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SkypeMay 25 2016

GPs have indicated a strong preference for sticking with face-to-face consultations rather than introducing e-communications such as Skype or e-mail.

Feedback from 391 general practices indicated that while two thirds were conducting telephone consultations frequently, only 6% were implementing email consultations, and 53% had no plans to do so. At the time of the survey (January to May 2015), none were using internet video services, and 86% had no plans to introduce this for consultations.

The findings are based on a survey sent out by researchers from the University of Bristol to 421 general practices in Bristol, Oxford, Lothian, the Highlands and Western Isles, with a response rate of 76%. The study is believed to be the first of its kind in the UK and was intended to identify the frequency and range of ways in which general practices are providing or planning alternatives to face-to-face consultations.

“Introducing alternatives to face-to-face consultations in primary care has been proposed as a solution to the increased demands on general practice,” the University had said. “Despite claims about how this may improve access and efficiency, the extent to which technologies such as telephone, email and internet video consultations are used at present is unclear. There is also little evidence to support claims they reduce GP workload or improve patient satisfaction.”

Despite there being policy pressure to introduce e-consultations, “there is a general reluctance among GPs to implement alternatives to face-to-face consultations,” concluded the researchers. “This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future.”

Professor Chris Salisbury, a GP and head of the Centre for Academic Primary Care, led the research. “The survey results show that, since few people are actually using email or internet video in general practice, views about the pros and cons of alternative forms of consultation are largely speculative and based on anecdote rather than evidence,” he said.

“The general reluctance to adopt alternatives to face-to-face consultations means the situation is unlikely to change soon unless general practices can see clear advantages from introducing new ways of consulting.”

The team’s research will now include in-depth case studies with a number of practices which had tried using different alternatives to face-to-face consultations. “Based on interviews with staff and patients, observation of practice life, and anonymised patient records, they will explore what practices achieved, how they overcame difficulties (or not), and what they perceived the advantages and disadvantages were for different groups of patients,” said the University.

Links:

University of Bristol announcement

H Brant et al. ‘Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice’. BJGP 2016. 66 (646). Published 24 May 2016

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