Situation
NHS Salford Clinical Commissioning Group (Salford CCG) has the responsibility for commissioning health services for circa 270,000 people registered with a GP across 45 different practices.
A target for Salford CCG is guaranteeing resident expectations are continually met, services are always improving and there is alignment with national objectives such as the NHS Long Term Plan. This aims for every patient in England to access digital services and health information from their GP. Meaning improved communication channels to incorporate texts, online services and digital technology – offering the potential to meet the evolving needs of patients who demand faster and more convenient access to health services. Meeting the digital agenda is therefore a high priority in increasing patient satisfaction in primary care services.
Salford CCG reviewed the current experience of patients and found that whilst all practices offered online services, take up varied from practice to practice and its initial adoption was low. The CCG explored what practices were currently offering and discovered that many were not using a text reminder service. The CCG wanted to ensure that practices were using the entry-level digital services before evolving to using more complex digital offers such as apps.
Specific areas of focus were outlined as:
- Allowing patients to book appointments online with their GP practice
- Ensuring practices are offering an SMS appointment reminder service to patients
- Facilitating the order of repeat prescriptions. Rather than having to visit the GP practice, the patient can collect their prescription at a time and pharmacy convenient to them
- Progressing other digital initiatives such as on-line consultations
Actions
The first action was to purchase a system which worked with all Salford GP clinical systems to allow two-way text messaging. The iPLATO two-way SMS solution was purchased in 2017 and rolled out across the region. As part of this the myGP® app was offered to patients in addition to the text service.
Following the implementation of the two-way text messaging and availability of myGP, the CCG completed additional consultation work with patients and GP practices. Speaking of the consultation Laura Hosey-Davies, Primary and Community Informatics Manager at Salford CCG commented, “we do not want to impose solutions but establish the facts. Since 2018, we have run a series of citizens panels and workshops with Salford residents around their experiences of using apps to access healthcare”. Following the CCG’s research Laura and her team established that:
- The basic two-way text is generating immediate benefits as patients can cancel an appointment by text if they no longer need it, immediately freeing the time up for other patients
- GP online service use has increased in all practices
- A number of patients are accessing online services via myGP®
- Over 30,000 individuals across Salford currently use myGP to book their GP appointments, this is rising each month
- myGP and preGP™, myGP’s in-app patient care navigation, are well established with both patients and practices championing the patient facing app
- iPLATO is proving successful for proactive campaigns, for example for sending SMS text messages to larger groups of patients, the QOF invites and other campaigns such as smoking status and flu jabs
- Feedback concluded that practices found the training experience with the iPLATO team highly positive: “The training programme is very well put together with an iPLATO trainer guiding you through each setup phase and then you gradually move on through to the next module. We like the fact it works hard getting people registered to use the myGP app to book appointments or cancel them”
Results
iPLATO has been helping practices in Salford CCG to achieve the targets set out in the digital agenda. By allowing patients to book their appointments online and issue SMS appointment reminders, the CCG have reduced the administrative burden on practice staff and the repeat prescription service has had a wide uptake across the region.
Based on the current feedback, Salford CCG is now seeking to share its work with partners across The Greater Manchester Health and Social Care Partnership STP.
Although not a primary objective the implementation of iPLATO has resulted in cost savings across the CCG. The Ellenbrook Medical Centre, has reduced the cost of SMS messages by 35% as when patients are using the myGP app messages are sent via data for free as opposed to an SMS cost.
Next Steps
As a part of the GP contract, all general practices need to offer online consultation tools to patients by March 2020 and video consultation by 2021. This baseline work with of the Salford practices and its patients has signalled that primary care in Salford is embracing digital solutions. It’s expected that uptake will continue to rise and the CCG is planning a number of citizen events throughout 2019 and beyond.