Our vision: to transform access to medical care.

How many patients are using webGP online access?

Our aim is to enable a channel shift to online access for patients.  A key measure is therefore how many patients have shifted.

Understanding patient demand is essential, and we know from our work since 2011 that this is predictable within a range based on practice list size and demographics.  Typically 6%-7% of a practice list seek help from a GP each week.  In younger, prosperous populations it is less, around 5%, in deprived populations more, typically 8% and at the extreme we have measured 10%.

We now have a benchmark for the level of demand in the webGP pilot report May 2014  (Or download the report here).  The population covered is 133,000, over a period of 6 months.  Expected GP demand is therefore approximately:

133,000 x 6.5% x 26 weeks = 224,770 consultations

The number of e-consultations received (page 6, top of pyramid) is 1,600.

1,600/224,770 = 0.71%

PMCF Prime Minister’s GP Access Fund evaluation

The conclusions on page 38 state:  “To date telephone-based GP consultation models have proved most popular and successful… other non-traditional modes of contact (for example video or e-consultations) have yet to prove any significant benefits and have had low patient take-up.”

The e-consultation system used is webGP, and more detail is revealed on page 14:

“Care UK implemented a diagnostic and e-consultation system at all eight of its practices but experience suggests that it has a limited appeal for patients; they tend to prefer the pilot’s telephone access offer, which provides patients with a GP response more quickly. Since going live, the pilot has provided 470 on-line consultations up to the end of May 2015”

Care UK’s scheme was run over its 8 practices with a total of 45,000 patients.  Demand for a GP is typically 6.5% of practice list size per week, which makes 152,100 per year.

470/152100 is 0.30% of demand.  This figure explains the comment of “limited appeal” for patients.  Other benefits of the scheme may be claimed but calculation is impossible, apart from the cost of submissions.

The price of 75p/patient per year, including VAT, implies a cost of £33,750 for the scheme.   This is £71.80 per submitted consultation.

In our view, such levels of usage are too low to have a significant effect on the workload of the practice.  Accessing symptom checkers and self care information may be useful to the patient, and we provide the same access to comprehensive information on NHS Choices, but there is no evidence that this reduces health seeking behaviour.

Cost per consultation

webGP pilot study: 133,000 patients x £0.63/year x 1.2 (vat) x 0.5 year = £50,274.    1,600 consultations, £31.42 each

askmyGP pilot study:  £1.00 each

See also The Diversion Myth, and a comparison of webGP with askmyGP.

Our pilot study shows steadily increasing online access by patients at a north London practice, now over 40% of demand.  The operating mode and capacity have thoroughly changed, the new patient behaviour driven by:

  • Rapid response, usually within the hour
  • Universal in respect of patients and their problems
  • Personal service, a choice of clinician building trust

Only by improving these approaches will NHS primary care achieve the efficiency gains it needs in order to thrive.