Need for evidence on telehealth providersBMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i1332 (Published 08 March 2016) Cite this as: BMJ 2016;352:i1332
Timely access to a GP is sometimes difficult to obtain, particularly for acute problems, and recruitment and retention problems within general practice clearly need to be addressed to overcome this deficit.1
Online providers are limited by what they can offer in a virtual environment, and there is no concrete evidence that they will help the NHS generate efficiency gains by reducing GPs’ workloads. In addition, the clinical performance of this sector is not well understood. Sixty telehealth firms currently operate in the UK market, and in its 2014-15 state of healthcare and adult social care in England report, the Care Quality Commission’s view on mobile doctors was that, “not all of these [have been] rated. However, our inspections to date suggest these services are performing well” (table 1⇓).2 We also do not know the extent to which this model of healthcare might distort equity if patients who cannot access their GP are then discouraged from attending an emergency department and elect to pay out-of-pocket. General practices in England receive an average of £136 annually per patient for an unlimited number of visits. Dr Morton’s, for example, charges £60 for one telephone consultation.
We anticipate that this sector will expand because of the considerable support from central government to expand the digital health sector and because patients are thought to feel more empowered by decision support tools and being able to access a doctor at a convenient time for them. Given the pressures facing GPs it is important to examine new avenues of care delivery. Telehealth remains an emerging field in the UK, and policy makers will need more robust evidence of clinical quality and efficiency savings without exacerbation of health inequalities before the model is wholeheartedly embraced.
Competing interests: None declared.
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