Incentives planned for e-consultations

Incentives planned for e-consultations

The Department of Health wants to give doctors incentives to carry out online consultations; but it will be up to GP practices to decide what technology they use.

NHS medical director Sir Bruce Keogh told EHI Primary Care that practices must decide how best to use available technology. 

He was responding to questions about a debate this week about the use of the software application Skype for doctor-patient consultations.

Sir Bruce told the Times newspaper that the DH was drawing up plans to introduce online consultations as part of its plans to encourage greater use of technology in the NHS.

He did not use the word Skype, and instead told the paper: “I am looking at how we can put levers into the system to encourage doctors to do online consultations.

"Once you have online consultation it breaks down geographical barriers. It opens up the spectre of 24/7 access.”

Online consultations would fit with the government’s plans to scrap GP practice boundaries from April 2012.

Some technology commentators think Skype offers benefits over email or telephone consultations, since it enables patients and clinicians to also see each other.

However, the use of Skype is unlikely to be prescribed in any incentives for online consultations.

Sir Bruce told EHI Primary Care: “Technology and expectations will collide to make greater use of on-line technology an inevitability.

"This technology is a tool. It is up to individual practices to decide how best to use it. I simply want to stimulate the debate."

Dr Laurence Buckman, chair of the BMA’s GP committee, told the Times that many GPs would be happy with Skype consultations.

However, he suggested the service would be more useful for patients already known to the consulting doctor.

A spokesperson for the DH told EHI Primary Care that the government’s information strategy would provide more information about online consultations when it is published.

She added: “The 'Information Revolution' consultation responses and the NHS Future Forum discussions with stakeholders will inform the development of the future information strategy, which will be published this winter."

Last updated: 31 August 2011 17:47

Fiona Barr

1 September 2011

The matter of evidence

Montmorency213 weeks ago

Dr Hawking is right to be sceptical about such political dictation, particularly when the evidence to support this technology is at best equivocal. It's worth citing the overall conclusion of Currell et al's Cochrane review published last year:

'Establishing systems for patient care using telecommunications technologies is feasible, but there is little evidence of clinical benefits. The studies provided variable and inconclusive results for other outcomes such as psychological measures, and no analysable data about the cost effectiveness of telemedicine systems. The review demonstrates the need for further research and the fact that it is feasible to carry out randomised trials of telemedicine applications. Policy makers should be cautious about recommending increased use and investment in unevaluated technologies.'

Of course, if Sir Bruce is suggesting that DH funds pilots and further research on this so that clinicians can take informed decision in the future, then that's another matter.





If remote consultations are good in general practice...

Mary Hawking213 weeks ago

why is there no apparent desire to enforce them in secondary care?

Just think of the potential savings and increased workflow! ;->

I find it interesting that Sir Bruce Keogh apparently feels that physical examination is not - or seldom - needed, and that remote consultation in real time would save GP time and allow the safe abolition of geographic boundaries: what happens if the patient needs a visit - or examination?

Would a surgeon be happy to diagnose appendicitis by videoconferencing via Skype?

It's interesting that the CCGs are supposed to be independent - but the talk of central incentives continues.

As a GP, I am uneasy about political dictation of the means of consultation: it goes along with MPs wanting to insist GPs reduce their prescribing of antibiotics by 25% - and sits very poorly with the Coalition Government's declared aim of devolving responsibilities to the front line clinicians....





What's the rush?

Montmorency214 weeks ago

A radical proposal: perhaps just for once the DH might back off and let people in primary care take the decisions about the appropriate adoption of online consultation technology and how this best fits with their responsibilities to their patients? There is no shortage of innovative, entrepreneurial individuals in primary care who will want to pick this up, so why the constant desire to push from the centre?





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