GPs are usually quite a resistant bunch to process change. That’s not to say that we do not adapt at all. In fact, I would say that we are the most adaptive and creative creatures on the planet when it comes to patient care. After all, we see around 90 per cent of all NHS contacts. What’s usually a serious challenge, however, is getting GPs and practice staff to accept innovative change to core and regular processes.
What’s more, that there are plenty of studies, both domestic and international, that report the rising levels of burnout through unprecedented demand on primary care.
So when we have excellent innovation like Patient Online that enables patients to manage appointments, order repeat prescriptions, message their GP, and view their medical records, it’s a no-brainer for there to be a concerted effort to ensure high patient uptake and usage. This is designed to reduce admin and clinical workload, and to offer a better patient experience, providing on-demand, convenient access to some of the most frequent patient requests. Used well, it also releases staff capacity, a sorely sought after resource that can enable better patient care and improved access.
What we know is that we have a long way to go to really appreciate the benefits that resources such as Patient Online can deliver. We can do this together – I mean together as a GP community, and together with our patients. And we can do this swiftly.
As a Founder and GP Director of AT Medics, managing 32 practices across 16 CCGs in London, and caring for over 200,000 patients, I know that at both individual practice level and at scale, it’s absolutely essential to make use of all of the proven innovations that are emerging in general practice – and there’s no shortage of these. The first step is as much about winning the hearts and minds of our teams as it is about practical training, because without change culture, there cannot be sustained change process.
What does this really mean within a single or group of practices? Our culture is to encourage our teams to 'think like a patient'. And that means using patient online services ourselves to really understand what the patient experience feels like, and to then be able to better inform and guide people to register and use patient online services. This needs to be GP-led – our teams and patients truly respect our GPs, so it’s essential that GPs are fully behind this to ensure success.
The next step is taking this to our patients. Our Patient Participation Groups (PPGs) have been instrumental in enabling this. Our first task was to get the PPG on board through awareness and training. We then transformed them into 'patient online champions', to teach and encourage other patients to use online services. And as a standard, we always ensure patients know that it’s as safe and convenient as using their online banking or paying bills online.
It’s really important to ensure we are inclusive, and to remember those patients who may not have access to the web. And we enable this through kiosks within some of our practices where patients can come and access online services and our websites, which also provide a well-navigated patient journey to resources such as self-referral, key health information and information about the availability and offer of relevant local services. We must also be respectful to patients who choose not to use online services.
During our online activation journey, we had steady progress, but we really wanted to ramp this up, so we made good use of our multi-channel communications (including SMS, web and email) to encourage patients to sign up for Patient Online.
This has resulted, in one of our practices, in the highest uptake and usage of patient online services in London, and we see a similar trend across many of our practices. To sustain this momentum, we’ve also built this into our core communications – we train our staff to follow protocols such as reminding patients who call or visit the practice to use online services the next time instead (where appropriate), and offer support in getting them setup and familiar.
No change process is without its challenges – we found that some staff were more keen and bought into the idea of how Patient Online could transform the way we work than others, but key reminders through our internal communications, admin and clinical meetings, bulletins and PPG meetings and so on have allowed a continued upward trend in Patient Online uptake and use.
Understandably, many patients initially felt uncomfortable with the idea that their medical records could be enabled for them to access online, so we maintained core messages about safe and secure access to respond to this.
Importantly, it’s through patients' support, by way of following our advice and recommendations, that the success of Patient Online services has truly been realised.
There are several innovations that AT Medics has designed and deployed. We share this learning through NHS England, our research association with Nuffield Trust and the University of Surrey. We also invite practices to talk to us directly so we can help them to realise the same improvements.
So, go on, 'think like a patient', and start encouraging patients to make use of online services.
Dr Tahir is Founder and Director of AT Medics. Please note that views expressed in guest blogs on our website are the authors' own and do not necessarily reflect the views of the Nuffield Trust.
Tahir A (2016) ‘How 'thinking like a patient' helped us get our patients online’. Nuffield Trust comment, 18 November 2016. https://www.nuffieldtrust.org.uk/news-item/how-thinking-like-a-patient-helped-us-get-our-patients-online