Online Services in Primary Care

Things, as we know it, are changing. We hear time and time again on the news that we don’t have enough GPs. Many are leaving the profession because of stress and an extensive workload. Yet patient demand is still increasing year on year. We need to find new solutions to manage the sheer volume of appointments. So, the NHS has turned to the internet to create online services to meet the demand. Some may think this is an excellent solution, whilst others are more cautious. So, what is the NHS setting up? What will it look like for us patients? And what are the positives and negatives of the new services?

What do the online systems look like?

Well, this depends on what GP practice you attend. Practices choose a programme that they believe will suit their patients’ needs. As patients, we will see a website associated with our GP practice online. There are three primary services these websites can provide: 

  1. Online Triage (deciding the urgency of your problem and directing you to the appropriate resources)

A patient enters their symptoms and receives pre-generated advice or is directed to an appropriate service, e.g. 111 or an appointment with their doctor. 

  1. Questionnaire-based online consultations

A patient fills in an online form for their problem, and this is sent to the doctor. The form may have a blank box to write down all the details the patient thinks are essential. Or the form might be more like a questionnaire and ask specific questions about the problem.

  1. Video Conferencing

Some clinicians may offer an online video or telephone consultation, and the clinical team will decide this. You may be able to use your phone, computer or tablet. 

How might a patient use these services?

The website your practice chooses may include all three of these different services. Here’s an example of how a patient could use all three online services for one problem:

A 20-year-old has a red, sore, itchy eye. They go to their practice website online service. The patient types in their symptoms and they receive some advice online. It tells them not to wear contact lenses and bathe the eye with cotton wool. After several days of doing this, the eye is still itchy and sore. The patient logs on to the practice site again and goes through the same process. This time, the triage advice suggests requesting a GP appointment. The website takes them to a form (online questionnaire) which they complete. They then receive a response from the practice within a given time for an online GP appointment – using a video call. The clinic arranges the video call with you. During the meeting, the GP provides an online prescription for antibiotics. The patient collects the medication from their pharmacy. After completing the course of antibiotics, the problem is resolved (hopefully).

In this simplistic scenario, the patient may have avoided two trips to the GP office. If they hadn’t seen and followed the online advice, the patient might have seen their GP in person only to be told to clean the eye with cotton wool. And the second time, they didn’t have to travel to the GP because it was an online video from their home’s comfort. 

It’s important to note that the online system’s route may be different in different GP practices. Some people may talk to a receptionist who takes details and triages them. 

Other services may also be available on these digital platforms:

  • Ordering repeat prescriptions
  • Requesting a sick note
  • Asking about recent test results 

Doing all of this admin online would save a patient taking time off work and avoid travel to a GP office.

If you want to know more about NHS Digital and its services, click here. 

What are the Benefits of these services for patients?

  1. Being able to get an appointment 

We may have more face to face appointments available if admin services are available online. Online appointments are also more convenient for a lot of people as you can perform them from home. Some GP may say that online consultations take longer to conduct because people think they have longer to talk to them on the phone or video when this isn’t the case.

2. Patient Satisfaction 

A lot of practices that have been using these online services have had excellent patient feedback. There is the benefit of not having the stress of travelling or taking time off work. You are also more likely to see the same doctor giving you better continuity of care. I also think this online system can empower you to perform self-care. Reading the pre-determined advice can allow you to resolve the problem yourself. I had a go at filling in an online questionnaire, and I felt like I was actively doing something to fix the issue instead of sitting in a waiting room.

3. Efficiency 

The online systems intend to send you to the right place straight away (using triage). They will avoid patients going to different healthcare providers until they see the appropriate person for the problem.

Having a questionnaire sent to the clinician before the appointment can also make appointments more efficient. We won’t have to repeat our medical history repeatedly if the clinician has already read about you and the problem you currently have.

What are the challenges of using online services? 

The NHS is taking into account the challenges patients may face in using the new online format.

  1. Technology 

To start, a person needs to have a phone, tablet, or computer with a reliable internet connection to access the website.

A person also needs to have basic online skills, such as being confident in using and accessing online services. These skills are important as a person needs to feel comfortable and confident enough to have an online consultation.

Not having basic digital skills can prevent you from using online materials. We call this ‘digital exclusion’. It affects low-income groups, older people, and those most vulnerable in our society.

Find out more about digital exclusion across the UK

2. Inappropriate method of communication 

Some people might not feel an online consultation suits their needs. Discussing some problems are better in person. For example, mental health problems can be a very upsetting discussion. Or you might not want to receive bad news or be diagnosed with disease over the phone. Instead, a face to face appointment would be better. And if lots of other appointments can move online, the meetings will be available for these discussions to happen on time. 

As we can see, there are positives and negatives to moving online. It’s important to remember this online move is about ensuring everyone has timely access to appropriate NHS services. Having online services will help to make sure everyone gets the care they need. We can move suitable appointments online and leave more face-to-face meetings available for the patients that need them. Whilst some may be cautious, I’m optimistic that this online move will reduce the number of times a receptionist has to say, ‘we don’t have any appointments available today.’

How can patients prepare for online consultations? Find out here.

If you are working in Primary Care and have a different perspective or additional advice to share, please contact us and write another informative piece. Equally, if you are a patient and have been using online services, we would love to hear about your experiences. Please contact us by email or use our contact form:


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