Can the demand on GPs be managed to the benefit of all?

Problem

With expectations on GPs and their practices continuing to increase, the challenge is managing demand to improve access to GP services, deliver the most appropriate response to meet patient requests, maintain levels of continuity and improve the lot of the GPs themselves. The digital agenda is seen as critical to success but only if workflow is managed effectively.

Approach

The approach adopted by askmyGP is that of total flow. This means that all demand presenting to a GP practice (online, telephone calls or walk-ins) is put through the askmyGP system. This provides one managed process to ensure equity of treatment whatever route the patient has adopted. All demand can then be assessed to determine both the level of response needed (e.g. a face to face or telephone consultation or advice) and a range of response styles (e.g. messaging, telephone, video). Access online is available 24/7 but patients are advised not to use the system in the event of emergencies and that their request, if submitted out of hours, will be dealt with when the practice is next open. The system does not allow online booking, a means by which undifferentiated demand can reach GPs without some form of triage.

Findings

The system is currently dealing with over 13,000 patients per week (a number which is growing) and over the period October 2018 to January 2019 our practices experience response times of minutes (median time-to-complete = 104 minutes, n=156,602 requests). High uptake by patients (some practices as high as 83% online) reflects the utility of askmyGP for both patients and practices and the quality of a managed change management process.

Consequences

Based on the experience of practices, there is evidence that efficiency gains can be achieved and that these can be used in several ways, i.e. time savings with a better quality of life for GPs, opportunity cost savings and/or cashable savings through a reduced use of locums and a reduction of demand on receptionists as call volumes fall.