To manage demand and improve efficiency
Before deciding to introduce an alternative to a face-to-face consultation you may wish to consider:
- What exactly is the problem you are trying to solve?
- Whether the use of an alternative to a face-to-face consultation is the best solution to your problem?
- That this is not a replacement for the face to face consultation but complementary
- An alternative to a face-to-face consultation is a learning process, it might take time to embed and could develop organically which might include finding more uses than originally expected.
- Even if an alternative to a face-to-face consultation is not time saving, there may be other benefits.
- Commercial interests are at play and people are selling products.
- Is this driven by the availability of funding to trial something for free?
- You might require support and guidance from other institutions such as the Medical Defence Organisations (MDOs) and Clinical Commissioning Groups (CCGs) or Health Boards
Rationale
Many practices are facing increasing demand that they are unable to accommodate. Your reception staff and phone lines maybe overwhelmed. One of the reasons that some practices consider introducing an alternative to a face-to-face consultation is to manage this demand by improving efficiency. This is with the expectation that this is likely to lead to a reduction in workload, or better access without increasing workload.
If this is the reason that you are considering introducing an alternative to a face-to-face consultation then you may wish to think about the following:
- That each rationale is not mutually exclusive.
- Who is driving the change; is it individual practitioners, local/national (centrally mandated such as 5 year Forward View)/or commercial drivers?
- Is the whole team behind this, or is it driven by just one or two enthusiasts?
- Which alternative to face-to-face consultations are you considering/would provide the best medium in your situation?
- What kinds of consultations do you envisage will be managed using an alternative to a face-to-face consultation for?
- How will you ensure that patients use it for the purpose its designed for?
- Can you afford it/what is the cost?
- Do you have the appropriate infrastructure/would you need to make changes?
- How exactly will the use of an alternative to a face to face consultation reduce workload and improve efficiency? What assumptions are you making?
- What might be the unintended consequences of changing the system? How can you reduce these risks? How can you tell whether or not they are happening?
- Although the intention is to reduce workload, if not introduced carefully, it could lead to additional GP work. How will you mitigate this risk?
- How will you assess whether the new system has actually improved efficiency?
- How will you record/integrate the consultation in the patient records?
- What impact will it have on your staff?
- What about information governance?
- What about clinical governance?
- Is this what your patients want?
- How will you inform patients?
- Will your patients seek help elsewhere to a greater or lesser extent? What do you anticipate will be the impact on the local A&E department and GP out of hours service?
The main attraction was to try to keep people away, to give GPs more time. That probably sounds a bit perverse, but it is a way of saying to GPs that you don't have to see people face to face. So it is changing that culture as well as the patient culture.
It’s easier for us, it’s much more time efficient to phone a patient and often more convenient for them as well.
It was done to try and reduce pressure of face-to-face appointments.