Why primary care innovation was long overdue

Dr. Murray Ellender, NHS GP and CEO of eConsult, reflects on developments of adopting technology in primary care during the COVID-19 pandemic.

It’s Monday morning and there are 100 calls in the phone queue already — it’s only 08:15. Most of the patients waiting won’t get the help they need. Routine appointment slots are booked out for the next four weeks; half of them have the bare minimum information, some might only have a full stop. First come, first served. That’s the way it’s always been.

In many ways, the NHS has been torn between the traditional processes embraced since its founding 72 years ago and the demands of 21st-century patients. An ageing, complex patient population — increasingly digital-savvy.

The speed of change and development of new innovations is immense. Societal norms now are almost unimaginable to someone that might have time-travelled from 1948, when the NHS was founded. The NHS has always fostered innovation, with many pioneering surgeries and drug discoveries under its belt which have improved patient safety and outcomes, with technology acting as an enabler. It’s impossible to imagine doing heart surgery today without a heart-lung machine or the drugs provided to sedate and avoid infection.

Pre-COVID-19, digital innovation was slowly creeping into our healthcare system. However, due to the pandemic, this has accelerated drastically as services such as General Practice look to provide the care their patients need whilst protecting them from the risk of infection. This technology is proving to be a game-changer and will change the NHS much as we’ve seen in other industries. Banking and retail are prime examples of technology changing established routines. Many newer ‘challenger’ bank providers have no physical branch to visit. Some have online-only presences or limited ‘brick and mortar’ sites.

Everything you can do in person can be done online. When was the last time you went into a branch of your bank? Whoever thought you could get your food delivered to your house without having to physically select and pay for items in a supermarket? You can buy, try on, and return an item without ever leaving the house if you so wish. Except, recently we’ve had no choice. We leave the house only for essential reasons. Thanks to the acceleration of digital transformation, we’ve realised it is possible to live in these conditions.

The same is now true with primary care, particularly with regards to digital triage and online consultations. Collect your patient history upfront in a structured and consistent way. Let your experienced clinicians understand the demand and allocate it to the most appropriate staff based on the resources available (resources that might change day to day). Spend your time looking after patients, providing advice and treatment, not on the phone trying to work out just how sick your patient is based on the one line they gave to your receptionist.

The digital transformation in primary care is not just streamlining how practices operate, but also playing a role in tackling COVID-19. Essential triaging is being carried out before patients even get an appointment. This eliminates the risk of the virus spreading between patients walking through the GP door, waiting in the surgery and being in contact with other people.

After the ‘no other choice’ scenario created by the pandemic, patients are truly understanding the value of digitisation, for both themselves and for our stretched NHS staff. We need to continue to reinforce the fact that the NHS is still there for them, but much like other elements of the world during COVID-19, it’s a little bit different. Different — but also the future.

Through necessity, we have moved forward two years in the space of four months. We can’t go back to 140 patients waiting on the phone by 9 am. It no longer works for anyone.