Our vision: to transform access to medical care.

E-consultations: “I couldn’t possibly comment”

It’s been a fun week after our official endorsement in the Daily Mail which meant two radio interviews before coffee on Monday.  Huge support came from many GPs and patients who know the truth that a demand led GP telephone consulting system has transformed their lives and their access – thank you all so much.

The DM is right on the button (in its inverted fashion) as a big report has just been quietly snuck out out by NHS England.  It’s the final evaluation of the GP Access Fund wave 1.  (yes, it’s right at the bottom of this page, just published though it relates to September 2015).

I’ve read the ever-so-small print and have concerns about some of their arithmetic but the headline is:  from a £60m investment they identify £1.9m savings.  Nevertheless, one bright spot in the conclusions is “Telephone-based GP consultation models have proved most popular and successful.”

We were involved in several of these, the financials showing a positive investment return (p31) and increasing GP appointments by 7 – 16% within core hours.   This is no surprise as we’ve been saying the same for years.

The contrast with the next conclusion is stark, “Other non-traditional modes of contact (for example video or e-consultations) have had fewer tangible benefits and have generally had low patient take-up to date”

Seven schemes offered e-consultations and sadly askmyGP wasn’t among them at that stage but the leading platform was webGP/eConsult.

Moving swiftly on, it’s time for NHS England Shared Planning Guidance.  Don’t worry yourself about the evidence for telephone access, the word isn’t mentioned, but on page 50 there’s £45 million ring fenced for e-consultations.  That means you can’t spend it on anything else, so your CCG might as well apply.  Do hurry!  Applications must be in by December 23rd.

Some say it’s no coincidence that the author of the GP Forward View and NHS England National Director for Primary Care, Dr Arvind Madan, is also a major shareholder in Hurley Group/webGP/eConsult, provider of such online e-consultation software.  Of course, “I couldn’t possibly comment”.

But I will be reviewing and comparing the evidence on competing platforms over the next few weeks.

As we know, only the Daily Mail can get away with ignoring the evidence.


Harry Longman


PS A number of readers have been commenting on this  Analysis of access in large GP groups.  It’s all from public domain data, so I’d be delighted if any researcher would reproduce or extend it.  A close look at the names reveals some surprises.

Note:  a reminder of the GMC guidance on conflicts of interest, the Nolan principles of public life and the RCGP policy on COI.

The BMA guidance includes the key message:

  • Doctors must use resources efficiently for the benefits of patients and the public. Difficult decisions about resource allocation are inevitable, but should be evidence based and made in consultation with other colleagues and patients.

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