by Dr Murray Ellender

Leading superpractice plans to phase out unnecessary face-to-face consultations

In this week’s Pulse, Carolyn Wickware writes:

A leading superpractice – which counts NHS England’s primary care lead among its GP partners – is planning to only offer patients face-to-face appointments where necessary, with the remainder to be dealt with via its eConsult online system.

As part of the plans, the Hurley Group in attempting to double the number of GPs employed to do online consultations over the next six months.

The eConsult system allows patients to submit their symptoms to a GP electronically, as well as offering around the clock NHS self-help information, signposting to services, and a symptom checker.

The Hurley Group’s eConsult team said its recruitment campaign comes as more GPs are needed to manage the growing number of online patient contacts, which has doubled in the last year.

The expansion also aims to incentivise GPs to stay working at the 100,000-patient practice instead of leaving to join private online GP consultation companies, it told Pulse.

The superpractice, whose partners include NHS England primary care director Dr Arvind Madan and former RCGP chair Professor Clare Gerada, developed eConsult in 2013, with 12 GPs now consulting patients through the system.

Dr Murray Ellender, GP partner at The Hurley Group and co-founder of eConsult, told Pulse: ‘Ideally, over the next six months, I’d like to double the size of that team – that’s the plan – and start to take more and more stuff online.’

Dr Ellender said the long-term plan is to only see patients in person where necessary.

He said: ‘Then we will only see the patients we need to see face-to-face, face-to-face. Often then, we can give them longer. If we take enough patients online, it frees up time in practice.’

He added that, last month, the practice saw 1,158 online consults and avoided 695 face-to-face appointments across 14 of the Hurley Group’s practices.

He also said the ‘volume of online consults doubled in the past year, hence the need to expand the eHub team’.

This comes after Pulse revealed that e-consultations are resolving ‘40-60%’ of patient ailments without a face-to-face GP appointment.

However, several studies have been released in recent months, calling into question the safety on online consultations and disputing that it lessens GP workload.

But Dr Ellender added that the GPs hired to work in the eHub ‘can work from home’, which he said is ‘good for recruitment and retention’.

He said: ‘We don’t start that at the beginning. We get them working in the hub first.

‘We train them up and make sure they’re confident and comfortable but then there is the option for the GPs that have been doing it for a little while to do shifts from home.’

He added that the profession is losing GPs to private online companies ‘because they offer something different’.

He said: ‘So this is us trying to retain those GPs within the NHS by offering them a similar sort of package.

‘They can work as part of a team, they can work remotely, they can potentially work from home but keep them within the NHS. So it’s for us to protect ourselves against that loss into those providers.’

NHS England offers practices funding to run eConsult through the £45m GP online consultation systems fund. However, Dr Madan previously told Pulse that he was ‘no longer involved’ with eConsult after taking up his position with NHS England in 2015.

The full article was first published in Pulse on 15 June 2018