Sophie Goodchild reports in the Evening Standard how a Northwood Health Centre in Hillingdon is offering busy patients a “phone-a-doctor” scheme in a NHS drive to increase choice and improve patient access to GP services. The trial offers patients the opportunity to phone up to book an appointment as normal but instead of having to attend the clinic the GP calls them back within two hours.
As many as 60% of patients are already requesting the “remote” advice alternative and after a year trial the service will now be offered to all 4,100 patients. The greatest demand is reportedly from professionals reluctant to take time off work.
Dr Tony Stern, who runs the Carepoint Practice, said phone consultations were not a replacement for face-to-face advice. But the GP said they gave patients more choice and meant patients did not have to travel to the surgery.
“Many patients prefer phone consultations over face to face as it is quick, convenient and can be conducted anywhere. The advantages are that it cuts out having to make a trip to the surgery, particularly if you are elderly or disabled, offers instant reassurance and means you can take the call anywhere, at home, work, even on holiday if you have a pressing problem that can’t wait”.
The report also quoted concerns from Michael Summers from the Patients Association: “There are a lot of non-urgent issues that doctors deal with and getting a face-to-face appointment can take days. But this should only be a halfway house – we have to shield our services so this doesn’t become a habit. Even patients who are stressed could have other problems such as high blood pressure which need monitoring with a physical check.”
Whilst i love the fact that this clinic is working with their patients in modern ways (as well as offering telephone consultations they have a comprehensive website offering things like opening hours, directions, email address, online registration etc) i would like to suggest a few small tweaks that i’m certain would improve its effectiveness:
1) Telephone consultations might not be the most effective way to utilize a Doctors time in his surgery facility. Maybe arranging for this work to be done from home would add considerable efficiencies for the Doctor and could free up surgery space for patients who need to visit a Doctor. By not including this service alongside the conventional surgery based practice it might also help avoid raising issues with patients in the waiting room who may feel their service is delayed because their Doctor is attempting to serve other patients who may have less pressing problems within the 2 hour call back time.
2) As pointed out in the comment by patient “Jason” the service is great “as long as you can describe your symptoms in details”. This seemingly small problem is probably a lot more significant that people think. Whilst Sir William Osler reminded us that we can “listen to a patient for long enough and they will tell you what’s wrong with them”, the reality of constraints on consulting time may hamper consulting Doctors from taking a proper history. There’s also lots of evidence to suggest that patients don’t always know how to accurately express themselves – especially when ill. I am certain that the service would be improved considerably by offering patients access to a comprehensive online medical questionnaire – for further information check out Instant Medical History.
3) There is plenty of evidence that patients don’t recall advice given during a face to face consultation and it is highly likely that without the visual cues this problem would be amplified. The use of a secure messaging facility would no doubt add to the effectiveness of the consultation process because it would enable patients to get a written report following the consultation that could detail the recommended advice and action plan. This too would benefit from the written output produced by the medical questionnaire.