Matt Neligan at Digital Health Rewired: delivering digital transformation in primary care

At Digital Health Rewired 2020, Matt Neligan, director of primary care commissioning transformation for NHS England, spoke about delivering digital transformation in primary care. His presentation was about inclusivity and his message simple; small digital changes can truly transform how any practice operates – regardless of patient demographic, funding, premises or otherwise

In his talk, Matt Neligan stressed that it can be hard for general practices to ‘get on the digital treadmill’;  GPs are overstretched, resources are finite, funding is limited and patient demand is ever increasing. Who needs the extra strain, bureaucracy, system rehaul and adjustment period of undergoing a digital transformation? 

The answer is everyone. The pressure on general practice is eating into the wellbeing of NHS staff – a sickness that can be cured by small, manageable digital transformations. Practices can become more efficient, patients can be redirected to appropriate services more quickly, and clinicians can feel a weight being lifted off their shoulders. 

Many patients across the UK already have access to some form of digital primary health care; they may be able to book appointments through their GP’s website or order repeat prescriptions online. In the next few years, as the NHS continues to roll out increasingly sophisticated systems and technology, the scope of digital primary care will expand and become more nuanced. 

Matt traced what the primary care digital landscape might soon look like. At the entry point, patients could use an app or website to check their symptoms, order repeat prescriptions or view their medical health records. The app or website could then offer accurate clinical advice, signpost patients to the most appropriate medical services, or notify the most appropriate GP in their practice. Patients could then book an appointment online to see a health practitioner face-to-face, or opt to have a video consultation. 

Video consultations, as well as triage, email, web chat and web-form based models, are becoming increasingly popular. Over 300 million appointments take place in general practice every year – and lots of these could safely take place online. Not only does this save doctors and their patients time, but people can be signposted to the most appropriate services for them, allowing for greater integration between general practice and wider primary care. This relieves burden on all NHS services. By April 2021, every patient will have the right to online and video consultations. 

‘Digital accelerators’

Many practices are already ‘digital accelerators’ – finding ways to use new technology to increase practice efficiency and enhance patient experience. Matt gave the example of practices in Herefordshire that are exploring ways digital healthcare could increase the accessibility of primary care for rural patients; those who would have to travel a long way to see their GPs face-to-face, for example, may particularly benefit from online consultations. 

As practices begin to embark on their digital health transformation journeys, evidence is emerging that digitising healthcare is improving outcomes for patients and practice staff alike. Witley Surgery in the Surrey Hills, was highlighted in the talk; they have adopted a new, web-based system to help manage their practice. Their figures are, overwhelmingly, positive; 60% of patients prefer to contact their practice online rather than by ‘phone; 87% of patients report that the new online system is easier to use, face-to-face consultations have been reduced by 43% and home visits by 73%, and the practice has calculated that the new system saves 10% of clinicians’ time overall. 

Given the mounting pressure on general practice, and a pandemic on our hands, digital healthcare can make room for longer, more in-depth GP consultations when people need them most. Doctors at Witley Surgery have reported they can now offer double appointments to patients with complex mental health problems – taking time to understand their unique conditions and putting in place a comprehensive mental healthcare plan for them as well as reviewing medication and signposting them to the other primary care services they require.

GPs often report feeling helpless when it comes to treating their mentally ill patients, as 10-minute consultations are simply not enough to feel they have done the patient justice. With digital healthcare becoming more sophisticated, and more widespread in general practice, the double appointments which Witley Surgery can now offer will become commonplace. Depression is the leading cause of disability worldwide, so moves toward digital healthcare could not be more vital in the primary care treatment of mental illness than now. 

A jog, not a sprint

Digital health transformation is a jog, not a sprint, says Matt. Small changes can reap huge rewards, and it is important to not get overwhelmed by the need to suddenly change everything all at once and ‘go digital’. Change takes time, and careful decisions need to be made by practice managers regarding which digital healthcare providers are the best value for money, offering services well-suited to their patient demographic. 

Whilst practices begin to transform themselves digitally, the NHS App is also well underway. Popular with both the public and primary care staff where it is already in-use, the app offers a new, digital ‘gateway’ to the NHS. According to NHS Digital, it offers safe, secure and simplified access to NHS services online. The NHS is currently exploring how to integrate the app with other digital tools, and the best methods of offering online consultations through the app. This way, the NHS App can be a useful additional digital tool for general practice – the two working in harmony to deliver a more satisfactory, comprehensive patient and employee experience. 

Matt’s talk generated excitement; the room fizzed with excitement at the promising healthcare horizon and the sheer potential of digitalised primary care. If there is one takeaway, it is that digital healthcare should be embraced and not shunned; it might just be the solution to so many of your practice problems. So what‘s holding you back? 

How do you feel about digital transformation in primary care? Excited? Worried? Share your thoughts and experiences @practice_biz

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