Dr Chris Morris: COVID-19 and the remote GP revolution

A remote private GP shares his view

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Dr Chris Morris: COVID-19 and the remote GP revolution

Partner insight: The COVID-19 pandemic has revolutionised people’s perceptions of remote healthcare

A quiet evolution has been taking place in healthcare over the past 20 years, with patients gradually accepting remote GP consultations via telephone and video.

However, this evolution has been slower than I anticipated. A few years ago, my fellow GPs and I tried to move our NHS clinic to a telephone-triage system. Our aim was to only see people face-to-face when it was necessary because we believed the majority could be helped over the phone. However, our plan met with some resistance and patients were reluctant to accept it. Since then patients were slowly increasingly willing to speak with a clinician by phone, but only if there is no alternative and most wanted to see a doctor face-to-face.

With coronavirus (COVID-19) this has all changed. People have no option but to have remote consultations if they want to talk with or be assessed by a GP, and they are discovering how effective this can be. The evolution has become a revolution.

We have seen this revolution take place in both private healthcare and the NHS. Private remote GP services have been around for quite some time; in fact, Medical Solutions has been providing a service for more than 20 years. Now, due to COVID-19, the NHS has been forced to take the remote consultation plunge and, rather than grudgingly accepting this as a dire necessity, NHS GPs are overcoming their initial reluctance and starting to realise it presents a great opportunity to provide a more efficient service. Clinicians now understand that 70%-80% of their care can be delivered without seeing someone face-to-face and that this is not only an acceptable way of consulting with people but offers many benefits.

Advantages of the remote approach

Last year, the government announced its five-year funding deal for the NHS. While this was generally well-received, it didn't extend to important areas of health spending, such as investment in buildings. According to the King's Fund, £112.9bn is spent on day-to-day running costs such as staff salaries and medicines, and just £0.2bn is spent on facilities and equipment[i].

With the remote approach, more doctors can work from home and surgeries with lots of consulting rooms may no longer be needed. This means rather than spending money on infrastructure and facilities, budget can be freed up and spent on other essential areas.

At Medical Solutions we are seeing this cultural change take effect among NHS GPs. Many GPs are asking to join Medical Solutions, while remaining part of their NHS practice, saying they have quickly learned that remote consulting is an effective way to work. This means that even if the NHS does go back to the old model post-crisis, there is a growing cohort of doctors who are used to and comfortable consulting with patients remotely. Furthermore, a greater number of patients are seeing the benefit of no longer needing to travel to surgeries and can appreciate the value of not having to take time off work to speak with a doctor.

More companies are enquiring about how they can provide remote GP services to their employees, while people who can't access this as a workplace benefit are joining membership schemes or purchasing insurance policies that do offer it.

Impact on the NHS

When the extent of the pandemic started to become clear in March, NHS England advised GP surgeries to move to a total triage system and undertake remote care via "appropriate channels" where possible.

However, most NHS GPs have never undertaken this level of remote consultation before and it soon became clear that many would require training to deliver it effectively. A variety of organisations have provided a range of resources and materials, including videos, webinars and e-learning packages to help GPs enhance their remote consultation skills.

Some NHS GPs have quickly adapted and are now asking patients to send them photographs of ailments and conducting examinations via video. In turn, patients are quickly adjusting to interacting with their doctors in this way while also getting used to navigating algorithms that direct them to the right care, such as the NHS's 111 service which uses a clinical algorithm tool.

At the same time, the private sector has been helping to relieve pressure on the NHS by treating people with non-coronavirus conditions and concerns and signposting Covid-19 queries to NHS services to ensure a single point of monitoring, traffic and treatment. At Medical Solutions we have seen demand increase by up to 300% and we are proud that feedback remains positive despite the extra challenges people are currently facing, and that patients have gained further reassurance through the services we provide.

It's clear that the COVID-19 pandemic has revolutionised people's perceptions of remote healthcare. However, to ensure this new approach and the benefits that go with it continue post-crisis, the revolution has to be sustained by medical professionals and their patients. Let's hope some good comes out of the challenging situation we are all experiencing.

Dr Chris Morris has been a practising GP for 23 years, a remote private GP at Medical Solutions for 18 years and a trainer of NHS GPs for the past 15 years

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