PMCF: not even measuring the right thing

I have to say I am very frustrated with the PMCF Wave 1 report, titled “Improving Access to General Practice”.  You’ll recall my offer to Dave that he could change the name to PM’s Dot Community Health Fund provided it was evidence-based.  This does not cut it.

The major failure is not to measure what actually matters to patients.  To restate the b*****n’ obvious, the question from patients is, “How soon can I get help from my GP?”.  There are 9 national metrics, change of hours, modes and fluffy satisfaction surveys, but this simple measure is missing.  Can it be done?  We did a little taster of 50 practices in the Dover Collection, showing we could do it on an industrial scale, and offered it to them.  But no, they wanted to spend far more money on this glossy verbiage.

So what is useful in the report?  Of course we are glad to read in the conclusions p38 “To date telephone-based GP consultation models have proved most popular and successful. There is growing evidence… due to the GP time savings that are being achieved.”  Yup, it works and it’s sustainable without more funds.  We were involved in delivering the two largest ones (p30) in Brighton and Birmingham.  In the latter it was so good that Vitality/Modality have started selling their own version!

But we also read “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 only numerical evidence cited for this is webGP/eConsult, where analysis of the CareUK scheme (p14) shows just 0.3% of demand moved online, even less than webGP’s own data which is around 0.7%.

With up to 45% of demand shifting online via askmyGP it’s a shame this was not evaluated, but there are clearly huge differences in approach.  We’ve listed them in this handy comparison chart.

Universality is crucial to uptake, meaning all patients, with any problem, can get help fast, and then they love it.  The mother of a 3 year old with foot pain wrote yesterday, “This is much better than being on hold on the telephone. Especially when you have young children and don’t have a lot of time to be on the phone. A big improvement!”

We’ve been doing a series of examples from patients seeking help, and this week’s is very short and simple, a painful eye.  It saves them having to argue for an “emergency slot”, suffering for days or going to A&E unnecessarily.  It means the GP knows what the problem is before getting in touch, and doesn’t waste time where there’s no need.

Message to Dave:  you’re looking in the wrong place for the wrong thing.  Hello!  Over here!


Dr Sara Cowell

PS I did my first ever webinar on Thursday, really enjoyed it, and we had about 40 minutes of questions at the end.  If you missed it there’s a recorded link here, Understanding demand, the key to better service and lower stress.  You can still get the CPD credit in the comfort of your own home.

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