Technology can’t replace GPs (yet), but it can save them time

Closing the GP Workforce gap – part 6

There has been an unprecedented focus in Primary Care to make better use of digital resources, providing virtual and remote consultations. Changing consultation modes will not provide the answers we need when looking at the growing GP workforce gap, which requires focussed planning on training, retention and addressing demand. We estimate that the benefit of innovation on workforce numbers will be relatively low compared to other strategies and that is by design – innovation should support, rather than replace, the workforce, though there is scope for potential productivity gains.

Closing the 2032 GP workforce gap, aiming for 8.5 % vacancy
Number of GPs expressed as Full Time Equivalent (FTE)

With that in mind, we should not put innovation on the back burner, for at least two considerations. One, that discovering new ways of working relies on innovation, which may yet provide us with strategies to tackle need; secondly, that innovative ways of work can have ripple benefits on other areas, such as workforce and patient satisfaction and increase the potential to attract and retain doctors in primary care.

What’s out there?

Innovative solutions are widespread in Primary Care, and some have demonstrated promising changes the way healthcare is provided, particularly through bridging primary and secondary care, and making care more accessible. Consultant Connect, a service developed for North Central London CCG that allowed GPs to directly message specialists for advice and guidance, reduced secondary care referrals in 64% of contacts as specialists could provide advice to be implemented in primary care rather than requiring a referral.

The virtual boost promoted by compelling need during the pandemic has allowed e-consultations to flourish and transform the way time is spent in primary care: e-consultations in North London have allowed non-clinical queries to be directed to staff other than GPs, and GPs were able to deal with e-consultations much faster than in person, reducing face to face consultations by 25%.

Our previous work has highlighted the vast impact of video consultations beyond healthcare savings – such as savings on inpatient travel resulting in lower greenhouse gas emissions as well as £108m savings in lost productivity through avoiding 3m lost work hours.

Productivity gains through harnessing innovation can be very material – virtual consultations have saved PCNs approximately 17,200 hours – scaled nationally, this is equivalent to freeing enough capital to employ 900 GPs –, and eConsult has shown to reduce missed GP appointments by 60%, with large time and cost savings. These strategies could give a substantial boost to our 2032 workforce concerns, though it is important to recognise the technology supports and enables the workforce, it does not (yet) replace it.

How can innovation become a reality?

Innovating does not always equate to revolutionising systems – sharing learning and making best use of resources in effective and innovative ways can be the best route to having a large impact. Working with Kaleidoscope and Cambridge and Peterborough STP, Edge Health supported the implementation of a digital first pathway for diabetic patients that enabled, through shared priorities and consistent approach to care, to improve care for diabetic patients and increase the uptake of the National Diabetes Prevention Programme without generating more work for GPs. Key to the success of the programme was the sharing of evidence that supported innovation within the STP, as well as the engagement with frontline staff that directly experienced the benefits of the innovative intervention.

We could draw four take home points from this successful implementation of innovation at scale:

• Ideas should be generated locally, where need is clearly understood
• Successful innovation relies on collaboration across practices – this promotes not only sharing of best practices, but also agreement on care delivery strategies that have the potential to level up working habits
• Taking on from the example of practices, collaboration across ICBs will also enable effective innovation to reach other areas through cross-communication; central channels need to be available for this to happen
• Innovation must involve frontline staff rather than be exclusively top-down, for effective implementation and longevity

The last consideration is particularly important in the context of workforce – attempting to implement innovative strategies will undoubtedly be a challenge amidst an overstretched, disenchanted workforce. Taking decisive steps towards tackling the workforce gap will be a necessary step to promote further innovation, and in return, innovation could hold the keys to better healthcare that makes best use of resources.