It’s a startling fact that since 1989, 40% of banks and building societies on Britain’s high streets have closed.
While on the face of it this is seems like a stark reduction, for the most part it is simply the outcome of our migration towards phone and online services over the past decades.
Changing consumer behaviour has forced the banking, retail and travel industries to change the way they deliver services – from creating slick, interactive websites we can manage our money and purchases from, to increasing self-service in stores.
Strikingly, however, health has not travelled in the same direction. Less than 1% of us in the UK are organising our healthcare online.
In fact, the basic model for how people access their healthcare hasn’t changed much in at least 60 years. We remain fixated with the eight-minute GP consultation and people still turn up to wait in long queues at surgeries in the morning in the hope of seeing a doctor.
This is an anachronism we have a huge opportunity to change. In the process, we can make the NHS more sustainable.
The potential benefits for primary care
Take the warnings we’ve heard recently about primary care. The Royal College of General Practitioners (RCGP) has said up to 600 surgeries could close in the coming year as more and more GPs come up to retirement and younger recruits become scarcer.
The political response from both Labour and the Conservatives has been to promise thousands of new GPs, however realistic that is.
But for all the good intentions, this discussion leads us down a dead-end street. What we need is a transformed model of delivering healthcare at scale that can be used by all of us, making better use of the human resources the NHS already has.
In Birmingham, Digital Life Sciences is pioneering what this future primary care model could look like, in partnership with a GP ‘super practice’, The Vitality Partnership. We have launched a clinical contact centre or ‘hub’ which can be accessed via the web, phone or a dedicated mobile and tablet app for a local population of 60,000.
Three practices are already offering phone and Skype consultations with a doctor or prescribing nurse from 8am to 6.30pm Monday to Friday, with more set to follow.
Eventually, it’s envisaged that all patients in the group’s area will be able to access this hub from 8am to 8pm, seven days per week.
The service is proving extremely popular, with up to 800 callers per day already making use of it. Over three-quarters of the calls are answered within 30 seconds by call centre agents who after an initial conversation with the patient, book same day Skype or phone consultations with the first available appropriate healthcare professional. The healthcare professional is then able to resolve the call remotely or book the patient in for a same-day face to face appointment.
Appointments are being booked throughout the day, moving away from the usual morning rush and meaning people don’t have to plan their whole day around a trip to the doctor’s.
But what’s most remarkable is the fact that 70% of these callers are having their problem dealt with remotely, rather than needing to come in to see the doctor. The average duration of a call between doctor and patient is also just five minutes – meaning doctors can speak to far more patients in the course of a day.
Importantly, this also frees up primary care doctors to spend their face-to-face time treating people with more complex needs and this saves money down the line by reducing the number of acute hospital admissions and the need for community care. This greater efficiency saves the whole NHS money.
While so much political focus has been about bolt-on extras to our existing services – more doctors here, longer hours there – what we really need is to entirely rethink the way in which we deliver services so that they better meet patient demand.
Take it online, deliver it online, and you change the whole service and cost model. For us, this isn’t just a hypothetical argument – we are putting it into practice in one of Britain’s most diverse communities right now, and it’s working.
And it’s not just about money; it is about making sure we have an equitable system that works for everyone who interacts with it.
Digital health shouldn’t be an obsession with databases and records – it should be about using the technological tools we have to improve people’s access to healthcare.