Agenda item

Mr Richard Ellis, Hillingdon Joint Borough Director at North West London Clinical Commissioning Group (NWL CCG), advised that digital consultations provided an opportunity to reach out to underserved communities.  GPs in NWL and Hillingdon had been using online consultations for 3-4 years following investment from the NHS.  However, during the pandemic, each practice needed to develop and transform its own procedures and online consultation facility. 

Time and money had been invested in providing support to patients to help them engage with online consultations.  As such, digital contact with healthcare was quite well advanced.  Patients were now being asked to provide feedback on their experience of online consultations, both good and bad. 

It was noted that one of the benefits to online consultations was the ability to access their practice at any time of day or night (although there would not necessarily be an immediate response).  GP surgeries had been open throughout the pandemic and Hillingdon had been one of the first areas in the country to get patients doing their own tests and transmitting them to the clinic. 

Mr Ellis recognised that not everyone liked online consultations and that some patients did not like using the telephone to contact their surgery.  NWL CCG had tried to engage with the various patient groups in Hillingdon to solicit feedback in relation to online consultations.  Healthwatch Hillingdon had also been closely involved in this engagement work. 

It was noted that the online consultation system was currently going through the re-procurement process so might change.  Healthcare was being responsive to patient needs and would be able to provide opportunities such as mental health patients being able to have an online consultation quicker than they would if they wanted a face-to-face appointment.  This digital offer would enable the workforce to work differently and would need to incorporate the estate. 

Members queried whether residents would still be able to see a GP face-to-face if requested.  Mr Ellis advised that they would.  The move to digital had enabled additional appointments to be created since the pandemic started with 50% of the total now being online and the other 50% being face-to-face. 

Mr Ellis noted that 34% of the eConsult contact had been in relation to admin assistance.  This would have been in relation to requests for things like letters for passport applications, travel issues or housing. 

It was queried whether, in the future, an online GP surgery would be set up that only did online consultations.  Mr Ellis advised that there were no specific plans for this facility.  In most practices, the day was organised with urgent call backs taking place first thing in the morning and then face-to-face appointments.  The urgent call backs could be undertaken by any clinician so therefore could be made by another practice within the same primary care network (PCN).  However, it would be important to understand the needs of the population in much more detail to be able to address them more effectively. 

Although there seemed to be a larger number of GPs using online consultations, some patients still ended up having to have face-to-face appointments.  Mr Ellis advised that NWL CCG received data on this and suggested that this would sometimes be because a patient wanted a repeat prescription but needed to come in for routine checks before this could be reinstated.  Although this data could (in principle) be broken down by ward, the data was fairly uniform across the Borough.  He advised that he could follow up on specific incidences offline. 

Ms Kirstie Neale, Primary Care Delivery Manager (Uxbridge and West Drayton) at NWL CCG, advised that some practices would have a lot of elderly patients so might be more likely to focus on telephone and face-to-face appointments rather than virtual.  Members noted that the virtual meeting facility worked really well in some GP practices but that it was still sometimes difficult to get a face-to-face appointment. 

Mr Ellis advised that proactive outreach had been undertaken as part of the population health management work in the Borough.  Although some residents were happy to engage with things like the Covid vaccination programme, there were will some who were not and it was likely that these patients were also not having things like cervical smear tests or childhood immunisations, etc. 

In terms of the virtual consultation system, Members queried whether there was a facility for the digital triage to be translated into other languages.  Mr Ellis advised that this had been raised with software providers as more could be done to mitigate this barrier.  He noted that, of the 107 language categories identified in the last Census, Hillingdon residents had representation from all 107.  Consideration could be given to graphic translations and conversations were ongoing with Healthwatch but there did not appear to be an obvious solution. 

The Committee agreed that it would like to receive a further update on this issue at a future meeting. 

RESOLVED:  That:

1.    a further update in relation to online GP consultation be considered at a future meeting; and

2.    the report and discussion be noted.