Greenwich CCG evaluation of access schemes

In the spring and summer of 2014 Greenwich CCG invited us to help them improve access to GPs.  Three suppliers were to work with 5 practices each, with our different interventions.  GP Access is scheme 1, Primary Care Foundation scheme 2 and Hurley Innovations with webGP is scheme 3.

An independent evaluation was made, relying mainly on surveys rather than operational measures which we would have preferred.  In December 2014 all participants were circulated this report.  It is not particularly flattering to us as you may judge for yourselves, but we do know that some practices we worked with have made a positive and permanent change in the way they work.

Pages 54-55 concern webGP, reproduced here in full as they are the only independent evaluation of the product which we have found.  Given the public money now being spent on this product through PMCF schemes, and the high profile role to be taken up by Dr Arvind Madan who was involved in the Greenwich work from the start and received this report along with us, this should be in the public domain.

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Scheme 3 (webGP): staff interviews

Expectations

Expectations of the scheme before it started were positive but low.

“I think, knowing it was for quite self-limiting conditions which it had to be, it couldn’t be for anything very serious. So we weren’t expecting a deluge of uptake.” Practice manager, scheme 3.

“It’s a good idea and that was hoping to alleviate some of the more mundane requests for appointments to the surgery.” Practice manager, scheme 3

Use

The main challenge with scheme 3 was the small numbers of patients who used the scheme. Whilst the self-care element may have been well used, the use of online consultation had low use participating practices. This makes it hard for staff to discern the impact on capacity and patients as a whole. Use of the scheme declined after the initial publicity surrounding its launch.

“We have a list size of twenty four and a half thousand patients, and in that time from July last year, we’ve only had since last week, 43 patients actually using the online calls.” Practice manager, scheme 3

“The online one it started with quite a lot of people looking at it and its dwindled right down I think May to November we’ve had 41 GP consultation and we’re lucky if we can sort of get one or two a month now.” Practice manager, scheme 3

“Only difficulty is the turnaround of 48 hours for a response. We met nearly all the times, but in a couple of instances, just mabe a little bit longer.” Practice manager, scheme 3.

it seems to have become less and less popular, which is a bit odd. I would have thought it would become more used as time went on, but it seemed that, actually, our patients weren’t as aware of it as much as they should be.” GP, scheme 3

Impact

The impact was felt to have been small. The online questionnaire was considered to be long and a potential barrier to uptake, and due to the small numbers of users, it was felt not to have influenced capacity.

“It didn’t make any difference to our workload at all.” GP, scheme 3

“They had to read through four pages of information and then lots of things really couldn’t be dealt with by giving a prescription. They often couldn’t be dealt with by a phone call, they needed an appointment.”

“We’d like to continue with the online thing, because I think it does help. Not very significantly, but it does help.” GP, scheme 3

“We haven’t seen any benefit in regards to reducing demand.” Practice manager, scheme 3

 

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