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We need to change the conversation about digital in primary care

By Dr Anna-Karin Edstedt Bonamy



Dr Anna-Karin Edstedt Bonamy, a former paediatric doctor and an associate professor in Sweden, who now works in health-tech in the UK and Sweden, explains how digi-physical care navigation tools can help PCNs relieve pressures on services.

But first, we need to change the debate about how technology can help in primary care.  

With winter fast approaching, and the subsequent additional pressures this puts on health and care services, it’s understandable how, now more than ever, access to services is front of mind for patients and the NHS workforce alike.

Whilst there have been some positive steps from the government to help, such as the recent £200 million winter support fund, it notably excludes primary care.

Yet, for many individuals, particularly as the days get shorter and the temperatures drop, their first port of call is their GP practice.

And primary care is already facing unprecedented challenges, such as the recruitment and retention of qualified staff and an undeliverable demand from patients.

As the debate about access to primary care services inevitably ramps up, it feels like there needs to be a more honest discussion about solutions, and specifically the significant role that digital can and should play in diverting the demand, for the benefit of patients and staff.

Digital revolution not evolution 

In recent months, there has been a lot of focus on the rollout of digital telephony in GP practices, given the fast-approaching government deadline for systems to be in place by March 2024.

GP leaders have commented on how this technology alone won’t improve patient access. And they’re right.

However, they’re wrong to only consider telephony in the context of improving access.

Digital encompasses far more than telephony. And whilst these types of evolutionary changes are right, and have benefits, given the national objectives (such as delivering 50 million more appointments in general practice by March 2024), primary care needs more comprehensive solutions.

The real answer – or revolution – will come from the scaling up of care navigation platforms that enable a clinically safe and effective digi-physical experience for patients.

These tools enable online triage at a time that is suitable to the person in need of help, and it refers them to the most relevant healthcare professional from the outset.

In instances such as Lakeside Healthcare in the East Midlands, which is the largest GP partnership in the NHS and supports over 180,000 patients, less than 12 per cent of patients have needed to see a GP.

The majority of the time the patient has been effectively treated by a nurse, pharmacist, emergency practitioner and/or been supported in self-care.

The redirection of patients has also had a significant impact on staff capacity – there has been a 33 per cent reduction in phone calls, which has helped minimise the 8am telephone queues and freed up the receptionists to speak to those who don’t have online access.

And GPs have been able to prioritise seeing the patients in greatest need, either digitally using an online consultation tool or in person at the surgery.

Patient satisfaction has also remained high, with over 90 per cent of users saying they feel like they have been dealt with understanding and compassion.

Opportunity for PCNs

As with collaboration across any network, there is the opportunity for benefits at scale, however, this is particularly relevant when it comes to considering the advantages of these digital solutions within a Primary Care Network (PCN).

Not only can the benefits such as a 33 per cent reduction in telephone calls be applied to all practices if the platform is rolled out at a PCN level, but scarce resources such as physiotherapists – who are often employed by the PCN and shared by GPs in the network – can be managed more effectively.

The real-time data from the platform can give a fuller picture of demand and can help clinical directors allocate physiotherapy services in a more efficient manner.

Plus, with bespoke, localised signposting baked into the triage process from the outset, patients are being diverted to the most relevant healthcare professional across the PCN, rather than just to who is available locally at their practice.

The time is now

As patients’ needs continue to increase, and with little additional support available in the winter resilience package from the government, it feels like now is the opportune time for primary care professionals to consider how care navigation tools can really help move the dial on access.

And importantly, consider the benefits of the economy of scale for allocating scarce resources, which can be achieved by making decisions at a PCN rather than local level.

The real transformative revolution can be achieved with digital, when primary care teams also have the space and time to consider its role as part of wider organisational and clinical transformation.

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