* Please provide a brief outline of your work.
Primary care is struggling to cope with unprecedented demand and more complex patient needs. Pressure on services is exacerbated by unnecessary attendees (who should be seen elsewhere) and others unable to make appointments. Our solution uses a digital platform, improving patient access to healthcare, directing them to the most appropriate care, reducing the need for appointments and increasing efficiency for clinicians and administrators.
Patient contacts their own GP, answering a set of questions relevant to their symptoms. GP (who has access to electronic-medical record) triages patient remotely, offering the most appropriate care (prescription, follow-up call, face-to-face appointment or general advice).
* Please describe the actions you took to achieve your result.
Involvement
The platform was developed in 2014 by NHS GP partners to address issues of access weighed against demand within their group of practices.
The product has been constantly evolving with the input from key stakeholders:
NHS clinicians
- 7 GPs and 2 Senior Nurses in core team
- Governance by 26 UK clinicians including GPwSIs, trainers, academics and leaders in emergency medicine, ITU, psychiatry and dental
- Syndicated with NHS Choices (self-help)
- Regular Expert Group meetings with 10-12 clinicians and senior NHS managers
- Design workshop for primary and urgent care
- Surveys/ interviews with customers (including practice managers, GPs, nurses) NHS administration team
- Design workshops for primary and urgent care platform involving multiple stakeholders
- Surveys/interviews with customers
- Feedback from CCGs and Federations Patients
- Patient Participation Groups, Patient Councils and Patient workshops
- Ongoing patient survey with >20k responders
- Design workshop for primary and urgent care platform involving multiple stakeholders
Development technology experts. A group of senior GPs and academics, software programmers, website user experience experts and input from Design Council, Patient Participation Groups and NHS Choices.
- In-house development team of eight experts in product creation, product management and user experience/interface
- Design workshop for primary and urgent care platform involving multiple stakeholders
Cost Since 2013 we have invested £1.2m to get us to this stage, covering both technical development and significant clinical input into the content of the platform.
Value
- Improved patient service: Patient consults with GP from home, 24/7 with response within 48h (access + convenience).
- Improved efficiency: signposting to most appropriate channel, prioritisation of appointments, remote closure (reduced time needed to review patient’s case), self-help system and financial savings (~£13 per patient).
- Improved efficiency/flexibility of admin team: decreased calls to the practice allows administration team to improve productivity.
- Wider range of services offered to patient: GP is able to access the patients’ medical history, it is possible to manage more complex, chronic and complicated patients. This means eConsult allows the GP to deal safely with medical administration tasks, refer patient to secondary care, deal with mental health and other clinical areas.
- Product is safe: eConsultations are reviewed by GPs and system offers red flags to immediately redirect patient to most appropriate channel.
- eConsult is user-friendly: used by diverse age group, with high satisfaction rate (>80%)
- Data is secure: via NHS server
* Please list the most significant results
- eConsult grown to 402 practices (UK) within 4 years (~5% market share)
- ~68% of eConsultations solved remotely, enabling savings of ~£13/patient
- eConsult resulted in estimated ~£850k saving in 2016, expected ~£1.5m in 2017
- eConsult improves access to healthcare offering 24/7 care and 48h response (cf. average 2-week appointment wait-time)
- >90% of practices would recommend eConsult, claiming it benefited patients (improved access and convenience), admin team (increased efficiency & flexibility) and clinical team (increased headspace, reduced time needed to review patients’ cases and costs)
- ~80% of patients satisfied with service, will return and recommend it
* Describe how your project has spread to other teams, departments or organisations
eConsult has spread from Hurley Group practices to currently 402 practices across UK (England, Wales, Scotland) meaning that over 3m patients can use it.
eConsult now links Primary and Urgent Care, enabling a rapid and effective see and treat model using
• online registration
• pre-history collection
• automated BP/pulse/temperature/O2 sats
• intelligent clinical risk stratification
eConsult worked with Bexley Urgent Care Centre and local general practice to develop an integrated platform for urgent care. eConsult partnered with Evergreen Life to add personal account management tools (online booking, access to records) via one platform, now providing the NHS Online app.
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