How has the pandemic changed the delivery of primary care?

Published on 27 July 2021 at 15:15

By William Hallowell | Editor 

The Covid-19 pandemic has seen unprecedented change. Not just for society, but for health, and the delivery of healthcare services across the NHS. Whilst for some it has been the worst period of their lives and for their careers, there has come some good, which will inevitably transform how GP surgeries will consult their patients across the country for good.


Before the pandemic GP surgeries either mostly or completely delivered primary care to their patients via face-to-face appointments, however some were beginning to use over-the-phone consultations. Due to the first initial lockdown, and second and third ones that followed, surgeries have become almost entirely reliant upon having appointments over video calls, online consulting, and over-the-phone triage.


Taking one example: ‘AccuRx’. This is a purposefully designed clinical system that enables easy video consultation, whereby GPs can send a link to their patients to facilitate an appointment. Though it has not been utilised nationally, surgeries have had the option to deploy it at the expense of their respective CCGs. The system is NHS Digital approved and conforms to data protection. Whilst it is not used by all practices up and down the country, there is pragmatically no reason why it can’t be, moving forward past the pandemic. This will essentially evolve the delivery of primary care services, ideally indefinitely, because it cuts out the factor of time significantly.


Discussions over whether to implement such systems across the NHS have happened for years, and it has not been enacted upon; Covid-19 has acted as a facilitator for doing so. Various wars throughout the nineteenth and twentieth centuries have been revolutionary in assisting the progressing of science – this pandemic is merely a contemporary example. From the perspectives of both the GP surgery and the patient, it seems completely practical to implement such technology nationwide – at least for less serious triage.


Another tool that has been used by GP surgeries is ‘eConsult’ – an online system which allows patients to contact their practice regarding pre-existing illnesses/conditions and advice about potential new ones. It is a system that CCGs have been encouraging practices to use, and the pandemic has meant that both practices and patients have become more reliant upon it, and like AccuRx, it is a third-party software paid for by CCGs. Though only a small sample, this is evident with a surgery in Hampshire – Ringwood Medical Practice, which has 11,200 patients – that received less than 10 eConsult forms a month prior to the pandemic; now they receive 80-100 a month. Like AccuRx, and whilst other surgeries across the UK may use slightly different products, the concept of video and online consultation leaves open the possibility for more time and fiscally efficient delivery of primary care services.


These changes to primary care at GP surgeries are almost inevitably indefinite, and there is good reason for this. For appointments that may take less than or up to five minutes it seems impractical for patients to travel to their surgeries when a simple video consultation can be arranged – particularly when taking into account urgent/late medical issues in the day. Going forward, there is little reason, pragmatically, why such services provided by products like AccuRx and eConsult cannot be brought to the forefront of how GP surgeries deliver their primary care services – concepts which have proved transformative in times of crisis, and that could prove to be incredibly beneficial to the NHS by being used for the foreseeable future.  


Image credit: William Hallowell, The Right Report UK 


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