Dr Tom Black

tom-blackI am a GP in a very busy practice in Derry City in the north west of Northern Ireland. I have a patient list of over 7,000. 
As with the rest of the UK, general practice here is the first point of contact for the majority of the population’s health and social care-related needs - 90% alone in Northern Ireland. And in keeping with trends across the rest of the UK, Northern Ireland also has a growing and ageing population with an increase in long-term and complex health needs.  This means waiting times to see a GP are now longer than ever. 
Northern Ireland has lowest number of GPs per-head of population in the UK - just 6.1 per 10,000.  It’s therefore not surprising that some practices are reporting up to a two-week wait to see a doctor.
British Medical Associations’ General Practitioners Committee (NIGPC), of which I am chair, represents the needs of primary care doctors and the wider general practice workforce to government and heath service commissioners. 
These spiralling appointment waiting times are one of the key areas of concern for the sector.
One way NIGPC are successfully addressing this issue is through piloting a new online scheme to try and reduce the number of appointments booked in advance and instead aiming to see patients on the same day that they call asking for an appointment.
askmyGP is a digital triage system that assesses patients when they initially contact their practice to make a GP appointment.
Patients have the choice of going online to the practice website where they enter their problem onto a computerized algorithm.
The askmyGP online algorithm is then read by the GP who can process the patient onto the appropriate health professional within the practice, such as a practice nurse or pharmacist. If the patient requires a GP’s input, the doctor will assess whether the patient needs a prescription, phone consultation or a face-to-face appointment. Patients who require an appointment are usually seen within four hours.
Alternatively, they can ask for a phone consultation and the GP will usually ring the patient within one hour of the request.
I attended a presentation of askmyGP in London in the early part of this year and took the idea to the Health and Social Care Board in Northern Ireland, which commissions primary care services in the country. The Board was impressed by the system and gave NIGPC the go-ahead to trial askmyGP in five practices across Northern Ireland, one of which was my own.
So far the pilot scheme has been a resounding success.  An average day in my practice would have seen at least 35 appointments on my list. Now up to 50% can be dealt with on the phone or through practice triage systems.  Since we introduced this system in May, my time has been freed-up to see the patients who actually need to see me, and at a time that suits the patient.
We have found most patients are opting for the telephone triage, but it’s expected that direct online access to askmyGP will increase, especially with the added option of accessing the system via an app for mobile and tablet devices.

NIGPC is now keen to roll-out askmyGP to practices throughout Northern Ireland as general practice here is currently under immense pressure.  Anything that eases our workload has to be welcomed.

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John Crowe

What, if any, shortcomings or failures have been experienced by any GP practice or their patients using this form of triage or, what criticisms of it?

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