Evaluation of PMCF schemes highlights outcomes

The PMCF Wave 1 evaluation report by Mott MacDonald makes fascinating reading, but much of it is between the lines.

Summary page VI:  “To date telephone-based GP consultation models have proved most popular and successful…

“Other non-traditional modes of contact (for example video or e-consultations) have yet to prove any significant benefits and have had low patient take-up.”

The e-consultation system used is webGP, and more detail is revealed on page 14:

“Care UK implemented a diagnostic and e-consultation system at all eight of its practices but experience suggests that it has a limited appeal for patients; they tend to prefer the pilot’s telephone access offer, which provides patients with a GP response more quickly. Since going live, the pilot has provided 470 on-line consultations up to the end of May 2015”

Care UK’s scheme was run over its 8 practices with a total of 45,000 patients.  Demand for a GP is typically 6.5% of practice list size per week, which makes 152,100 per year.

470/152100 is 0.30% of demand.  This figure explains the comment of “limited appeal” for patients.  Other benefits of the scheme may be claimed but calculation is impossible, apart from the cost of submissions.

The price of 75p/patient per year, including VAT, implies a cost of £33,750 for the scheme.   This is £71.80 per submitted consultation.

By contrast, page 30 describes telephone triage systems, in two of which Dot Community Health was involved in delivery.  We were not consulted on the evaluation, but the assessment is made, “This is an encouraging outcome to date.”

Our view remains, changing to a demand led system where GPs respond quickly produces rapid and sustainable benefits.  With the telephone this is well proven, operating as a whole system, and pays back investment.  Online access has not been proven to work in the PMCF, but this is a function of the product and service offered.  We have shown how over 45% of demand has shifted online with askmyGP.  Fundamentally it is a better solution than telephone only, both for patient convenience and GP efficiency, and the evidence continues to grow.

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