The GP Confederation has been commissioned by City & Hackney CCG to lead on a number of initiatives in relation to Demand Management.
e-Consult provides patients with a number of alternatives to traditional face-to-face consultations. It gives GP practices the opportunity to use their practice websites to showcase several remote healthcare solutions to speed up access to safe, efficient care, whilst also reducing the practice workload, so that GPs can focus on seeing the patients who cannot be managed by phone advice or a prescription.
It is expected that e-consultations will become a contractual obligation in the future, in the same way that online services such as appointment bookings are, and the GP Confederation is encouraging GP practices in City and Hackney to try out measures like e-consultations while there is some dedicated funding for support and training.
A key requirement of the demand management contract is that practices have a consistent digital offer via practice websites. Signing up to pilot e-Consult is one way for a practice with no website to have one. Alternatively, a practice that wishes to have a new website that offers more functionality then their existing one can also have the provided by signing up to e-Consult.
Further information on e-Consult can be found at: www.webgp.com
Patients and families, particularly those with long term conditions who visit their GP more often, are increasingly commenting that they want:
- To talk to someone who understands their situation; who has been there and overcome the difficulties they face;
- To have a closer relationship and spend longer with their GP, which would give them confidence to self-care;
- To take control of their health issues and feel able to cope.
In addition, healthcare professionals say that:
- Repeating the same story to people day after day wears them down;
- Ten minutes is not long enough to have the kind of discussions people want to have, which leaves the professional feeling frustrated and powerless to deliver the kind of care that they want to.
To address these issues, a number of practices across England have been piloting group consultations in primary care, providing care that is person-centred with peer support. Group consultations are personal medical consultations delivered by a clinician in a supportive peer group setting, with all patients listening and learning. They are not group therapy sessions.
The evidence based for group consultations (from those that have piloted and subsequently embedded them into normal working patterns) shows that:
- The clinician can see up to 12 patients in 60 minutes, which potentially doubles access to routine care and follow-up appointments;
- Patients, carers and families reported feeling reassured and having increased personal confidence;
- Both clinicians and patients reported an improved care experience;
- Practices report greater ability to do more within the same resources.
The GP Confederation will provide facilitation training to practices to support the development of group consultations. This will ensure that no one person dominates the group, that people are able to learn from each other, and that the balance of content is suitable for a clinical interaction.
Over time, the Confederation would like to develop 'group consultation champions' in each Quadrant who will act as a resource for advice and support to practices. This will also provide mentoring from those that have already undertaken group consultations to those that are new to the concept.
Additionally, those patients who have completed a group consultation course and successfully achieved their original goals/aims (usually around 6 months) will be encouraged to become future facilitators and 'expert patients', as an additional resources for practices. Training will be provided as required to those patients willing to engage in this way.
Over time, the model can be adapted to choose who is best in a position to run the consultation, which may for example by a GP, nurse, pharmacist, physiotherapist or midwife.
For further information about the Demand Management Programme, or to find out how to get involved, please contact Peter Sheils, Project Manager, at firstname.lastname@example.org or on 0207 729 7236.