The Changing Dynamic of Primary Care

Published 12/07/2019 by Ric Thompson, Managing Director, Health & Care, Advanced

“As medicine advances, health needs change and society develops, so the NHS has to continually move forward so that in 10 years’ time we have a service fit for the future.”  NHS Long Term Plan

That statement, laid out on the NHS’ own website, summarises perfectly the tumultuous situation our health network finds itself in. We are in the midst of a shift to care that is more patient centric than ever before and technology plays a key role in that move. The days of a primary care system that uses printed letters, fax and other, outdated, transfer of care methods are coming to an end. Thanks to the NHS Long Term Plan, the coming years will see a modern NHS service that looks to technology to support its plans1. This will allow patients more control over the care they receive, and deliver patient information into the hands of practitioners instantly and seamlessly - not only speeding up consultations but also reducing the workload burden on GPs.

A lot can happen in five years, especially in health where medicine collides with social change and technological advancements to force a near constant re-evaluation of priorities. In the Five Year Forward View of 2014, some of the key themes highlighted the need to provide more control to patients, whilst simultaneously breaking down barriers to how care is provided. This has continued to be a key theme in the Long Term Plan.

More choice in how healthcare is provided

Greater control over how their healthcare is delivered has now been given to patients by offering a wider choice of access points within primary care. The introduction of Urgent Treatment Centres is just such an example, providing patients with access to healthcare whenever they need it. The Long Term Plan states that the patient is always the main priority and that they must come first, no matter what. Making the delivery of healthcare flexible to the needs of the patient allows this, while also reducing the stress on the Emergency Departments.

Self-service and self-asses are becoming the norm

Another key development within primary care over the last five years has been the increasing adoption of technology by both clinicians and patients. Barriers are broken down and care is placed directly in the hands of patients thanks to the availability of free-to-access, accredited symptom checkers, like the NHS app and 111. Our own Odyssey system is at the forefront of this, delivering clinical decision support to both the practitioner and the patient. In addition to digital tools, the availability of online GP services2 throughout the UK has seen a sharp rise over recent years with an expectation that the market will continue to grow3. Adoption of self-asses technology and access to online services can only help to reduce waiting times for appointments within GP practices, while providing choice and control for patients.

Collaboration and the rise of ‘primary care at scale’

The NHS Long Term Plan includes the statement; “encourage more collaboration between GPs, their teams and community services as ‘primary care networks’”.  With a drive to a more joined-up NHS, the journey towards ‘primary care at scale’ has begun with federated working in operation throughout the UK. This model, where GPs are working together to optimise back-office efficiencies while also increasing the availability of services on offer in an area, helps drive towards a more integrated care system. Our own Docman 10 product has plans to directly support this model, allowing GP Federations to scale as they need, centralising administrative duties from across practices and enabling cross-organisational appointment bookings.

Data in the hands of the data owners

As primary care at scale continues to develop, GPs will require more flexible access to a patient’s personal health record. The introduction of Urgent Treatment Centres, combined with out-of-hours services and the growth of federated working, means that a patient may now access care in any setting. It is therefore vital that the latest revision of a patient’s documentation is available to all clinicians in all care settings.

Within the Long Term Plan, they also discuss ‘Personal Health Records’ and how patients have control over what data they share within the NHS. This is a major step forward for patients being empowered to decide on how much of their data is shared. This is forcing technology and service providers to develop mechanisms to allow for the control of clinical data. The requirement for functionality within clinical systems, such as ‘Share / Do not share’ is becoming vitally important to ensure patient data security is maintained.

10 years will come soon enough

The NHS Long Term Plan is ambitious, driving to keep the NHS ahead of the changes that it is facing every day. Those improvements are being tackled in a multitude of ways, with technology being just one of them. As Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) work together to improve patient care, they will look to employ technology where it makes sense to do so, reducing the process burden and using it in innovative ways where possible. The challenge set by the NHS for companies like Advanced is to be there to support them when they do.

 

1 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/the-nhs-long-term-plan-summary.pdf

2 https://www.england.nhs.uk/2018/03/dramatic-annual-surge-in-online-gp-services-as-patients-sign-up-for-convenience/

3 . https://gkstrategy.com/wp-content/uploads/2018/11/The-Rise-of-Digital-Doctors.pdf