GPs are not to introduce online consultation services until there is ‘clear evidence’ that it is beneficial to patients, a conference has heard.
The emergency motion was passed at the Conference of England Local Medical Committee’s (LMC) in London on Friday morning.
A debate on online consultations follows the launch of GP at Hand across London.
The 24-hour smartphone app which allows patients to video chat with their GPs in a bid to slash waiting times, has been met with criticism.
One Digital Health reader said: “If you visit the site you find that, unlike any other NHS practice, they appear to be picking low-risk, non-complicated patients.”
General Practitioners Committee chair Dr Richard Vautrey hit out at NHS England support for the rollout of the GP at Hand service.
The GPC chair told the conference: ”Unlike some new services promoted this week that NHS England seems to support, we don’t cherry-pick young, fit and healthy patients.”
“We don’t refuse to treat people who are vulnerable, frail or housebound, those with learning disabilities or complex problems. We deliver a service that is open to all, no questions asked.”
The conference went on to raise concerns that there was no ‘good evidence’ to suggest online consultations would reduce workload and is ‘disadvantageous to those patients who do not have access to the internet’.
The motion called for the GPC to ‘make it clear to government and NHS England that GPs will not formally agree to begin online consulting until there is clear evidence that it is beneficial to the health of patients’.
After the motion was passed, the news gained traction on social media (see below).
Dr Marcus Baw told Digital Health News that he welcomed the profession “taking a mature and evidence-based stance on digital transformation.”
Baw said: “As GPs we have been at the forefront of digital health, and we welcome the many advantages it will bring, but it is unacceptable for these advantages to come at the expense of widening inequality or equity of access to healthcare, loss of patient privacy and confidentiality, or a lowering of standards of clinical care.
“As ever, the care of the patient is our first concern.”
This month, NHS England also launched £45 million worth of funding to help GP surgeries implement online consultation programmes.
head of general practice development at NHS England, Dr Robert Varnam, said the money will be used to implement an online consultation programme for three years across a number of GP practices.
Calling online consultations ‘exciting’, Varnham added: “The future of primary care cannot look like it is now and patient facing technology is a key part of helping the pressure in primary care.”
SOCIAL MEDIA REACTION:
#LMCconf archaic thinking to reject online consultations ? or optional tool rather than mandatory?
— GP Survival (@cgps_gp) November 10, 2017
Where would we be if BMA said that about the NHS itself…oh it did. I don’t think video consultations is for every one, but for some it will be hugely beneficial. Like telephone but with added visual contact. Get into 21st century
— Ivan Benett (@Benettivan) November 10, 2017
Forms of Skype consultation being debated at #LMCconf great speech from Sarah Kay calling for evidence based change @BMA_GP pic.twitter.com/YX6RcZlumd
— Jeeves Wij (@AskJeevesWij) November 10, 2017
#lmcconf Tech today can enable remote working, catering to needs of both workforce & patients, it has the potential to ⬇️ & better manage workload. Formal assessment, scrutiny & finessing of the systems on offer is necessary! @BMA_GP
— Dr Farah Jameel (@DrFJameel) November 10, 2017
Online consultation- no evidence, does not save time, increases demand, and is not safe #LMCConf @BMA_GP
— Kieran Sharrock (@KieranLincsLMC) November 10, 2017
15 November 2017 @ 08:08
IT’s about providing the best possible service now and in the future for all people with what money is available. If health providers can generate their own cash flows then that would be a good thing.
15 November 2017 @ 00:15
what im hearing is a lot of hysterical nonsense from people who are out of touch with patients and the rest of the world.
You had your chance but your time is rapidly running out. Its time for change.
15 November 2017 @ 08:48
Dan…..or should I say Jeremy
Your comments/trolling are akin to a certain eastern ex communist countries (successful) attempt to invoke brexit.
Go back to the tory party and tell them you’ve been rumbled.
15 November 2017 @ 10:06
so wots going on? NHS vs the Conservatives ?
if politicians are open … about what they do, that’s fine, it’s the ones that are hidden that frighten me
14 November 2017 @ 14:22
“As ever, money is our first concern.”
15 November 2017 @ 00:31
Those silly GPs are always getting their words mixed up.
Information governance. We’re resistant to change.
Patient safety. We’re resistant to change.
Underfunded. Lining our pockets.
13 November 2017 @ 16:43
Online GP services may well be the icing on the cake, but only if there is a cake to ice. There is self interest, but not protectionism from GPs and LMCs. The entire edifice of the NHS reforms depends on a stable primary care service and making GP practices non-viable does nothing to help. The patients who , this week , can be safely and effectively be seen virtually can quickly become more unwell, develop complex physical / psychological needs or simply get pregnant at which point the online service says ‘go back to your traditional GP’. It would be sensible to fund the two types of service in a way which reflects the complexity and cost of providing the care but the current situation merely cannibalises the full GP service to provide the funding for the online offering. Conventional GPs are already trying alternative modes of consultation so it is not the method of delivery that is the problem but the inequity of the situation for patients and practices alike
15 November 2017 @ 15:25
As a GP I would be more than happy for the model to change because it sucks to be a GP right now. That’s why practices are closing left, right and center with the workforce retiring early or simply leaving the NHS.
If this model is rolled out, all I want to be able to do is take part / provide services like this myself so I can make more money. What I am against (and I don’t believe any GPs have been reticent about this) is the NHS favouring private companies and taking advantage of long serving GPs.
No conspiracy here. GPs want the best for themselves obviously and this often means that patients get a better service too.
If this means the business model changing, patients paying, “disrupting” the market or whatever you want to call it then so be it. But I’ll tell you one thing, the market place is not just about pleasing patients – it’s about pleasing the GPs as well because we’re the ones ultimately doing the work and have just as much say in the market place.
13 November 2017 @ 13:46
Some GP’s have perhaps forgotten that they do not provide a great service to ALL patients, so there is an issue to address. I am sure there will be a group (s) of patients who can quite safely and effectively be seen virtually. This will free up GP’s to see those for whom that route is not appropriate. Only by trying these things will we know what does and doesn’t work.
That the LMC appear to mark this as out of hand, without investigating it, smacks of protectionist self interest.
13 November 2017 @ 23:23
No it doesn’t reek of protectionism.
GP’s at present cannot advertise for patients.
GP’s at present cannot cherry pick patients.
GP’s at present cannot offer extra services as they’re not being funded properly to do their job (over 90% of patient consultations with only about 7% of the total NHS budget).
All GP’s want is a level playing field.
14 November 2017 @ 04:09
a level playing field is what all patients deserve, IT, (especially the efficient management of datd) can help to achieve that
15 November 2017 @ 00:26
Seconded. Id settle for an adequate service
As a patient with a long term condition im glad the the cartel is being broken up and challenged.
The cornershop GP model is broken, monopolistic and does not provide an effective or scalable service.
Those crying foul have interests to protect and they are not the interests of patient’s.
GPs have refused to even consider alternative operating models, they simply demand more money.
Technology and innovation is challenging the status quo and makes change happen.
13 November 2017 @ 13:19
This is not the LMC’s being luddite but a concern that this sets a precedent that new entrants like this company are allowed to work under much weaker regulation than other practices. If we put up a sign listing the patients we were less happy to see, including some of the most needy, we would face both criticism and censure for being in breach of our contract. This new service, unlike the private doctor apps, seeks to replace the full GP service rather than as an add-on and will be paid the same rate as ‘traditional’ services so should be required to provide the same range of services required from those practices.
MR C N SPINDLEY
11 November 2017 @ 20:16
i am led to believe doctors. buy their own stephoscopes, well everyone is unique and it, the real world, is all about consumer choice isn’t it?
11 November 2017 @ 16:51
There were objections to that awful piece of medical equipment in the 19th century, commonly known as the stethoscope! I recognise that GP lists are funded on a shared risk model so by taking out digitally enabled patients (not necessarily younger and fitter!) GPs get paid less to look after the rest. That funding arrangements is worthy therefore of review. HOWEVER, let’s just be straight that this is about income and not patient benefit. Digital access to consultations should be about increasing access and not reducing it.
13 November 2017 @ 09:31
Wow, the all-caps brigade HAS ARRIVED.
11 November 2017 @ 02:46
I HAVE TAKEN ADVANTAGE OF FREE ON LINE SEVICES IN MENTAL HEALTH, THEY HELPED ME. IT DOES NOT WORRY ME WHO PROVIDES THE CARE, JUST AS LONG AS IT REMAINS AS FREE AND AS FAIR AS POSSIBLE, NOW AND ESPECIALLY FOR FUTURE GENERATIONS.
15 November 2017 @ 00:16
What he said.
10 November 2017 @ 21:00
This is a matter for patient choice !!! just as a reminder, patients are the people that NHS doctors serve and the people that pay the NHS doctors salaries, not the other way round.
10 November 2017 @ 22:21
This is the reason the NHS is doomed, because of entitled members of the public like you.
Do you not realise that if this app is allowed to take off that a) it’s likely the primary care will collapse and will go private or b) there will be more services like this which will be private.
Yes, patient choice is a good thing, but the people working the front lines should be well looked after and remunerated. GPs are already undervalued as it is in the NHS (private GP appointments which last 15 minutes are usually charged at £75-£85) and this model would make it even worse for GPs who actually care about the NHS. You’re attacking the wrong people – you should be angry at the doh who has created this shambles of a situation.
11 November 2017 @ 02:51
App ologies, I do not wish to “attack” any one.
11 November 2017 @ 09:21
I don’t believe Clive was attacking anyone. NHS isn’t free, my ‘insurance’ is somewhere between 4 and 5 figure sum annually.
I’m also in the group that doesn’t visit doctors (male and in full time employment) and I believe that’s a public health issue? On a related note, it can cost me over 200 to visit a Gp.
I don’t mind the ‘insurance’ costs but access shouldn’t cost me extra?
10 November 2017 @ 17:44
It’s not 1948.
This just proves disruptive innovation is doing its job and people are in fear of losing the status quo on their monopoly.
Just another patient
10 November 2017 @ 21:10
How many buzzwords can you fit in one post?
I’m all in favour of online consultations but not if it means that the provider can cherry pick easily-dealt-with patients and leave the harder cases to regular GPs
Why not adjust the rates paid to reflect the easier workload of the online service and boost the price paid for complex cases?.
10 November 2017 @ 15:57
Sadly at my age GP consultations are a more frequent occurnce. Most are routine and could easily be on the phone, which is what by GP practice is now doing and no doubt video soon. That’s great as part of a full line service but GP at Hand are cherry picking leaving colleagues to pick up hard stuff. Fine, but we have to make sure the funding goes to where the work is. Current GP funding assumes a full line service and will inappropriately fund cherry pickers.
10 November 2017 @ 15:02
Wow, the LMC talking some sense for a change.
As with so many things in the NHS, this is bitter sweet as there are obvious advantages to video consultations but it shouldn’t be at the detriment of front line GP surgeries which are shutting down on a monthly basis right now. Depriving them of even more funds will prove disastrous.