View from the ground, by Dr Murray Ellender
Pressure on GPs has risen dramatically over the past year. Already substantial daily workloads have been intensified by the added task of safely distributing the COVID-19 vaccine to local communities.
As a GP myself, I have seen the heavy toll that the COVID-19 pandemic has had on the profession. Responses from a recent British Medical Association survey of members revealed that almost 50% of respondents, including GPs, were experiencing a work-related mental health problem such as burnout, anxiety, stress, depression, or emotional distress, and 40% said their condition had worsened throughout the course of the pandemic.1
One route that CCGs, primary care networks (PCNs), and GPs are exploring to help tackle spiralling workloads in primary care healthcare is digital triage. It enables GPs to offer online consultations via their practice website, and allows patients to submit their symptoms or requests to their own GP electronically. It can also offer round-the-clock NHS self-help information, signposting to various services, and a symptom checker for patients.
The rise in demand and implementation of digital triage since the start of the pandemic is evidenced by the number of consultations being carried out online. For many surgeries, the concept of establishing digital triage can seem daunting and time-consuming, despite being more time- and cost-efficient in the long run. There are, however, five key considerations that can help to make this journey pain-free.
1. Bring your whole team on the journey
As is the case for most business processes, unless everyone in the company is invested in making it work, it won’t. Some people embrace change more readily than others, so it is vital to take the time to ensure all members of staff are on board with the concept.
2. Choose a trusted and experienced service provider
Different digital triage tools operate in different ways; it is crucial that services provide the safest process for both staff and patients—and their data. It is vital to read the privacy policies of potential providers to understand what staff and patient data may be stored.
Some digital triage tools only provide a free-text box service. This leads to the risk of patients entering symptoms that are poorly articulated, which is counter-productive and leaves practice staff even busier. Patient safety may also be a concern, as free-text boxes do not flag alarming symptoms, and are unable to signpost patients to more appropriate, urgent treatment when needed.
3. Educate the local community
Keep the local community actively informed and consulted about the changes being implemented. Older and more vulnerable patients who may not have access to digital devices or the ability to take full advantage of the service will need extra attention. Providing education and guidance, as well as facilitating opportunities to ask questions and raise concerns, helps build relationships and will encourage use of the new service. Involving patient participation groups by tapping into existing communities and via social media may also help to explain the benefits of this new tool.
4. Implement a comprehensive training programme for practice staff
Committing time and resources to a comprehensive onboarding and training programme enables staff to use the service effectively. It is important to arrange internal workshops and forums to allow both clinical and administrative staff to discuss issues and resolutions openly and together.
5. Convert inbound calls into online consultations
When digital triage services are introduced, many patients continue to ring the surgery through force of habit. Educate your community on how the service can ensure patients get the right care, from the right person, as quickly as possible. Encourage reception staff to direct patients to the online tool and explain its purpose, and distribute promotional leaflets to help convert inbound phone calls into online journeys.
Embracing digital triage services, and following the considerations above, allows surgeries to provide the most effective care for their local community without increasing the burden on overworked GPs.
Dr Murray Ellender
GP and Chief Executive of eConsult
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1. British Medical Association website. Pressures in general practice. www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice (accessed 11 August).