The lasting changes to healthcare in the wake of Covid-19 are a hot topic of discussion. Due to necessity, we’ve seen a transformation in the way care is delivered, managed and accessed across our country and world. Less discussed though, is the opportunity to reconsider the role that the traditional physical surgery plays in primary care – and what this means for patients and our healthcare system in the future.
Although physical surgeries will always be a central hub for care delivery, the concept of the physical surgery as the main entry point into the health system no longer meets the needs of the population or the system. In the future, digital can bring together all forms of healthcare – including urgent care, specialist or care based in patients’ homes – so instead of different parts of healthcare feeling disjointed, they are all brought together, with the patient firmly at the centre.
That’s why I was happy to see this week the Royal College of General Practitioners (RCGP) say that there was a “compelling case” to keep “total triage” – where patients are assessed online or over the phone – before a doctor decides whether they need to come into their surgery. The RCGP’s report on the future of primary care shows the massive drop in face-to-face appointments “within weeks” of the pandemic and their chairman even suggests that 50 per cent of all appointments will be remote in the near future. This is a massive change, but it’s one people are more used to than you think.
The same fundamental change has been made in other industries such as high street banking. The local bank branch was once a pillar of the high street, but now people walk into a bank branch once or twice a year, whereas they interact with their bank on mobile devices several times a month. The majority of customers have remained with their existing bank, but have switched to digital apps as their main entry point. Some traditional banks – like Nationwide – have transformed the role of branch banking by offering a more personal and customer-focused experience in their physical environments.
The current pandemic could have the same impact on healthcare. Covid-19 has forced physical GP surgeries to rapidly evolve to reduce unnecessary face-to-face appointments to protect both patients and staff. Post-Covid, patient experience would be transformed if physical GP surgeries maintained this lower traffic and focussed on delivering care for those with more complex needs or who need to be physically examined or treated. The majority of patients – like banking customers – increasingly want and expect a tailored and efficient healthcare experience, without losing quality of care. Digital can deliver this.
In this model, the physical surgery is focussed on supporting patients who need physical examination, specialised care or for those who have barriers to accessing digital services.
Too often there is a bottleneck for demand, with patients accessing inappropriate levels of intervention based on who is available, rather than what they genuinely need. Digital can help us streamline the system – for instance, the Livi app’s network of clinicians and healthcare professionals are flexible to demand, so services are expanded or contracted, where needed.
Patients can then access the right medical advice they need, sooner. Practices don’t just use general practitioners but a range of experts – pharmacists, nurses, physiotherapists or psychologists – either remotely or in person. The system benefits from fewer wasted appointments and more patients accessing quality self-care information.
This new, digital-first model brings significant benefits and will rise to meet fundamentally shifting patient behaviour, for the better.
Digital triage can also connect patients to relevant self-care and symptom information, which can empower them to take control of their own health, reduce the need for appointments and increase patient satisfaction.
Patients in the future – as with digital banking – want to be more in control. They want to manage how and when they can access healthcare, on their own terms and at the touch of a button.
As a GP who has spent many years in frontline NHS services, I know both the brilliance of and challenges facing our national health service. Change has been a long-time coming, and if done well will ensure empowered patients, an efficient healthcare system and a healthier nation.
Harriet Bradley is the medical director of Livi.