GP hours and the much needed tech-care revolution

New data from the King’s Fund published last week has found that the average GP works less than three and a half days a week. The research also found that only 21.7 per cent of respondents planned to work in full time clinical general practice one year after qualifying (falling to 5.4 per cent planning to do so 10 years after qualifying).

The most common reason given for not undertaking full time NHS general practice work, irrespective of gender, was “intensity of working day”.

Health and social care secretary Matt Hancock has promised a technological transformation and technology, such as remote consultations or chatbots, could play an important enabling role in freeing up GPs’ time. Artificial intelligence in particular, although still in its infancy, has the potential to play a major role.

Role of artificial intelligence

As argued in Nesta’s Confronting Dr Robot report, AI has a role to play as the front door to healthcare, making the health system simpler, more accessible, responsive, sustainable, and giving patients control. Where AI can play a critical role is in the triage stage – not every patient seen by a GP needs the expertise of a doctor.

AI can help people find the right information about their medical problem and signpost them to the most appropriate method of support. We know that 20 percent of GP appointments are for minor medical problems that could be treated at home.

Earlier this year, it was reported that more than five million people across England are unable to book an appointment with a GP outside of working hours. As pressures on accident and emergency services also intensified, it is unsurprising that there is demand for more accessible GP hours.  

Where AI can play a critical role is in the triage stage – not every patient seen by a GP needs the expertise of a doctor

AI has already been trialled through the digital NHS 111 service, with solutions such as Sens.ly and Expert 24 pointing 18 per cent of patients to self care information. We are also starting to see chatbots and apps enabling patients to be triaged and pointed towards other support such as a community pharmacist, a nurse or resting at home until they feel better.  

AI based triage products have the potential to free up appointments in primary care, but they need to be robust, accessible to all and used in parallel with the knowledge and skills of healthcare professionals.  

Remote consultations are another way that technology can help relieve pressures in primary care with a study from the King’s Fund finding that although they can involve some overhead costs, overall they reduce consultation length and improve accessibility.

New care pathways and ways of working

Other technologies are bypassing GPs altogether, creating new pathways that are more efficient at reducing the burden on the system. CareCity, one of NHS England’s seven Test Beds, piloted a device that sits on a mobile phone which can spot atrial fibrillation in 30 seconds.

AF is the most common heart rhythm disturbance and people with AF have a five times higher risk of stroke. The technology is being used by community pharmacists and people with an abnormal result receive a rapid referral to a One Stop AF Clinic with the total pathway being reduced from 12 weeks to 2-3 weeks.

Embracing the digital revolution

For the full benefits of technology to be realised in the health system, we need to ensure that GPs and patients are equipped with the technology and skills they need to engage at the right time and in ways which best meet their, and their patient’s, needs.

Patients, especially those with low digital skills, need to be supported to embrace new technologies and should continue to be offered non-digital options when needed. GPs, including those in training, need to be able to evaluate and recommend digital technologies for their patients, while understanding their potential limitations.

For the full benefits of technology to be realised in the health system, we need to ensure that GPs and patients are equipped with the technology and skills they need to engage at the right time

It’s, therefore, timely that Dr Eric Topol, commissioned by the health secretary to examine the future needs of the NHS workforce, has published an interim report looking at skills needs.

Harnessing the power of technology and AI could make the health system more dynamic and responsive.

Although it cannot replace individualised conversations, it can be an effective personal healthcare assistant, signposting patients, supporting decisions to ensure that patients are getting the care they need at the right time from the most appropriate resource.