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    ePACT to be decommissioned on June 8 as ePACT2 takes over

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a smartphone imageNovember 10 2017

An app allowing patients to have an NHS consultation with GP using a smartphone has been launched by a practice in London. 

Patients will need to register with the practice to be able to use the ‘GP at Hand’ app and will need a photo ID to upload to the app. Patients do not need to be in the traditional catchment area – eligibility is open for people if they work in Zones 1 to 3 in London. During the early stages of the app roll-out, the NHS has advised that certain patient categories may also be less suitable for using the app.

The app has been developed by Babylon Health. Among the app’s features are:

  • booking an appointment for a video consultation at any time of the day or night;
  • booking face-to-face appointments;
  • consultations are available 24/7 and the patient can usually be seen within 2 hours;
  • patients can replay the video consultation to remind themselves of the GP advice;
  • a symptom checker with triage advice;
  • prescriptions can be requested and sent to a pharmacy of the patient’s choice;
  • the GP can make referrals to secondary care;
  • patients can monitor their health “using a Monitor tool that integrates with over 150 existing health apps and wearables”.

“Our aim is to provide a great service to everyone who wants to register with us. The NHS has reviewed our service and has found it provides important benefits to patients,” says the practice.

Responding to the app launch, RCGP Chair Professor Helen Stokes-Lampard warned that “some patients will see this as a ‘golden ticket’ to get quick and easy access to a GP – and for younger, healthier commuters it could prove a solution to long waiting times for an appointment.

“Technology can achieve wonderful things when used properly, but we are really worried that schemes like this are creating a twin-track approach to NHS general practice and that patients are being ‘cherry-picked’, which could actually increase the pressures on traditional GPs based in the community.”

Prof Stoke-Lampard recognised that “increasingly long waiting times to see a GP” will make an online service appear “convenient and appealing,” but she added that there will still be a need for many patients to be able to see their own GP in person.

In addition, she said: “We notice there is an extensive list of patient conditions such as frailty, pregnancy and mental health conditions that are the essence of general practice and which GPs deal with every day, but which are not eligible for this service.

“We are also concerned that patients are being given the option of switching back to their local surgery if they are not satisfied with the level of service offered by the app. As well as issues with patient confidentiality and the safety of the patient record, it is hard to see how this could be achieved without adding to the huge burden of red tape that GPs are already grappling with.”

The RCGP is concerned that “while this scheme is backed by the NHS and offers a free service to patients, it is undoubtedly luring GPs away from frontline general practice at a time when we are facing a severe workforce crisis and hardworking GPs are struggling to cope with immense workloads.”

A qualitative interview study in the BJGP has indicated that current technology for patient consultations still has room for improvement. Views on e-consultations were collated from 23 respondents in six general practices. It noted there were benefits as consultations could be completed without direct contact between the GP and the patient.

“However, most e-consultations resulted in GPs needing to follow up with a telephone or face-to-face appointment because the e-consultation did not contain sufficient information to inform clinical decision making. This was perceived as adding to the workload and providing some patients with an alternative route into the appointment system. Although this was seen as offering some patient benefit, there appeared to be fewer benefits for the practices.”

Links:
GP at Hand          
RCGP comment                 
J Banks et al. ‘Use of an electronic consultation system in primary care: a qualitative interview study’. Br J Gen Pract. November 6 2017; bjgp17X693509.                  

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