Times article this morning on the Health Secretary’s desire to enable people to book GP appointments online (linked in comments). Some quick thoughts:
It is currently functionally possible to book GP appointments at any time of the day through the NHS App. This works via API access to the EMIS/TPP clinical software that runs GP practices. However, the user experience varies from practice to practice because GPs can configure what appointments (if any) they make available to book via their internal clinical systems. The reason for this is that GPs, reasonably, would like some control around what how appointments are being allocated, so that constrained resources are directed in the right place. Another challenge is that there are different types of appointment but no agreed standards for describing them so the way they surface in the app is confusing to users. Serious plumbing work is needed but never sexy enough to prioritise.
But ‘online appointment booking’ is a red herring – not all patients will actually need the GP appointment they think they do. Instead, a wider concept of ‘digital access to GP services’ through the App, which takes a more nuanced approach to meeting patient needs, would provide a better experience for patients and practitioners. This should include digital triage: in preceding years, NHS England has encouraged a “digital first primary care” policy in which GPs are encouraged to use digital tools to gather initial information from patients that then allows them to be triaged (such as e-consult, Klinik, or Accurx). This works pretty well in a lot of places depending on which product you have integrated. I’ll try not to name faves. Triage is well used in A&E and 999 – so why not primary care.
Rather than demand GPs release appointments, a successful policy would demand integration of triage and communications tools into the NHS App, with strictly mandated data and design standards using the NHS design toolkit to ensure a good experience. This could be further extended to different care settings. But barriers to this, and necessary reforms to overcome them, lie more in traditional models of care, commissioning and payment, and managing software vendor markets, as well as technology challenges.
P.S. I do appreciate a lot of this is happening behind the scenes. I’m just tackling the article 🙂
This post originally appeared on LinkedIn.