NC-SA 2.0

The NHS is becoming ever more digital too, with video GP consultation service GP at Hand in London, as well as the newly-launched NHS App, through which people can book appointments, check symptoms and order prescriptions. GP At Hand is an NHS GP service that you use via a free app. It’s run in partnership with Babylon Healthcare service. To register, you will need to switch from your current GP practice. Once an application is made, a registration period will apply before you can access the service. The service is available for people living or working within the catchment area of one of their clinic locations. Not every Online Doctor service requires a switch and de-register from your existing GP surgery.

The Pros for using an Online Doctor

• Convenience – you don’t have to drive to the surgery.
• Speed.
• It’s good for GP morale.
• It may help ease pressure on the NHS.
• It provides a second opinion and can offer directions to appropriate care.

The Cons for using an Online Doctor

• It’s not suitable for all patients.
• It’s not ideal or appropriate for all complaints: more complicated issues, such as pneumonia or abdominal pain, may require an in-person examination.
• Cost – waiting for an NHS GP appointment may be frustrating, but at least it’s free. Digital GP appointments vary widely in price. Babylon Health, for example, charges £9.99 a month for unlimited appointments if you subscribe, or £49 for a first one-off appointment, while Doctor Care Anywhere wants £149 a year for unlimited appointments for subscribers, or £60 for one pay-as-you-go appointment.
• You may be asked to de-register from your existing GP.
• Absence of the human touch.
• You might not talk to the same GP online each time you use an online service.

A selection of Online GP Services
Most, if not all of the following offer prescription services:

• VideoGP is a service from Lloyds Pharmacy. Details are HERE. No need to switch GP.
• Doctors Clinic Group offers a range of services. Details are HERE. No need to switch GP.
• Doctor Care Anywhere offer several plans, from a one-off consultation to an annual subscription on a personal or family basis. Details are HERE. You use the service alongside your existing GP.
• The GP Service provides live access to real doctors from any device. Details are HERE.
• Simply Consult: Simplyhealth’s online doctor The Simplyhealth Plan starts from £7.50 a month, and all levels include access to SimplyConsult, their video GP app. Details are HERE.
• Livi is the first digital healthcare provider to be rated as ‘Outstanding’ by the CQC. Download the Livi app and select your existing GP practice for a free NHS service, or you can choose to use their pay-as-you-go service instead. You can book an appointment – at a time that suits you. See a GP online the same day or book up to three days ahead. Your GP will call you in the app to start your video appointment. Their GPs can offer medical advice, prescriptions delivered to a pharmacy near you and referrals to a specialist, if necessary. Details are HERE. You can view a video about their service at https://youtu.be/5rxRe93e1FE.
• Push Doctor works in partnership with the NHS. Details are HERE. No need to switch GP.
• Patient Access connects you to local health services when you need them most. You can book GP appointments, order repeat prescriptions and discover local health services for you or your family via your mobile or home computer. Details are HERE.
• Babylon Health gives you quick, easy access to GPs, physiotherapists, nurses and pharmacists—right from your device. You can also take control of your well-being with digital health tools that are available 24/7. Details are HERE and HERE. You need to switch GP.

A brief analysis of the GP Patient Survey by Citizens Advice (HERE) reveals several insights:

• Despite the fact just over a third (34 per cent) of patients would like to book online appointments, only 6% of patients usually do so despite drives to promote online access.
• This is partly explained by low patient awareness of online GP services – fewer than three in ten patients (27%) said they were aware of booking appointments online. But the functionality of online GP services might also be a barrier. Users have encountered technical difficulties and can find the requirement to attend the GP practice to collect online login details problematic. Meanwhile, new paid-for services are starting to offer new ways to access a GP online or via a mobile device.
• By encouraging and supporting online access, GP practices can improve the patient experience. Patients who were aware of online services and use online services were more likely to rate their overall GP surgery experience as ‘very good’. For instance, half of patients (50%) who order repeat prescriptions online rate their surgery as ‘very good’. In contrast, only 41% of patients, who said they cannot access online services, described their experience as ‘very good’.

Picture Credit: “Stethoscope On Laptop Keyboard Keypad” by focusonmore.com is licensed under CC BY 2.0

Caution: No advice is implied or given in articles published by us. This guide is for general interest only – and should never be used as a substitute for obtaining advice from your doctor or other qualified clinician/medical practitioner. The facts are believed to be correct as at the date of publication, but there may be certain errors and omissions for which we cannot be responsible.