One of the many groups getting stick for the current pressure on NHS emergency wards are GPs, criticised for their long waiting lists and inflexible hours which lead to people pitching up at A&E with sore shoulders and the flu. The GP contract, which allowed primary care physicians to opt out of out-of-hours cover, is the popular scapegoat for this, but there’s also the question of whether there are enough GPs in the system at the moment to serve the number of patients who need them.
Some patients are giving up on the free NHS primary care system. The doctor can see you now, in your living room, via webcam, using apps like Push Doctor. The GPs who work for Push Doctor do so on a private basis, but many of them work their normal hours in the NHS, popping up in their kitchens in the evenings to speak to paying patients who remain curled up on their sofas. The company says it has already provided ‘thousands’ of consultations, and that it works with a network of over 7,000 doctors.
I was curious to see how this service worked – and had run out of a regular prescription while hundreds of miles from my London GP over the Christmas holiday – so signed up.
Rather comfortingly, the virtual waiting room was rather similar to an NHS one: my GP was half an hour late to see me. When he popped up, clearly in his kitchen, with his General Medical Council registration number emblazoned across the screen, he asked me about my medication, whether it was agreeing with me, and then issued a repeat prescription which was sent the next morning to the pharmacy down the road from where I was staying. My consultation was relatively straightforward, but the GP didn’t have access to my notes, and had to take on trust that the drugs I was asking for were the right ones for me.
The Royal College of GPs is worried that this sort of service might not be fully safe. Professor Helen Stokes-Lampard, RCGP chair, says:
‘We have potential patient safety concerns about apps offering consultations via smartphones, particularly if they are not linked to a GP surgery. GPs will be giving patients advice about their health without necessarily having access to their medical history, or information about drugs that they have been prescribed, thereby relying on information provided by patients that is unlikely to be as comprehensive as that held in their medical records. We need evidence from pilot projects to evaluate the safety and effectiveness of these new initiatives before they can be fully endorsed.’
The RCGP isn’t surprised, though, that people who can afford to do so are turning to private online services for primary care. Some, like me, are simply disorganised and are grateful to be able to compensate for that disorganisation by paying a small fee. Others will be exasperated that they have to wait so long to see their doctor – and aren’t sure whether their ailment is really serious enough for them to take time off work to attend an appointment at a surgery during the day.
Perhaps this will relieve some of the pressure on the system for those who cannot pay – but it is rather a verdict on the state of primary care and supply of general practitioners that people are having to turn to an app at all.