View from the ground, by Dr Murray Ellender
Once again, the growing backlog of patients waiting for NHS care has made the headlines. On 10 May 2022, the Queen’s speech pledged that the Government will continue to ‘fund the National Health Service to reduce the COVID backlogs’,1 addressing plans to tackle the long waiting lists of individuals whose treatment has been delayed by the pandemic.2 The reforms that will facilitate this Elective Recovery Plan are long awaited; patient satisfaction in the UK at its lowest level for 25 years, and waiting times for GP and hospital appointments was the primary reason given for this dissatisfaction.3
The problem is compounded by the fact that growing waiting lists have a negative impact on patients’ mental health. In a survey of 2005 respondents conducted by Censuswide for eConsult on 9 and 10 May 2022, 61% of those surveyed said that increased waiting times have caused them heightened feelings of stress and/or anxiety. This relationship between soaring waiting times and increased stress levels existed even though 84% of the respondents said that they understood the pressure NHS workers are under.
Given that waiting lists currently show no sign of decreasing, it is understandable that patients are feeling frustrated and clinicians are experiencing burnout. Although it is great to see that reforms are being put in place to address the situation, more needs to be done. COVID-19 exposed flaws in the health service, such as the broken patient pathway.4 We can improve the patient experience by ‘joining the doors’ between the different entry points to the health system—helping clinicians to decide which patients to see and how and when to see them, and ensuring that patients receive the right care in the right place.
Future-proofing the health service
To improve patient satisfaction, it is necessary to look beyond hiring more staff. We should be doing more to protect those already working day in, day out to care for the UK population.
To reduce burnout, GPs must be able to prioritise the care of those who need it most urgently, and direct others to the most appropriate healthcare professional. To do this, GP practices need technology that enables them to route patients safely, efficiently, and directly to the right point of care. At the start of the pandemic, when GP practices were trialling the exclusive use of video consultations, I quickly discovered that video alone was ineffective—patients still needed the same 10 minutes with a doctor when on a video call as they did in person, so there was no real time saved. Plus, it could take several of those minutes to connect with the patient in the first place, not to mention the time lost to technical issues throughout the call.
Digital triage is one way of ensuring that patients who need to be seen urgently can get rapid support, rather than sitting in a long phone queue first thing in the morning, hoping to get through before their day starts. With digital triage, messages (including prescriptions) can be sent from GP to patient via email or text message, delivering personalised information that patients can trust. However, it is not the aim of digital triage to remove face-to-face consultations altogether; in-person appointments will always play a critical role, especially for patients with complex needs. Instead, digital triage is intended to direct patients with simple or routine requests (for example, blood tests or repeat prescriptions) to another healthcare professional, allowing GPs to dedicate more time to patients who need face-to-face appointments.
The benefits of increased digitisation
Digital tools can also help to improve the patient journey by recording a more detailed account of an individual’s story. In my opinion, greater uptake of technology in healthcare is needed to drive an increase in patient satisfaction. Until this is widespread and its benefits are felt, patients will continue to be filled with worry and frustration. Technology can give patients the ability to describe their symptoms, seek help online, and be seen by the right clinician. Knowing that they are being promptly directed to the right point of care will likely reduce feelings of anxiety and dissatisfaction.
Technology in the NHS must continue to evolve to keep pace with patient and business needs. Currently, eConsult is working with partners to develop technology that facilitates remote observations via a camera that picks up vital signs from a patient in the waiting room. Providing that digital transformation is recognised as key to satisfying, protecting, and caring for patients and staff, healthcare has, in my opinion, an exciting future ahead.
Dr Murray Ellender
GP and Chief Executive Officer of eConsult
- GOV.UK website. Queen’s Speech 2022. www.gov.uk/government/speeches/queens-speech-2022 (accessed 24 May 2022).
- GOV.UK website. Oral statement on the NHS Delivery Plan for tackling the COVID-19 backlog. www.gov.uk/government/speeches/oral-statement-on-the-nhs-delivery-plan-for-tackling-the-covid-19-backlog (accessed 24 May 2022).
- The Kings Fund, Nuffield Trust. Public satisfaction with the NHS and social care in 2021—results from the British Social Attitudes Survey. London: The King’s Fund and Nuffield Trust, 2022. Available at: www.kingsfund.org.uk/sites/default/files/2022-03/BSA%20Survey%20Report%202nd%20pp_0.pdf
- Ellender M. Tensions in general practice and A&E point to a system in crisis. www.guidelinesinpractice.co.uk/view-from-the-ground/tensions-in-general-practice-and-aande-point-to-a-system-in-crisis/456776.article (accessed 24 May 2022).