Despite policy pressure on GPs to offer consultations by email or internet video programmes such as Skype, few GPs do and most have no plans to introduce them in future, according to a new study.
The study, published in the British Journal of General Practice (BJGP), was conducted by researchers from the Universities of Bristol, Oxford, Edinburgh and Exeter. Introducing alternatives to face-to-face consultations in primary care has been proposed as a solution to the increased demands on general practice. Despite claims about how this may improve access and efficiency, the extent to which technologies such as telephone, email and internet video consultations are used at present is unclear. There is also little evidence to support claims they reduce GP workload or improve patient satisfaction.
This study – the first of its kind in the UK – aimed to identify the frequency and range of ways general practice teams in five areas of the UK were providing alternatives to face-to-face consultations, or had plans to do so in the future.
The researchers sent a postal survey to more than 400 practices in and around Bristol, Oxford, Lothian, the Highlands and Western Isles of Scotland. The areas were chosen to include practices with a range of characteristics: urban and rural; inner city and remote; and in affluent and deprived locations.
Dr Heather Brant, senior research associate at the University of Bristol’s Centre for Academic Primary Care said: “We found that, despite the majority of practices offering telephone consultations on a frequent basis (66 per cent), fewer were implementing email consultations (6%) and none were currently using internet video. In addition, the majority do not plan to implement these methods in the future.”
Professor Chris Salisbury, a GP and head of the Centre for Academic Primary Care, led the research. He said: “The survey results show that, since few people are actually using email or internet video in general practice, views about the pros and cons of alternative forms of consultation are largely speculative and based on anecdote rather than evidence. The general reluctance to adopt alternatives to face-to-face consultations means the situation is unlikely to change soon unless general practices can see clear advantages from introducing new ways of consulting.”
The survey was part of a larger study called The Alt-Con Project, funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme.
The researchers have used these survey results to identify practices that either currently offer, are about to introduce, or have ceased to offer an alternative method of consultation. They will do in-depth case studies with a number of practices that have tried different alternatives to face to face consultations. Based on interviews with staff and patients, observation of practice life, and anonymised patient records, they will explore what practices achieved, how they overcame difficulties (or not), and what they perceived the advantages and disadvantages were for different groups of patients.