Technology is specifically designed to help make life easier. This applies to healthcare as much as any area of life, but is the new NHS App – rolled out across the country last year – a good example of such technology and a good use of NHS resources?
The NHS App, which is slowly but surely growing in use across England – around 220,000 patients are now signed up to it – is an example of how technology – at least in theory – can help patients and GP practices communicate more easily and save time.
The app provides patients with a secure way to access a range of NHS services on their smartphone or tablet, such as managing repeat prescriptions, booking GP appointments and viewing their GP medical records.
It is early days for the app, but it appears to be gathering momentum.
Earlier this month, NHS Digital said that more people than ever before booked NHS appointments digitally choosing to use this route rather than calling their local surgery. In September of last year, there were 1.4million GP online service appointment transactions – a small but significant slice of the 26.4 million GP appointments that took place that month.
Firstly, has the introduction of the app been handled well? Some practice managers say no and wish that more could have been done to smooth it’s arrival.
Nicola Davies, practice manager at The Roseland Surgeries in Cornwall, says the app has great potential but its introduction has not been smooth and it should not be the only way for patients to access services.
“I didn’t get any communication to say it was going live,” she says. “The communication to organisations about it has been poor.”
There have been some teething problems for Nicola’s practices such as confusion over the fact that her organisation is a multi-site one with three practices, and patients who have sent prescription requests via the app but which were not received – this was how the practice found out that the app had gone live.
Secondly, are there limitations on how well the technology will work in some parts of the country or could it help circumvent these issues?
Nicola explains: “We are in a particular part of Cornwall where public transport is poor and we have lots of patients who are isolated so those can use the internet are massively aided by it because they can’t get out and about otherwise.
“However, our mobile signal is not great in certain pockets of the area that we cover so for patients to have lots of different ways of accessing their surgery is a brilliant idea and the beauty of having online access – whether that is through the app or via the website – is that you can do anything you want at any time of the day or night.”
A practice manager speaking on a discussion forum on the subject on Practice Index’s website, says: “It [the app] will disadvantage patients in rural areas, like ours, for whom mobile signal is but a distant dream!
“We were very keen on the NHS App when it was first announced and even asked our CSU if we could be an ‘early adopter’. However, we asked a couple of tech savvy patients to register and tell us how they found the process. They didn’t like it at all, found it too complicated in terms of sending videos and copies of ID etc.
“We are now going with iPlato, which gives access to the MyGP app. Have only just signed up but it looks very much more user friendly to patients.”
Robert Campbell, a retired practice manager, says: “For some strange reason, my local practice is now encouraging the use of the NHS App. To get this to work, you need either to go through a system of proving photographically who you are or obtaining three sets of login passwords to get on line. So far I haven’t logged in.
“However I have logged in to the MyGP site with logins provided by my practice. I have to say that the screen presentation is simpler and clearer that Patient Access, more informative and has reminders to tell me when my next appointment is.”
Thirdly, patients’ enthusiasm for as well as willingness and ability to use the app will have a huge impact on its success.
Robert says: “I do feel sorry for patients who cannot get their heads around new technology and I have to say that I also feel sorry for practice staff and GPs who live in fear of yet another password change!”
Nicola adds: “With the app, I would be very surprised if we were to have older patients using it because they may not have a smartphone. The older generation do not use the phone in the same way that younger people do. Generally, the app is not going to be used as much by the older generation.
“It’s about saying to patients that there are so many different ways that they can contact us. It doesn’t have to be by phone if they don’t want to. It is time efficient and if it reduces traffic at the desk in terms of phone calls, that has got to be a good thing.
“In theory, it is brilliant. If you can do all of the routine stuff – request and book appointments, send for a repeat prescription – to be able to do that remotely, out of normal office hours is just brilliant.”
Scepticism of the app is perhaps not so surprising in its early days and one manager speaking on the Practice Index discussion forum page, says: “Just finished a webinar re the NHS app. It was clear that the primary focus for the NHS is to get more appointment booking online. Barely a mention of repeat med requests.
“They are really, REALLY pushing for us to make way more appointments available online. With the best will in the world and all the planning of slot type descriptions, we will end up with a huge increase in inappropriate bookings.
“Even if it’s possible to make it hard for patients not to give a reason (agree you have to have an opt-out), we simply don’t have time to check the reasons each day for appointments booked online and phone the patients, which is what they suggested!
“Apart from the NHS 111 triage algorithm, I see zero advantage to the practice of switching to this app.”
Nevertheless, Nicola argues that it could help all parties if used in the right way, saying: “The technology is there to support you and it’s a really useful tool, time efficient and user friendly mostly, but I think we need to be careful about what we are putting behind it.
“We have to give people as many different ways as possible of contacting us. We are never going to get rid of the phone nor the receptionist on the end of the phone but we will offer other options.
“Having various different mediums is a bonus. I think it’s a step in the right direction but we need to be careful about what we throw at it. Let’s use it ‘in addition to’ and not ‘instead of’.”
Initial experiences of the NHS app by GP practices seems to indicate that there is a lot of room for improvement.
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