The core remit of The Scottish Government’s eHealth Strategy is to use digital technology to help deliver improvements in healthcare. As part of the plan they set a target for at least 90% of GP surgeries to offer repeat prescriptions and appointment booking online by the end of 2017. Reform Scotland say this target is likely to be missed and that most health boards have a long way to go. After sending out FOI requests to all of the boards they found that only four were on track to meet the digital provisions targeted.
The Report highlights that the practical arrangements employed by GP surgeries and the subsequent lack of online services was undermining the standard of patient access. This adverse effect is clearly conveyed in the most recent Health & Care Experience survey, in which four of the five most negatively answered questions related to issues with access.
Legacy of slow adoption from Scottish GPs
There has been a legacy of slow adoption when it comes to digital services, which Reform Scotland has highlighted over a number of consecutive reports. In 2010 the Royal College of General Practitioners Toolkit was created in partnership with The Scottish Government, this promoted the value of digital tools for booking appointments and servicing repeat prescription requests. However, when the Examining Access report was carried out four years later in 2014, it established that 43% of GP surgeries still didn’t even operate a website.
Part of the challenge in tackling this issue is the lack of consistency across the country: 94% of the 960 Scottish GPs surgeries are operated by private sector contractors, and therefore the vast majority of surgeries are free to make their own decisions around access arrangements. This results in a wide variation in the standards of digital patient access. Ultimately, it often comes down to the individual preference of the practice: in some cases GPs are choosing not to provide online methods to access appointments or repeat prescriptions even though they have the facilities in place to do so.
Patients have too little choice over their GP
One of the key conclusions of the Report is that patient issues are compounded by a lack of choice. In most areas of life people can choose an alternative if they are unhappy with the service they are being provided. This even extends to other services which are paid for by the NHS, like pharmacies, dentists or opticians; if a patient is dissatisfied with the service provision then they can choose to go elsewhere. The report argues that this same level of choice is not available when it comes to GP services, as many people are only covered by one practice and even those that have multiple are often unaware of which surgeries can take them.
Reform Scotland make a direct policy recommendation on the back the report: they want NHS boards to allow new Scottish GPs surgeries to open up and increase competition for existing practices. This, the report argues, would increase choice, improve services and ultimately make surgeries more responsive to patient needs.
The full Reform Scotland Report is available online.