May 24, 2016 - Survey reveals few GPs use alternatives to face-to-face consultations 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 today 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 per cent) 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.
'GPs are slow to make use of new technology' by Brant et al in The British Journal of General Practice
For more information about the AltCon study, please visit the research websiteAlt-Con logo
The National Institute for Health Research Health Services and Delivery Research Programme
The NIHR HS&DR was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR Programme is funded by the NIHR with specific contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland.
The National Institute for Health Research
The NIHR is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.