NHS England has just launched a consultation on the future of GP practices, with a slide set of the case for change and the NHS’s underlying objectives for general practice together with an evidence pack which provides some information about current general practice and health needs.
This is important to everyone who senses that modern technology can help make a real difference to the way care is delivered because there is a serious lack of ambition in the case for change, supported by an absence of key pieces of evidence.
Starting with the evidence, although there is much about appointments, there is for example no mention of the growth of online consultations. Entering phrases like ‘online doctor’ into search engines shows that many services are available, albeit primarily paid-for, including that provided in part by a reader and commenter to TTA, the 3G Doctor. However the Hurley Group, for example, with some 160 GPs in London, is said to provide Skype consultations as part of its NHS service and of course saying the right things to NHS Direct/111 will get a ring back from a doctor. The fact that some doctors want to make a charge for online NHS consultations should not distract from the huge benefit to the NHS that this now means for those GPs who for one reason or another want to work from home so are currently unable to practice.
There’s also no mention of the proliferation of smartphones with increasingly sophisticated apps that will start alerting users of problems they need to visit their doctor about. Nor is there any mention of the benefits of health coaching. Or of the one million-times reduction in the cost of genome mapping that has already taken place that is likely to introduce gene-specific prescribing into general practice. Whilst we believe it is unrealistic to expect patients to know the terminology, it is reasonable to expect mention in packs such as this covering the future of primary care of words such as telehealth, telecare, genetic and smartphone, yet, as confirmed by the search engine, they are absent.
Without the evidence, there is of course no case for change, with the risk that these issues will be ignored, as seemingly they were when the RCGP produced its recent vision of what a GPs will be doing in 2022 which we critiqued in our WSD soapbox.
The consultation says it welcomes suggestions for how to build and improve the packs. You are therefore urged to complete the survey (which does mention online consultations), the final page of which invites comments specifically on the above-mentioned slide-set. Also, email@example.com is keen to receive examples of local success stories.