GP remote working: 2020 the year when everything changed
On the 10th of March this year Health Secretary, Matt Hancock, told Parliament that “wherever clinically and practically possible people can access and should access primary care through phones and digital means”.
The rapid rate of change caused by Covid-19
The transformation that followed has been seismic. In the following weeks, 71% of GP appointments were conducted by telephone compared to just 26% face to face, according to RCGP data from approximately 500 practices. This was almost a complete reversal from the same period in 2019 when 71% of appointments were delivered face-to-face and a quarter by telephone. These vehicles for remote consultation have, in turn, provided new opportunities for GP’s to work more flexibly and from home, or other remote locations.
Few GPs had previous experience of working from home and consulting with patients remotely, so do they now expect to spend less time in the surgery in future? According to a survey by GPonline, 63% of those surveyed agreed that the profession would take the opportunity to spend more time working from home.
The value of remote working for GPs
During the COVID-19 emergency period, significant numbers of general practice staff have been unable to work from their normal GP practice base, so clearly there is value in enabling remote working in these unprecedented times. However, it’s not all about the response to the current pandemic. Remote working has the potential to increase the pool of clinical capacity to help overcome the challenges of geography, working hours, access to clinical space and recruitment black spots. When demand exceeds capacity, a backlog of clinical administration work quickly builds up. A team of remote clinicians who are available to work away from traditional practice settings can provide the extra capacity needed. This can be in the form of ‘one off’ support to help a practice experiencing a temporary period of reduced GP capacity, or as ongoing ‘business as usual’ support.
There is of course a bigger picture to be considered as one respondent highlighted, “I think phone consultations are excellent for certain things but not to replace face-to-face because lots of issues can be missed. I also feel that it is not healthy to do a social job and not be sociable. We still need human contact, not just screens and telephones – and that goes for both doctors and patients”. However, the case for remote working, at lease to some extent, is clear, so how do we go about enabling our GPs to work effectively away from the practice?
Ways to work from home
There are three main ways of remotely accessing or working from home.
- Option one is using a VPN tool to join the NHS net. Technically you can have software like EMIS, Docman, AccuRx and iGPR installed on a computer and, once connected, it should work. It is important to understand here that there can be firewall issues depending on where your VPN connects to in the NHS, not all VPNs are created equal. Limitations include covering other practices that use different systems, these systems may not be available and devices may not be kept up to date could be prone to viruses.
- Option 2 is to use the VPN to connect and then use remote desktop to control your in office machine, which needs to be switched on and free at all times, those using this method will be familiar with signs like these!
This method can work for those lucky enough to have exclusive use of a machine, but often the reason you want to logon is because your room is unavailable so this can be of limited use. There is also a privacy and compliance issue in that someone could be watching the screen that you are remotely logged into, and therefore can see what you are doing. This approach also ties up machines/rooms and reduces the space available within the practice. - Option 3 is to log onto a virtual desktop. Here, by logging in through a browser or special software, you use a virtual desktop that runs in a secure cloud. The environment is preprogramed with whatever software you need and is device independent, meaning you can use almost any machine including Macs.
Now it’s time to take stock
During the pandemic, we have seen NHS services adopting digital technology at an astonishing pace, so within your practice you may have seen any of these options come into play. As it does look like remote working is here to stay, it’s now critical that we review the technology that is being used and ensure it is truly fit for purpose. Is it reliable? Does it give me access to the systems and application that I need? Is it easy to provision to new/temporary staff?’ Is it cost effective and scalable to changing requirements? And perhaps most importantly of all, is it secure?
Driving change around the way people work, particularly within their own desktop, will always carry a degree of sensitivity. Understanding the value, capability and enablement that must be achieved is therefore paramount. When affecting true cultural change, it is not the choice of technology alone that will deliver success. The technology must be combined with a plan for people, process, knowledge and awareness. This plan will mean the difference between a great technical solution lacking adoption, and a true programme for transformation able to deliver measurable business value and improvement.
If you are considering ways to enable remote working within your practice, please take a look at Block’s Primary Care Workspace service, or get in touch via our website, we’re always happy to have a conversation and share our insight.
