COVID-19: Has primary care had its online banking moment?

Written by Dr Shaun O'Hanlon, Chief Medical Officer, EMIS Group 

As lockdown measures ease and we learn to adapt to a ‘new normal’ in our personal and professional lives, we can take a step back and consider some of the lessons we have learned during the first wave of the COVID-19 pandemic.  

With local lockdowns and further waves likely over the next 12-18 months, how we can ensure we are better prepared in the future?  

Technology has played a pivotal role in the response to COVID-19 – enabling an almost overnight digital transformation of NHS services from face-to-face to remote and virtual. This has been particularly marked in primary care, where online, telephone and video consultations are now the new normal.  

This rapid transformation was possible due a number of linked factors. 

Firstly, there have been many years of investment in interoperable electronic medical record systems in primary care which deliver NHS services such as the electronic prescriptions service, along with the development of online patient services such as Patient Access. These systems have underpinned the safe, digital delivery of primary care. 

Secondly, GP practices have rapidly adopted new ways of working. The NHS total online triage model has been fundamental to the ongoing delivery of primary care during the pandemic – ensuring patients can access support and advice while protecting GPs and their staff.

A digital first NHS

The biggest transformation, however, has been in the interaction of patients with their GP; the uptake by the public of online and telephone consultations has delivered in just a few months the digital transformation that took the banking industry some 10 years.  

NHS Digital statistics for May show that 48% of all GP appointments were by telephone, compared to just 14% in February.  

We may finally be seeing a sustainable model of general practice (some may say that mother is the necessity of invention) – but our next challenge is to maintain the momentum and ensure that COVID lapsed services such as screening and vaccination programs, mental health services, cancer referrals and long term condition management are restarted with a new foundation around a digital first model.

A word of warning, however – we must ensure that the new ‘digitally powered’ NHS does not create a digital divide; there are 1.3 million people without access to digital services and we must ensure they receive the same access to care as everyone else.

COPI notices: A game-changer

Alongside the digital transformation of healthcare, we have seen another hugely significant change – the relaxation of data-sharing and data access rules that was enabled by the government’s emergency COPI notices.  

These have literally revolutionised legitimate access to key NHS data – allowing patient data to flow safely from GP systems to secondary care to support the diagnosis and care of patients with COVID-19.  

They hold great promise for the future; there is so much more we can do as we maintain the safe and legal use of aggregated data from multiple care environments.

First, it will allow us to deliver new insights into COVID-19 itself, for example, understanding why it disproportionately affects BAME communities and what steps we can to take to better protect patients and clinicians who may be at risk.

Joined-up data will also improve our ability to closely track the progress of the virus in real time – and to support public health teams dealing with localised outbreaks.

Risk-based interventions

Looking beyond COVID, data-led insight gives us a unique opportunity to improve the care of those with long-term conditions, many of whom have had to take a back seat during the pandemic. We can start to shape interventions based on individual risk – targeting those who are most in need, perhaps even before they present to ask for help. It’s an exciting prospect.

Data can also transform the performance of vital screening and vaccination programmes that have suffered during the pandemic.   

Looking ahead, we need to consider in more detail what impact the COPI notices have had on NHS care delivery and to consider how they can help us to develop new, more sophisticated ricks management tools. We must also consider privacy and professional concerns.

But the opportunity in front of us – to deliver a paradigm shift in how the NHS uses data – should not be passed up.