Intended for healthcare professionals

Feature Healthcare Improvement

Can GPs find time for a million extra appointments a year?

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1999 (Published 07 May 2019) Cite this as: BMJ 2019;365:l1999

Re: Can GPs find time for a million extra appointments a year?

Our paper "The impact of patient record access on appointments and telephone calls in two English general practices: a population based study" published in the London Journal of Primary Care 2014;6:8-15, Royal College of General Practitioners, researched the question "What is the impact of patient record access on telephone calls and appointments in UK general practice?"

We asked patients in two urban general practices who used RA whether it had increased or decreased their use of the practice over the previous year. Using practice data, we calculated the change in appointments, telephone calls and staff cost. We also estimated the reduction in environmental costs and patient time.

Results
An average of 187 clinical appointments (of which 87 were with doctors and 45 with nurses) and 290 telephone calls were saved. If 30% of patients used RA at least twice a year, these figures suggest that a 10 000-patient practice would save 4747 appointments and 8020 telephone calls per year. Assuming a consultation rate of 5.3% annually, that equates to a release of about 11% of appointments per year, with significant resource savings for patients and the environment.

Discussion
To our knowledge, this is the first such study in the UK. It shows similar results to a study in the USA. We discuss the study limitations, including the issue of patient recall, nature of the practices studied and nature of early adopter patients. Strengths include combining national data, practice data and local reflection. We are confident that the savings observed are the result of RA rather than other factors. We suggest that RA can be part of continuous practice improvement, given its benefits and the support it offers for patient confidence, self-care and shared decision-making.

Our key messages in a small study in two practices were:

Patient record access is likely to save time for patients and practices. If 30% of patients accessed their electronic GP record online at least twice a year, a 10 000-patient practice is likely to save 4747 appointments and 8020 telephone calls each year – about 11% of appointments. Patient record access offers environmental savings from fewer patient visits. There is a business case for patient record access for uk general practice.

The government has made a commitment that all patients who want it will be able to have online access to their electronic GP record by 2015.

Competing interests: No competing interests

13 May 2019
Richard P Fitton
Data Protection Officer for West Pennine Local Medical Committee
West Pennine Local Medical Committee
Glossop, Derbyshire