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The hybrid GP: Protecting patients and practitioners

By Dr Murray Ellender, Practicing GP, CEO and Co-Founder, eConsult 

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Dr Murray Ellender, Practicing GP, CEO and Co-Founder, eConsult

Eighteen months ago, businesses were forced to quickly embrace remote working models, as the typical office commute was turned on its head. Perhaps to many people’s surprise though, this period of change made it apparent that combining the best of the digital workplace and the physical workplace is the future. But questions have been raised as to what this hybrid working model could and will look like for the general practice, a sector that has traditionally relied on face-to-face meetings for everything.  

GPs are experiencing new workplace challenges as a result of the COVID-19 pandemic. In fact, according to the latest data from NHS digital, demand for GP services is quickly outstripping capacity. Figures released by NHS digital highlighted that in June 2021, GP appointments were up by 3.5 million, excluding vaccinations, compared to May 2020. The health service faces a challenging winter ahead, with no one truly able to predict the impact that the unlocking of the UK will have on the spread of coronavirus, norovirus and the flu. To manage any potential increase in pressure, more consideration needs to be given into how GPs will get the support they need to manage rocketing demand.  

Over the course of the pandemic, the primary healthcare sector has been forced – somewhat out of necessity – to embrace more digital ways of working. Electronic prescriptions, the ability to remotely access clinical systems securely via Virtual Private Networks (VPN) and the adoption of digital triage services have been transformative for both GPs and patients during a particularly straining time. 

The potential of these technologies is evident. GP surgeries need to adopt the platforms and technology that support them in delivering the ultimate patient experience, whilst enabling them to embrace hybrid working.  

Digital triage is here to stay 

The rise in implementation and demand of digital triage since the pandemic has been evident from the number of online consultations being carried out. For example, at eConsult, we went from 130,000 online consultations across 1,200 practices in February 2020, to over one million across 3,200 practices in the same month the following year. 

For many surgeries, digital triage may have initially felt like a temporary measure to serve patients that couldn’t make it into the surgery as a result of COVID-19. However, digital triage is emerging as a long-term solution to supporting GPs in embracing hybrid working. With digital triage, GPs can send messages via email/SMS to their patients – including prescriptions – delivering personalised information that the patient can trust. However, it is important to note that the point of digital triage is not to remove face-to-face consultations altogether. In-person appointments will always play a critical role, especially for more complex or urgent cases. Instead, digital triage is intended to remove the ‘noise’ – hay fever, blood tests, repeat prescriptions – and is set up to empower GPs to dedicate more time and headspace to the more complex patients that need face-to-face appointments. For patients, digital triage ensures that the patients who need to be seen, aren’t stuck in a long phone queue at 8am desperately trying to get through before their day starts and that they actually get support quickly.  

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Embracing eHubs for additional support  

In instances where demand becomes particularly high in a specific region, we’re seeing some GPs embrace outsourcing in order to allocate resources to where they are needed the most. 

This doesn’t just mean hiring remote doctors as we recently saw with the Ranworth Surgery in Clacton-On-Sea who opted to hire a part-time remote GP after struggling to find a traditional salaried GP. But there’s a real opportunity for GP surgeries to embrace eHubs. In this context, these are online systems for delivering digital and traditional primary care across primary care networks (PCN). The first model eHub which was set up by The Hurley Group offers PCNs the chance to reduce the crushing workload from the pandemic by working together to resolve patient issues that don’t necessarily require face-to-face consultation. It’s important to note that the individuals resolving the patient query don’t just have to be GPs, but can be skilled primary care specialists such as nurses or pharmacists, further alleviating the pressure.  

This is a revolutionary idea that delivers patients the care they need in an efficient, safe and timely manner by empowering GPs to seamlessly deploy a remote workforce at a time of critical need. If we take The Hurley Group’s eHub as an example, over the course of 10,000 online consultations, a remote closure rate of 86% created an estimated saving of more than £82,000. This is an exciting model for GP practices across the country to explore, but it’s success will ultimately rely on robust training and dedication to the building of experience within the team. 

The future of the General Practice  

As life returns to some form of ‘normality’ and we learn to live alongside COVID-19, the operation of the General Practice should not return to normal. Normal means overflowing waiting rooms, the 8am phone call lottery and no flexibility for GPs. Instead, if we want to give our GPs the support they need and ensure the delivery of a high standard of care, embracing technology and using it to its highest potential will be critical. The end goal should always be more time with the patients who need it the most, and a flexible approach to work for our NHS heroes. 

As healthcare innovators look to sustain or build upon the digital transformation that the pandemic encouraged, smart technology should be utilised to make hybrid working successful in General Practice. It is now recognised that cloud-based, SaaS models offer a pathway to innovation, giving GPs the support they need to deter burnout and offering patients access to efficient care. And, most importantly helping an organisation to thrive in times of crisis. 

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