Intended for healthcare professionals


The BMJ Awards 2018: Primary Care Team of the Year

BMJ 2018; 361 doi: (Published 27 April 2018) Cite this as: BMJ 2018;361:k1867
  1. Nigel Hawkes, freelance journalist
  1. London, UK
  1. nigel.hawkes1{at}

This year’s shortlisted teams have found innovative ways to use resources in the community more effectively, finds Nigel Hawkes

GPs enter the digital age

GPs everywhere are struggling under demand. Chelston Hall Surgery in Torquay, with three sites and 22 000 registered patients, gets 500 calls in the first hour of each day, and queues form outside. Practice manager Mark Thomas looked around for a solution.

He found e-consult, an online triage tool for GPs, developed by GPs, and headquartered in London’s Docklands. Mark Harmon, a doctor and now strategic director of the company, says the GPs at Chelston Hall were initially sceptical. “Would offering patients a new way to consult GPs just add more to the load? That was their fear.”

The system was introduced cautiously. On the practice website there are three choices: help for a previously diagnosed condition, such as hay fever or cystitis; a symptom checker for new symptoms; and administrative help, such as a test result or a sick note. “The symptom checker is essentially history taking online,” says Harmon. “It’s simple for the patient, requires no login, and takes five minutes. It’s submitted in encrypted form to the practice and triaged by a GP or a nurse practitioner.

“If the symptoms are concerning, a red flag is built in, pointing to a 999 call or a visit to an emergency department. An amber flag, and the GP may want to see the patient—safety is paramount. But 70% can be dealt with online.” At Chelston Hall, GPs are closing up to 40 queries a day without needing to see the patient. More than 370 practices now use e-consult, some at a much higher rate. “Unity Health in York now does 30% of its consultations online,” Harmon says.

Personalised care plan SMS

Keeping patients with chronic conditions, …

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