In light of the prioritisation of phone lines in the Government plans to help patients access GPs this winter, Dr Owain Rhys Hughes (pictured below), an NHS clinician and founder of Cinapsis, argues that the focus should instead be on introducing more-integrated digital systems which streamline patient referrals and reduce the administration burden
Resolving problems with GP phone lines are just the tip of the iceberg when it comes to improving access to primary care services
It was a welcome sight to see improving access to primary care services made such a priority in the Government’s Plan for Patients.
Yet the focus on making it easier for patients to book appointments by opening additional phone lines and setting targets for GPs fails to acknowledge a crucial truth: demand from patients currently far outstrips the capacity of primary care clinicians.
The maths simply don’t add up.
While GP appointments have risen by 35 million compared to 2019, a reported 42% of GPs are planning to quit in the next five years.
This exodus, which is already underway, will leave an increasingly-depleted workforce to treat an ever-growing number of patients with increasingly-complex needs.
And, no matter how many new phone lines we open, without enough clinicians, and the infrastructure to support them, waiting times will continue to grow.
As a doctor, I know that measures to improve patient access are a positive thing.
But they simply won’t deliver if we don’t balance the equation via an equal investment in boosting GP retention and improving clinical capacity by giving doctors, not just patients, better tools.
While the NHS staffing crisis is the driving force behind primary care pressures, the clunky tools GPs grapple with every day are not doing them any favours, either.
Already under immense pressure, GPs are facing a multitude of obstacles that get in the way of effectively organising patient care thanks to outdated digital infrastructure.
No matter how many new phone lines we open, without enough clinicians, and the infrastructure to support them, waiting times will continue to grow
From convoluted email chains and busy phone lines, to hand-written referral letters and the need to manually re-enter information into separate digital systems; primary care staff are being slowed down and forced to spend time on admin when they could be seeing patients.
One example of that impact in action is that most of the digital systems currently in use are ‘non-interoperable’; preventing information from being efficiently shared with other care services.
Without being able to ‘speak’ to each other, these systems work in silos, leaving clinicians unable to easily share key information and data with their colleagues.
For GPs, this can mean facing considerable delays in receiving the information needed to refer or triage patients, resulting in the need for multiple appointments and often slowing down access to care.
It is also a huge time drain. Having to repeatedly manually input patient data and grapple with outdated email or paper-based referral processes to organise care requires extensive admin, which eats into GP time.
To increase access to primary care, and tackle appointment waiting lists, we need to unblock GP capacity by removing this time-intensive admin and streamlining the channels of communication available to clinicians.
And simply deploying additional practice phone lines will not achieve this.
With hundreds of different digital systems in use across the NHS, prioritising the implementation of fully-integrated technology which will help these connect with one another is key.
Having to repeatedly manually input patient data and grapple with outdated email or paper-based referral processes to organise care requires extensive admin, which eats into GP time
This means introducing new systems which are designed to seamlessly integrate with those already in use.
We must hand clinicians tools which enable them to connect directly with their colleagues in other services.
Whether this is via direct electronic referrals, or advice and guidance systems which enable primary and secondary care clinicians to make shared referral decisions; providing access to real-time communication will significantly improve collaboration and speed up the organisation of care.
Through enabling cross-organisational communication and automating data transfer, digital integration can considerably help strengthen the primary-secondary care interface. This will not only streamline diagnostic and referral pathways, but it will also reduce the manual admin required by GPs, freeing up their time to spend on patient care.
When building the Cinapsis platform, we have always been conscious of the need for integration – and it is something we’ve factored in from day one, and continue to develop as the platform grows.
One of the ways we’ve done this is through integrating with the NHS e-Referral service (e-RS).
This has enabled our clinicians to seamlessly upload information from within an advice and guidance request made on our platform to a resultant electronic referral.
Until genuine digital integration is delivered within primary care, clinicians will continue to have their workloads compounded by time-intensive admin and communication silos
This is saving precious time for primary care clinicians by eliminating the need for them to manually re-upload this information once a referral decision has been made. Instead, it is automatically transferred to e-RS, enabling the referral booking team to arrange an appointment for the patient sooner.
Until genuine digital integration is delivered within primary care, clinicians will continue to have their workloads compounded by time-intensive admin and communication silos.
And, no matter how much easier it is for patients to reach their local practice via additional phone lines; without an equal increase in GP capacity, we will not make a dent in appointment wait times.
For now, policy makers must instead focus on supporting the implementation of fully-integrated technology to connect services and free clinicians of unnecessary admin.
Integration is key to unblocking vital capacity in order to meet rising demand and tackle growing backlogs as we head into a busy winter.