GP partner Dr Hussain Gandhi outlines what practices need to know about funding available for implementing online consultations and how to bid for it
NHS England previously allocated £45m to support the use of online consultation systems by practices. This fund was created to align with the GP Forward View’s 10 high-impact changes that can be made in primary care to release capacity.
Patients can use these consultations to describe their problem, with the details sent directly to their practice, or use the system to access self-help or medical information.
All practices are eligible to access the funding from their CCG allocation, but uptake is optional. The funding was made available to CCGs in instalments over three years to be used by April 2020.
The aim is for CCGs to buy the licence for the software or systems for use by practices, or to pay for training and engagement to facilitate the uptake of online consultation systems. This may include out-of-hours and urgent care services if agreed locally.
So far practices have applied the fund in a variety of ways.
NHS England has now announced that more funding is to be made available to practices over the next four years to 2023, although the details have not yet been revealed.
It is essential that any system you consider includes free access via a web browser or app, and allows the patient to enter a query, symptoms or other information. The information then must be transmitted securely to the GP practice they are registered with. Optional aspects include signposting information to local services, minimising the processing work for practices in the electronic health record (eHR) and video consultations.
This GP Forward View funding has already been allocated across regions to each CCG on a weighted capitation basis. This year the funding has been transferred to Sustainable Transformation Partnerships (STPs) rather than CCGs.
To access it, contact your local CCG IT or primary care management liaison. For 2019/20 this should be done rapidly as remaining funds may already be in the process of allocation. Further release of funds will be determined by criteria such as spend to date, uptake and use.
When applying for this fund, it is important to cite evidence – from any published reports and also through audit at your own practice once you have trialled a package – on how your practice’s online access tool has freed up time for GPs, and resulted in increased patient use of online services such as online appointment booking, medication requesting or access to notes.
You also need to do background research, looking at which groups of patients may need help with online tool use. Promote any new service, for example by running a sign-up campaign, using your patient participation group to encourage patient uptake or working with local digital literacy groups or charities. It is worth discussing this in your networks and CCGs to draw on other practices’ experience of this.
Keeping these aims in mind is vital as well as ensuring procurement is in line with the wider planning for IT investment and service transformation principles as outlined below.
There are several systems and providers. The dynamic purchasing system (DPS) created by NHS Digital lists approved providers. You may use other companies but they may have to work with an approved provider to allow the use of the funding.
To qualify for funding, providers must detail the software and equipment needed to run the system.
They must show that their system:
Other aspects to consider include integration with the NHS App (part of the digital roadmap of the NHS) that is being rolled out. How will this affect practice workflows? How adaptable will it be in future, for instance, if you wish to work in a federation or conduct video consultations?
New companies, referred to as ‘digital disruptors’, such as Babylon Health, have come to prominence since the GP Forward View was released. It’s important to realise that they may not comply with the online consultations funding requirement that patients must have access for free via a web browser or app.
WiFi is also an important part of the digital plan for the NHS. If, as a practice, you do not have WiFi access for your patients, contact your CCG to set this up; it should be in place.
Training for new tools is a key consideration but is often not included in new funding streams, unless it is approved as part of a practice development. Changing digital systems, such as your eHR, or adopting electronic prescription services usually comes with some training. However, the kind of tools we are discussing here are unlikely to be covered, unless offered by the provider or as part of an enhanced service.
Access to funding is vital for innovation. The government is encouraging a greater focus on digital development in healthcare and other funding streams will be developed as outlined in the NHS long term plan. How practices adapt to and use these systems will be key to patient engagement and service delivery.
Dr Hussain Gandhi is a GP in Nottingham and runs the eGPlearning website. You can follow him on Twitter @drgandalf52
This article was first published in August 2019; last reviewed and updated in October 2019
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