It became apparent relatively early on in this project that there is a heightened willingness to embrace new technology because of the NHS brand - our app is regarded very differently to other health-related apps. Throughout the testing and initial rollout, we have seen large numbers of patients and practice staff who have never been involved with digital technology before, show strong enthusiasm for the NHS App.
Giving digital technology a go
I work with an eight-strong team working with more than 7,148 GP practices across England to implement the NHS App. It’s very much a matter of building trust in digital technology, and it helps that we come from a variety of backgrounds. I’m a registered nurse, while colleagues have worked at Clinical Commissioning Groups (CCGs) or in practice support.
We know from personal experience that it’s difficult to find time on the front-line, even for labour-saving initiatives, so we advise health care professionals to just give the app a try. Register, set up a dummy account so you can see what patients see, and get some appointments or test results online. You can then build upon this when you have more time and can see the benefits it brings.
Most of the services within the NHS App are not new but have been packaged in a really user-friendly way. People can sign up themselves for a secure account by taking a photo of their driving licence or passport.
During our pilot before Christmas we were pleasantly surprised by the number of people trying the app who had never used GP online services before – a third of the people who signed up were new users.
This was a testament to its convenience for patients. You can see all the appointment options available to you at the time of booking. It’s discreet. You can be in the office and no-one knows what you’re looking at on your phone, whether it’s blood test results or arranging a cervical smear test. It is also available 24/7, so it can really help reduce those busy phone lines and long waits to get through to your GP practice first thing.
To give a personal example, my 90-year-old stepdad has limited mobility. His hearing isn’t too good, so seeing the dates and times of the GP appointments that are available on his tablet means he can complete his booking much faster. Using the NHS App has supported his independence, as without it he would have to rely on others to do these tasks.
Little changes = big differences
Small changes can make a huge difference to patients and staff. Many practices are trying different approaches and improvements – it’s gradual and careful change so they can see the impact each little step has. One practice tried releasing half of its on-the-day appointments at 6am on a Monday morning, having set its out-of-hours answerphone to inform callers that they could use the app to book an appointment from this time. The rest of the appointments were put on at 8am. The call volumes dropped significantly at this time, allowing the patients calling the practice to get through quicker. They got the support they needed, and the reception staff benefited from a less hectic start to the week.
Another practice released flu jab appointments online and sent a link to patients inviting them to download the app, register and book their slot. This proved highly effective and meant practice staff could focus on other tasks.
Invest in your digital front door
Digital technology is only a tool – don’t stick it in a box in the corner as it will never benefit you. Figure out how you can use it properly to make things better.
The more unexpected finding during our pilot was the challenge presented to people from the names given to appointments in practice’s clinical systems. These were not always user-friendly, even with practices that were already familiar with digital technology, with some including clinical information and codes that patients could not understand.
It’s a worthwhile investment to improve these systems. There’s a real benefit to practices if patients go digital – staff time is a valuable resource. Even a relatively small number of patients using the app will free staff up to deliver support to those that can’t, as well as carrying out the tasks that only clinical staff can carry out. Patients want to do the right thing and support their practice – but they can only do so if they understand the appointments available.
When observing GP practices, we identified that the average time it took for people to book an appointment over the telephone was one minute 42 seconds, with some people taking up to ten minutes. With high numbers of appointments being booked this adds up to a lot of staff time. Supporting patients to book digitally not only saves this time, but also removes any confusion regarding the date/time of the appointment. Appointments can also be cancelled at any time night/day without long call waits, leading to fewer Did Not Attends (DNAs).
Facilitating change
Change can be scary; we’re giving patients the power to book appointments for themselves for the first time. The reassurance we can give is that the app is safe to use and has been developed with security in mind.
The standard contract for GP practices requires that they make a quarter of appointments available online by July. Practices are surprised when we challenge them to put all their appointments online. However, if I ask a group of 30 practices if they feel this is possible, usually one or two will put their hand up to say they are already doing this. For those practices that are unsure, I encourage them to see it as opening the digital front door on what is already available. It’s the same patients and the same appointments. The only difference is that the patients will do the booking, saving staff time.
Implementation is a complex process and we’re responding to feedback, understanding how practices work so we can continually support them. Although we can’t realistically visit every GP practice, we are working closely with regional teams, integrated care systems, sustainability and transformation partnerships, and CCGs to support them all with their transition.
Direct contact with frontline staff is still essential. If it’s more than 25 days since a practice was connected to the app and no patients have registered, we call the practice to offer support and encourage them to visit our website for guidance . We are also holding webinars for practice managers and CCG employees to help answer questions about tech and safeguarding.
So, my message to staff in general practice is not to worry about trying out this new tool If you haven’t done so already – download the app and give it a try or watch the demo on our website. Implement it properly, support your patients to give it a go, and the rewards will be significant for everyone.
