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Online portals and shared records are a priority for GP services, says Nuffield Trust

Shared records, video communications and online portals are key to a successful future for primary care, says report

Technology is central to the future of primary care services, but still has a long way to go before it improves the working lives of staff and patient outcomes, according to a report by the Nuffield Trust.

The report, on digital requirements for new primary care models, was commissioned by NHS England and sets out a series of possible scenarios for the future of primary care, including improved patient access through mobile working and remote consultations, and “permeable boundaries” between care settings. 

It said GP services would have to “fundamentally change in the coming years” because of financial difficulties, increasing patient numbers and a shortage of clinicians. 

“Technology connecting professionals will enable GPs to work consistently with hospital doctors, and general practice will become increasingly part of the same service as district nursing,” the Nuffield Trust said. 

It said there are three types of technology that need to be prioritised, including shared electronic patient records that any professional can access at the point of care, “including when they are physically away from hospitals or GP surgeries”. 

The report also called for “video, voice or online communication to allow patients to get in touch and have consultations with primary care professionals more easily, and to be matched up with the staff group who can most efficiently meet their needs”.

It added: “Similar links between professionals should enable hospital-based specialists to advise GPs during or after a patient consultation, and feedback on test results or images.” 

But although the report said digital technologies are key to the future of primary care, it noted that both staff and patients are often resistant. 

“Their concerns include increased workload, increased cost and reduced quality of care,” the report said, adding that the challenge can be overcome by communicating clearly and opening up for feedback and engagement.  

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“Staff engagement and money are both needed for change,” the Nuffield Trust said. “Local leaders need to set a realistic amount of staff time aside to design, understand and implement new technology.”

Primary care is often seen as a leader in NHS technology, but the report said there is a long road ahead before technology can “improve the working lives of professionals and have an impact on patient outcomes”.   

To increase take-up and usability of digital technologies, the report urged NHS England and other national bodies to “foster an environment that supports local freedom to innovate and adopt technological solutions”.

The report also highlighted the problem of innovation and transformation happening in small, short-term pilot schemes that are not sustainable in the long term. 

“During this phase of rapid and potentially radical change, significant investment in infrastructure, software and training is needed,” the report said. In the future, it added, central organisations must change to “reflect on what level of innovation is desirable and achievable” and what level of investment they are prepared to make.

In February this year, the Nuffield Trust published another report on delivering the benefits of digital healthcare, in which it said NHS organisations need to invest as much in culture change as they do in technology.

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