An app a day doesn’t keep the doctor away

By Sara Rainwater, operations director 


The coronavirus has left a mark on every part of our country, not least the economy and, of course, the NHS. With Nightingale hospitals put up almost overnight and hundreds of thousands of staff drafted onto the healthcare frontline, the health service may have changed more in these 3 months than it has in the last 3 years. Nowhere more so than in the use of technology. 

In our 2019 report, launched by the current health secretary Matt Hancock, we explored “how embracing existing and developing technology can enable the health and social care system to increase productivity, reduce costs, and result class health and social care”. The use of tech in medicine can make patient experiences faster, easier and better - and therefore save money for the NHS and the taxpayers that pay for it.

We could be on the cusp of a tech revolution. 79% of adults in the UK have a smartphone and 93% of UK households have internet access. It is therefore unsurprising that the public do not fear further technology in healthcare, with patient attitudes generally very positive, as you can see on page 22


Technology and the NHS

The most obvious symptom of this has been the adoption of apps. In 2018, the NHS app, developed by NHS Digital and NHS England, was launched and made available for smartphones and tablets. This app allows patients to save frustrating hours trying to organise medical appointments and information. We can now easily order repeat prescriptions, manage appointments, check symptoms and view GP medical records, amongst other things. Former health secretary Jeremy Hunt called the app “the death-knell of the 8am scramble for GP appointments that infuriates so many patients”. Just as usefully, it frees up time for a significant number of staff who, when these scrambles are done manually, have to be at the other end of the phone. Connection to the NHS app will, in time, be mandatory for all GP practices. 

Another important new feature within the NHS app is eConsult, a digital triage tool which “enables NHS based GP practices to offer online consultations to their patients”. An initial roll out of eConsult to 1,200 GP surgeries was due by the end of June 2020. Finally, the NHS seemed to be slowly moving in the right direction, with a commitment to embracing tech as a method to improve patient experience and care. 


The coronavirus crisis intervenes

Skip back, though, to March of this year, when the coronavirus pandemic reached our shores. Life as we knew it suddenly changed as the nation locked down. GP practices were trying to work out how to safely provide regular, ongoing care for non-covid-related medical issues. Traipsing into the GP’s surgery for every little niggle was clearly no longer an option.

Cue tech, stage right. 

In an article for Business Cloud, eConsult’s strategic director, Dr Mark Harmon, states: 

“Before the crisis, approximately 70-90% [of] patients in primary care were seen face to face. Now that has been turned on its head and 90% of patients are treated remotely. The current crisis has stimulated innovation and accelerated the adoption of digital as an enabler to assist in clinical decision-making and diagnostics. It has definitely moved the acceptance and adoption of digital triage forward a number of years, in a matter of weeks.”

Tracy Higgs, product lead at NHS Digital, goes on to say, “Those [initial eConsult] targets are already in the rear-view mirror. By 30 April 2020, eConsult was available through the app to more than 2,200 practices, covering 20 million patients.”

Necessity, in this case, has been the mother of speeding up invention. 


The situation in Sutton

The fact remains though that most people engage with the health service via traditional means, as opposed to these new apps. If I’m honest, I had only vaguely heard about the NHS app, and didn’t even know the eConsult tool existed until researching for this blog. My GP practice has not promoted the NHS app and is not one of the 2,200 that have linked up with eConsult. (They have, however, been using the My GP app - listed in the NHS app library - for a couple of years, which provides an excellent appointment booking and repeat prescription service.)  

Lockdown for my GP practice has meant using a much simpler form of technology - Alexander Graham-Bell’s telephone. It may not be the fanciest, but it's worked. Over the past three months, my family of four has booked no less than five telephone consultations with our GP through the My GP app. On each call, we have received excellent care, and been triaged appropriately. When the GP has deemed it necessary for us to attend in person, we have been able to do so safely. 

My youngest child has even been referred to a specialist at our local hospital during lockdown. Our initial appointment was over the phone, where we talked through the situation in detail and arranged for a follow-up appointment in hospital. The consultant was thrilled that we had managed to get through on the phone what normally takes up the first 15 minutes of a face-to-face appointment. This will significantly reduce the amount of time my son and I need to spend in the hospital for the follow up, meaning time saved and even better, reducing any potential exposure to coronavirus. Also, despite social distancing measures affecting how they schedule her clinic, the consultant may actually be able to see more patients per clinic, by significantly reducing face-to-face appointment times. 

I’ve no doubt my family’s positive lockdown experiences have been replicated up and down the country. And the benefits of opening this up to more patients would be profound. 


What can we learn?

It would be a good thing for patients and taxpayers too. Moving to more telephone and virtual consultations could significantly reduce the number of did not attends (DNAs) with GPs, which costs the NHS an estimated £216 million a year. That’s around 7.2 million GP DNAs at £30 a pop, which could pay for 8,424 full time community nurses.

The recent waste of nearly £12 million on the failed covid tracing app is a stark reminder, though, of the government’s less-than-stellar IT record. Politicians must not shy away from a decentralised approach. EConsult, My GP and a host of other medical apps and tech have all been developed by the private sector, where R&D is light years ahead of anywhere the government could be. 

So what are the important takeaways from all this? 

  • That tech already in the pipeline can, and should, be sped up.
  • That simpler, existing technology can, and should, be better utilised. 

  • That patients can, have, and will adapt to using new technology to manage their healthcare. 

  • That patients can still receive excellent primary care, without the need for face-to-face appointments. 

  • That secondary care can, and should, use existing and new technology to improve patient care as well. 

The momentum for change is there, and the NHS must keep it’s foot on the gas, because embracing tech in healthcare more wholeheartedly can only make things better. When the NHS is better run, it means taxpayers get the top-quality frontline service they expect at better value, meaning they keep more money in their pockets as well as getting improved treatment. Technology could still yet turn out as a miracle cure for the health service.

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