“In order to give patients the service they need, we have to find a way to manage demand, and eConsult helps us do that.”
Falmouth Health Centre Practice wanted a better way to manage demand, but they also wanted to be sure to meet patient expectations with any new solution. Electronic consulting has helped them do just that.
With six GP partners, a nursing team of four and 14 reception staff, Falmouth Health Centre Practice in Cornwall serves a population of just under 9,000. It’s a mixed demographic in a predominantly urban setting.
Facing the challenge of managing demands on GPs’ time in a way that would still fully support patients led Falmouth Health Centre to consider electronic consultation as a possible solution, explains Geoff Dennis, practice manager. “When our CCG suggested a trial of eConsult, we were very enthusiastic. One of our problems was being able to balance patients’ expectations with doctors’ availability. Incoming phone calls were going through the roof, and patients didn’t know there were other ways they could access the help they needed, so GP appointments were in heavy demand, with a wait of 10-14 days for routine issues.”
Implementing eConsult at the end of February 2016, the team at Falmouth Health Centre found that patients responded really well: “One of the first impacts we noticed was the reduction in incoming calls, because people who were using eConsult were not phoning us,” says Geoff, “when a patient does need a call back following an eConsult, we can call them at a time that’s more convenient to us, rather than having to react to an incoming call without having all the information to hand.”
Geoff was encouraged when analysis of nine months’ eConsult statistics in January revealed that only 35% of eConsults had been converted into appointments, with the rest being dealt with in other ways. “The self-help function is well used by patients and it’s helping them find ways to help themselves,” he reports. Of the eConsults surveyed, 25% had been responded to by email – another benefit of the system from the practice’s point of view, and an option that does not open up a two-way communication channel with the patient, which could add to workload rather than reduce it.
Geoff’s positivity seems to be echoed by patients. The practice’s local Healthwatch carried out a detailed survey to find out what patients thought of eConsult and, he says, “Overwhelmingly patients were exceedingly positive; so much so that we’ve used a lot of their testimonials in our marketing.”
Spreading the word
Like other practices that have implemented eConsult, Falmouth Health Centre found that promoting the service before it went live, and continuing to promote it throughout the trial, has been essential in influencing uptake. “There’s no point in implementing it and waiting for something to happen,” says Geoff. “Everyone has to be selling it. Receptionists need to ask patients if they know about your eConsult service when they come in or telephone the practice. If you have a patient group, it’s vital to get them on board too.
“We made sure it was all over our website and we pushed it heavily on Facebook. We also put posters up and displayed a message about eConsult on our TV screens, but we found the single biggest driver was when we changed the welcome message on our phone system. Now, when you ring the practice, you hear someone saying ‘If you’ve called for a GP appointment, have you thought of using eConsult?’, and then explaining how to use it. After we’d done that, our eConsult stats really took off.”
More choices – happier patients
Falmouth Health Centre found the data provided by eConsult particularly useful. “Analysing the stats really helps us improve our service. We found out a lot more about our patients too.”
“Many of them don’t actually want a call or an appointment – they prefer a remote consultation or getting advice via email.”
The data also provides a good guide to who is using eConsult and how they benefit from it: “Usage is pretty good across all age-groups. Although the highest users are under 65, we have plenty of older patients who use it,” says Geoff. “Sometimes people find eConsult helpful when there are things they find difficult to articulate. It can be easier to write about your problem than talk about it.” He is dismissive of claims that electronic consulting favours the more affluent: “I think it benefits people who might not have online access, as well as more vulnerable groups like the very frail or elderly, because it keeps the phone lines clearer for those who really need to contact us in that way.”
Preparing for success
Geoff says the practice had no difficulties in implementing eConsult, although he cautions that it’s vital to prepare for the impact of a new system. “We made sure we thought about how to manage it in the practice ahead of the pilot. My advice to others thinking of implementing eConsult is don’t make it fit in with what you do now. Instead, ask what you can do to make it work without having a massive impact.”
Wherever possible, responses to patients are sent via the eConsult messaging service. This is not done by a GP – the idea is to free-up GPs’ time, so reception handles it wherever possible.
Like primary care providers up and down the country, the team at Falmouth are facing several challenges. “Demand has gone through the roof yet the number of GPs has reduced and we’re finding it really difficult to recruit,” explains Geoff. “I don’t think doctors see it as an attractive career anymore. The pressures on them are enormous.”
However, he’s optimistic that electronic consultation makes a difference: “Patients are coming round to seeing that this is a useful way of interacting with their doctor. It’s not always necessary to sit in front of your GP to have your health issues dealt with. In order to give patients the service they need, we have to find a way to manage demand, and eConsult helps us do that.”