Sunday, 4 December 2016

If you’re really smart, you won’t bother trying to get an appointment with your GP

Despite there being 33m landlines in use in the UK, a growing number of the population, around 14%, live in a mobile only home. OfCom 2016 research report noted that mobile phones are the media device most adults would miss the most. In 2014 it was their TV (and it still is for those aged 55 and above). So perhaps it shouldn't have been too much of a surprise to sit in a meeting the other day and watch a colleague endlessly switch from looking at (and using) the 2 mobile phones she had. There was almost something rhythmic to what she was doing in her constant scanning and responding to her emails. Amazingly, she also appeared able to actively participate in the discussions.

One phone is more than enough for me – but there must be lots of folk in the UK who routinely have and use more than one mobile. Indeed worldwide there are over 7bn mobile phones in use. The UK has a population of just over 64m. However, and interestingly there are currently 83m mobile phones in use and over 91m active mobile subscriptions. 93% of the UK population personally own or use a mobile phone, although only 71% of these users have a smart phone.  

It seems that the smart phone is becoming the preferred device to use for 60% of our on-line activities. There is a 10% increase each year in the numbers of people who only use smartphones or tablets to go on line rather than a PC or laptop. Most of us (87%) use the internet however, and the only group where this is not true are those aged 75 years and older In this group most (65%) don't use it at all. However there is one area of use where on-line access is still not generally fully developed - the NHS. The Nuffield Trust recently published report - The Digital Patient: transforming primary care? builds on previous work in this area. For example it acknowledges the way in which digital tools are already changing how many people manage chronic health conditions such as diabetes or asthma.

But equally many of the 165,000 health apps available today have not been properly assessed. And of those that have been assessed, many have been found to be inaccurate or ineffective. This is slightly worrying when its known that 51% of people using search engines cannot correctly identify what might be an advert or sponsored link. 62% of users accept that some websites will be accurate and unbiased, and some won't. However, 18% of users, and predominately people aged between 18–34, think that if a website has been listed by a search engine it must be accurate and unbiased!

The Nuffield report focused upon a number of digitally based services. For example, online triage programmes; symptom checkers; wearable technology; on-line appointment systems; and video consultations. One of its conclusions, was that the evidence around the effectiveness of health apps also applies to some of these other digital services. Leaving such quality issues aside (I'm sure someone somewhere will find a way to address these concerns) there is still the issue of the modern day equivalent of Horse, Trough, Water and Drinking going on here. Patients will not make use of the emergent digital services if they are not shown how they might benefit from doing so, and some people will simply not be interested in finding ways of increasing self-care.

In the UK, it is the NHS England's strategic aim to get at least 10% of patients to use one or more [official] on-line service by this year and 20% by 2017/18. The GP Forward View aims to ensure every GP practice is able and equipped to gain the benefit of high quality wi fi services and as such can make better use of technology in enhancing our experience of contact with health care services. A quick recap – we all use mobile phones, more of us own and use smart phones to access a wider range of services. The NHS is playing catch up but getting there. GP practices are to be equipped to ensure we start to access health care services in the same easy way we buy a take away, order a taxi, fill in our tax returns and find our way when lost. 

That might have been the end of this week's blog – and a good place to end it would have been. That was until I read about those good folk at NHS Somerset Clinical Commissioning Group (CCG). They have joined a growing group of CCGs who have started to ban GPs from prescribing a range of 25 items that are considered suitable for 'minor ailments'. It is one way to get people to think more about 'self-care' I guess, but some might think about it as another example of care rationing. If this is the case for you and you are already reaching for your smart phone to look for someone to complain to – I have saved you the effort – you can click on the hyperlink here.