We looked at the online services available at 10 Greater Manchester GPs a week after the Government pledged to solve the problem. Helena Vesty reports
‘From a GP’s perspective it’s a good thing because people know their request will get looked at, and they won’t just be left having to ring at 8am tomorrow for another scramble’, says Dr Murugesan Raja
The 8am scramble for a GP’s help is going to be a thing of the past, the government has declared.
But some doctors have aired concerns that the move will actually mean less time for appointments.
Others have claimed practices will simply refuse to make the changes mandated by politicians because of how they will stretch already scant resources.
While some GPs say that if an illness is caught early through an online request, then opening practices up to higher demand is worthwhile.
Last week, Care Minister Stephen Kinnock declared that, from October 1, all NHS GP surgeries in England are contractually obligated to keep their online consultation tools open from 8am until 6.30pm between Monday and Friday.
Under the new system, patients will be able to request appointments, ask questions, and describe symptoms online throughout the day rather than calling their surgery or visiting in person.
Join the Manchester Evening News WhatsApp group HERE
The government promises that this will help free up practice phone lines for urgent requests and those who have no online access, and make it more convenient to get appointments.
The Covid-19 pandemic sped up the need for GPs to offer online services and, in Greater Manchester, every GP practice now already has some kind of online offer. But, like much of the rest of the practices in England that do have online services, how they work varies from practice to practice.
Some GPs turn online requests off when they reach a certain number, while others only have the online function available for a few hours a day.
On October 1, I looked at the online offering of 10 GP practices in the different boroughs of Greater Manchester.
The results varied wildly as the announcement was made – with some senior GP sources telling the Manchester Evening News that they would not be enacting the government’s new rule because of a lack of staff to deal with a rise in online requests.
A week later, on October 8 and 9, I checked back again.
Routine appointments and non-urgent requests are taken via the NHS app for one GP in Hulme, but were turned off all day with no opening or closing times advertised on October 1. It was the same again a week later.
But in Middleton, one practice had non-urgent and routine appointments requests turned on all day online, again with no opening or closing times, or information on whether they get turned off depending on demand. This was also the same on October 8.
In Didsbury, one practice offered same-day appointment request forms online between 7am and 10am on weekdays on October 1, and that was the same the following week.
Following the hyperlink to the form on the afternoon of October 8 also led to a second message saying a different form was available for non-urgent requests, between 10am and 6.30pm.
Meanwhile, at a Gatley surgery, medical request forms were available on weekdays between 8am and 2pm. On October 8, that policy remained on the website – and just before 2pm, the practice released a message saying it had ‘reached capacity for medical queries and temporarily paused access to online enquiries’.
It added that administrative and routine care requests were still available, and encouraged people to call the practice for anything urgent.
Care Minister Stephen Kinnock said: “We promised to tackle the 8am scramble and make it easier for patients to access their GP practice – and through our Plan for Change, that’s exactly what we’re delivering”(Image: PA Archive)
In Bury, online services requests were available on AskmyGP until 2pm, if urgent. One practice advised that any requests made after 4pm may not get a same-day response. According to theor website, these rules were the same a week on.
Over at a surgery in Salford’s Boothstown, online request forms were able to be submitted between 8am and 6pm from October 1 for both urgent and routine appointments.
On the same day, in Cheadle Hulme and Heaton Moor, two GPs offered online services from 8am to 6.30pm. Those practices used the nationally popular AccuRX to host their online services, which appeared to have updated many of its websites to advertise the government’s mandated opening hours on the day of the announcement, the M.E.N. understands.
The same goes for Econsult, another online consultation website used by GPs widely across England. A GP practice in Bolton using Econsult also offered online services from 8am to 6.30pm, specifying they should be used for non-urgent queries.
However, at another Stockport-based practice which used AccuRX, one patient reported that the practice advertises an 8-3pm timeframe to request urgent same day, next day, and routine appointments online. The guidance on the practice’s website advised that online queries will be responded to in ‘three working days’.
The practice had closed off online appointments and urgent care requests by 9am on October 1. Just before 3pm on October 9, all these messages were the same, including appointments being closed off.
The message on the website read: “We have paused access to online requests and we have reached safe working capacity for the day.”
Despite a week passing since the government’s announcement, the online offering of this snapshot of Greater Manchester GP practices does not seem to have become any more uniform. Perhaps this is not surprising as there have been no extra resources.
Dr Valeed Ghafoor(Image: Handout)
Dr Valeed Ghafoor runs a 22,000-patient practice in Hyde, as well as a business training some 200 practices across the country in efficiency improvements. Greater Manchester already has online services, but that’s not the same elsewhere, he told the M.E.N.
“Nationally, I think this is a poor idea. From my experience and exposure, around 20-30 per cent of practices in this country still don’t have any online provision.
“It will be difficult for staff to switch over to such a different way of working, but also for patients who have learned they have to contact the surgery early in the day.
“Practices will have to staff their online tools late into the day, but will have fewer resources to deal with a morning rush that may still happen because patients are used to it.”
The changes have come with a requirement that all online requests are triaged quickly.
“If you have to triage people straight away, you’re going to have to have fewer appointments to free up someone to do that. There hasn’t been any additional funding with this announcement to hire more staff,” added the GP.
Dr Helen Wall(Image: Dr Helen Wall)
As the M.E.N. reported earlier this year, opening the floodgates to requests all the time runs the risk of clogging GP services even further, taking doctors’ time away from those who really need it.
Bolton GP Dr Helen Wall spoke about opening up online consultations and requests during the Covid-19 pandemic.
She said: “As we’ve gone digital, we’ve become more accessible. By trying to fix the very problem that we were struggling to cope with – demand – we’ve increased it.
“People contact us now for much more minor things than they would have done previously, because they can fill an online form in or they can do something digitally, reply to a text message.
“We had online consultations during Covid and people would send us an online medical form at 3am and say they had a sore toe. Then when you would call them at 11am, they’d say, ‘well, it’s better now. I forgot I even sent that in.’
“The fact that people can ring us, have an appointment while they’re at work during the day means that they’ll just get one just in case. Whereas before, they might have not taken an afternoon off work unless it was something that was really serious, or really bothering them.
“It’s Amazon Prime culture. You can, so you will.”
Dr Murugesan Raja says if he can catch illnesses earlier through online requests, dealing with higher demand is worth it(Image: KBP)
But following the changes last week, Fallowfield GP Dr Murugesan Raja said that, although the move may require more resources, he would rather patients feel encouraged to use the online tools to flag their symptoms, even if innocuous, than risk ignoring something serious.
“These services get busy for a reason,” he told the M.E.N. “There’s a need for it, and we don’t want urgent queries not to come through because the phone lines are busy with routine queries.
“We do state clearly that our online services are for non-urgent and routine enquiries that might be picked up the next day. The worry is if someone uses the online tools for an urgent request right at the end of the day and we don’t see it. Sometimes people don’t know what’s urgent either.
“From a GP’s perspective it’s a good thing because people know their request will get looked at, and they won’t just be left having to ring at 8am tomorrow for another scramble.
“The minutes spent on requests I don’t need to do anything about add up, but everyone’s perception of their illnesses is different. How do I know whether something needs to be done unless a patient verbalises it? We, as GPs and the NHS, need to find the solution to that.
“Practices have to try and get additional resources to manage that in a fool-proof way to make sure patients are safe – and that’s hard when general practice has been chronically underfunded over years.
“But if I get 100 queries online and two pathologies out of them, it’s worth it to catch something early for the patient and for the public purse, as it will be easier and cheaper to treat.”
Join our Family WhatsApp group HERE
A spokesperson for NHS Greater Manchester said: “All GP practices are now contractually required to offer online access for non-urgent appointment requests and medication queries from 8am to 6.30pm, Monday to Friday, and many have already been doing so for some time.
“In Greater Manchester we’ve supported our 406 practices to get ready to have online access in place, but as with any new initiatives there can be some early challenges.
“Practices are independent businesses contracted to the NHS, and each has chosen the online appointment platform that best suits their needs.”
NHS Greater Manchester says it is supporting practices, staff and patients to make the most of digital tools for care, while ensuring non-digital options remain for people who need them.
The health service for the region said 61 per cent of Greater Manchester residents have signed up to use the app, allowing them to order repeat prescriptions, book appointments and view their medical records.