The Desire for Digital Access in Primary Care


In October 2021, NHSEI published plans on how it would improve access for patients, and support GP practices in doing so. One of the commitments made was to ‘commission an additional QOF improvement module, focused on optimal models of access including triage and appointment type’. This QI module aims to complement the work already being delivered in practices, and the work being led through the National Access Improvement Programme. However, with the increased demand for appointments it is more important than ever for practices to utilise their existing resources to meet demand. Practices should be looking to optimise use of the multidisciplinary team and wider primary care services, alongside the use of care navigation, and triage to ensure access to care is equitable. Our new digital support programme, EDATT, will support automated navigation to wider primary care services, which could be directly bookable, and support self referral options via digital tools; websites all accessed initially via the telephone. Supporting practices and PCN’s to deliver QIOA011 and QIOA012.

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Having read the Fuller Stocktake Report (May 2022) – ‘Next steps for integrating primary care’, and being armed with our primary care knowledge, and experience, we are confident there is a solution to deliver the recommendations in the Fuller report – ‘to improve experience, access & outcomes along side improving the digital literacy of patients and the public’.

The opening paragraphs from the Fuller Stocktake Report (below) encouraged our team to look at how the recommendations could be realised using the data and feedback from national and local staff, and patient surveys. Working with the innovation and resourcefulness of primary care staff and the eagerness of the public and patients to once again see the NHS as it should be, ‘The flagship health and care service delivered at point of need across England’.

Fuller stocktake Report May 2022 pg 2

‘Inadequate access to urgent care is having a direct impact on GPs’ ability to provide continuity of care to those patients who need it most. In large part because of this, patient satisfaction with access to general practice is at an all-time low, despite record numbers of appointments: the 8am Monday scramble for appointments has now become synonymous with patient frustration. Improving the experience of accessing primary care is essential to restoring the confidence of the public.

Fuller stocktake Report pg 30 May 2022

“Following COVID, there is a “belief that we (The NHS, patients and public) can use digital and technology much better than before”

While the Fuller Stocktake Report is not specifically ‘digital’ focussed, the recommendations lend themselves to reviewing how digital can be further exploited to deliver improved access to services across the board.

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National and local evidence

Patient and staff surveys carried out across multiple Buckinghamshire PCN’s, by Hanley Consulting, during 2022 captured both quantifiable and verbatim data. The verbatim evidenced the frustrations that patients endure in attempting to ‘become’ digitally enabled. The eagerness to avoid the 8am telephone scramble or being number 28 in the queue, just to find out the results of a recent blood or urine test was clear. Not only does the delay waste patients’ time and increase frustration in accessing services but also puts increased pressure on the reception staff, who are continually having to apologise for the long waits, and in many cases still not being able to resolve the caller’s query. Many survey respondents highlighted the fact that they were calling the practice as they were having problems in registering for, or accessing, online services.

Hanley Consulting Patient Surveys

Buckinghamshire PCN’s commissioned Hanley Consulting to carry out staff and patient surveys during May 2022 – July 2022. The responses caused us (Hanley Consulting) to look at how digital access to primary care could be improved and how patients could be better supported to become digitally enabled.

Read more about our Patient Engagement Surveys here.

The idea was simply to look at the patients default method for accessing primary care and offer the patients alternative digital channels at the point of access and need.

The graph [below] shows 88% of patients, who responded to the NHS England patient survey 2022, defaulted to the traditional access route of the telephone when accessing the GP Practice. Marrying this up with the telephone call queue messaging in the practice, we see that patients would benefit from being ‘nudged’ across to the digital tools, digital tools that 50% of the population said they have access to and of the other 50% that didn’t have access, 40% said they would like digital access but didn’t know they could, or how to get access (see PCN local surveys Figure 2, also below).

NHS England Patient Survey 2022

Digital Tools

Many ICSs are rolling out new digital tools across GP Practices, PCNs and Federations, with these ‘new’ digital solutions comes much more functionality that can be utilised to support the redirection and education of patients around digital access; improving digital literacy.

Hanley Consulting have been working with practices to understand the digital tools at their disposal, including the much under-utilised new VOIP telephony systems, and helping the practices to get the most out of everything available to them. Using the technology to not only improve patient digital access but to also help the practice staff manage demand efficiently, pushing patients online where appropriate, and driving a change in behaviour. 

The Proposal

Practices nationwide are experiencing high levels of recruitment and retention issues, escalating complaints, and patient dissatisfaction, all evidenced through national and local staff/patient surveys, and social media reviews.

Earlier we explained how Hanley Consulting used the data gathered to devise a proof of concept framework that is now being delivered into numerous GP Practices; to relieve the pressure which has been leading to burn out amongst clinical and admin staff. Digital literacy regarding healthcare tools can be improved, telephone demand reduced, and more patients self-serving where possible.

Hanley Consulting have developed a solution to support patients and practices to access services digitally and improve digital literacy across the registered population. This solution reflects requirements set out by NHSE in the PCN Development Programme.

    • Make sure practices are using the latest technology to offer more telephony lines
    • Monitor call response times
    • Offer support with the NHS app and local online consultation tools

Figure 2 - Bucks responses PCN patient survey

The Solution

For information on the solution Hanley Consulting provide to the issues raised above, please email [email protected].

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