Patient safety fears as GPs pay private firms to give consultations via computer

September 20, 2016

GP surgeries are offering consultations by webcam to cut waiting times
Private doctors will conduct the online appointments and NHS will pay
Advantage is that the patient’s wait can be reduced from days to minutes
Three practices covering up to 31,000 people have launched the service

Sophie Borland Health Editor For The Daily Mail

Published:
18:18 EST, 19 September 2016

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Updated:
04:01 EST, 20 September 2016

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GP surgeries are offering consultations by webcam to try to cut waiting times.

Private doctors will conduct the online appointments. The NHS will pay.

Patients will first have to download an app on their computer or mobile phone.

At the allocated time they log on and speak to the GP using their built-in camera or webcam. The advantage for patients is that their wait can be reduced from days to minutes.

Three practices covering 31,000 people have launched the service. Scores more are expected to follow.

Waiting times to see a GP are the worst on record and surgeries are struggling to cope with the pressures of immigration and the ageing population.

But campaigners point out that online doctors do not have access to medical notes and might miss serious symptoms they would spot in a regular consultation.

GPs are giving patients the chance to speak to them by using a webcam to cut waiting times

There are also questions over ‘privatising’ the NHS and whether surgeries should pay firms to do their work.

Richard Vautrey, of the British Medical Association’s GP committee, said surgeries should be wary of the webcam system. He pointed out that their insurance would not cover them for blunders.

‘It is always better for a patient to receive treatment or advice from their local GP who has the ability to give full, competent medical advice,’ he added. ‘Private GPs cannot for example access full medical records which is crucial in assessing the advice that should be given to an individual if the issue is serious.

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‘The real solution to these workload pressures that result in schemes like this is for the Government to urgently reverse a decade of underinvestment in general practice so that GP services can be properly funded to meet the growing health needs of their patients.’

Babylon Health has had webcam contracts with the Highlands surgery and Eastwood group practice in Southend, Essex, since mid 2015, covering 22,000 patients.

And Push Doctor is carrying out pilot projects including one with the Woodlands Practice in Oldham, Greater Manchester, which has 9,500 patients.

Both firms employ NHS GPs from all over the country who earn extra cash by doing the virtual consultations from their homes or surgeries in their spare time. They can prescribe drugs but do not have access to medical records, and have limited knowledge of their patient’s complaints.

Patients have to download an app on their computer or mobile phone before they speak to their GP

The participating surgeries strongly encourage patients to take advantage of the webcam service when they request a face-to-face appointment. An automated message at the Highlands surgery promises callers they will be able to ‘speak with a doctor in minutes’.

A spokesman for Babylon Health said about 3,000 Essex patients had used the webcam service and 70 per cent of them decided they did not need to see a GP face to face after all.

Paul Bates, the firm’s director of NHS services, said it was in talks with other practices in Essex and London. He hopes to have contracts covering a million patients within five years.

The firm would not confirm how much GPs earn for consultations but said fees were comparable to locum rates.

That would imply £60 to £100 an hour, depending on the area and time of day.

FAMILY DOCTORS TURN TO VIRTUAL CHECK-UPS

GPs are increasingly encouraging patients to have webcam or Skype consultations.

But this is the first time surgeries have hired private firms to carry out virtual consultations on their behalf.

Over the past few years several private firms have begun offering webcam appointments at a cost of up to £30 for 20 minutes.

They claim there is huge demand amongst patients who are having to wait up to three weeks for an appointment with their own GP. Patients can also have virtual consultations on their mobile phones, using Facetime.

Private firms say the majority of patients prefer to do them on their laptops as they can see the doctor more clearly.

Babylon and Push Doctor have both developed their own webcam apps for online appointments.

Katherine Murphy of the Patients Association said: ‘We are most troubled about the consequences this could have on safety.

If the private providers do not have access to medical records, then we are naturally suspicious of how an accurate diagnosis can be made without these important details.

‘Outsourcing to a private firm is most certainly not a solution that most patients and the public feel comfortable with.’

Owen Smith, Labour leadership candidate, said: ‘This is yet further evidence of an NHS which is being privatised by the back door. General practice is in crisis because of years of underfunding and a dangerous shortage of GPs.

‘And yet rather than tackling these issues, ministers are letting private companies profit from patients waiting weeks to get an appointment.’

The latest NHS figures show that half of patients cannot get an appointment in two days and many have to wait up to three weeks.

Jeremy Hunt said earlier this month he wanted the NHS to embrace technology to improve the service to patients.

Although the Health Secretary did not mention webcam consultations specifically, he said he wanted smartphone applications to be developed as part of a modernisation scheme that will cut pressure on the service. Patients will be able to have ailments diagnosed by a new app instead of calling the NHS Direct helpline on 111, Mr Hunt said.

On Saturday the Mail reported that GPs are earning extra cash by charging patients registered at other surgeries up to £70 for an appointment.

They are signing up to a scheme that lets them offer private consultations to anyone outside their catchment area willing to pay.

GPs charge between £40 and £50 for a 15-minute slot, or £70 if it is out of hours. Same-day appointments are also available. Critics have said this sort of service is a ‘slippery slope towards privatisation’.