NHS England and NHS Improvement asked general practice to move toward a ‘total triage’ model to reduce avoidable footfall in practices and protect patients and staff from the risk of infection. This means every patient contacting their practice should first be triaged before making an appointment, helping the practice to decide how they can best help each patient. 

Online consultation technology is crucial in helping quickly achieve total triage while preserving good standards of care – and due to their ease of use apps like the NHS App are an ideal platform for driving the rapid adoption of this technology. Where possible each enquiry or online consultation will be passed to the patient’s regular GP or member of the team.

We are continuing to work at an unprecedented pace to integrate online consultation in the NHS App to respond to the pandemic.

After a successful pilot using the eConsult solution earlier this year, we had planned a national rollout to about 1,200 GP practices by the end of June 2020. Those targets are already in the rear-view mirror. By 30 April 2020, eConsult was available through the app to more than 2,200 practices, covering 20 million patients.

Early feedback has been positive. Users are finding and using the online consultation service in the app and we’ve received emails from GP practices telling us how they’re finding the feature useful.

As we work with more online consultation suppliers on how to best integrate their products into the NHS App, our goal is that an even larger number of patients will be able to ask for help and advice from their GP surgery through this route in the future.

Long before any of us had heard of coronavirus or social distancing, we were already working with suppliers to integrate their services into the NHS App. Matthew Gould, Chief Executive of NHSX, explained this approach in a blog post last year – how we would keep the NHS App ‘thin’ and let innovators build on it.

This means that people accessing online consultations in the NHS App have a consistent user interface, through which we can simplify and improve their user journeys, no matter which supplier their GP practice uses.

In the current situation this is invaluable and helps to rapidly drive uptake of online consultations on a platform that people understand and trust in a crisis.

Our first supplier to emerge from the process is eConsult but we are not adopting a single-supplier solution. In early 2019, we conducted market research with the NHS England Primary Care team, completed a supplier analysis and chose eConsult to do a proof of concept. We wanted to see what the architecture could look like for implementing online consultations within the NHS App.

We followed this up by going live with a pilot of eight practices from November 2019 to January 2020 using eConsult, and the feedback was overwhelmingly positive. This provided the foundation for the national roll out.

From our user-testing, we found that a tight-knit integration, where the user doesn’t leave the NHS App, works best from a user’s perspective. A Fast Healthcare Interoperability Resources (FHIR)-based API was the preferred method of doing this.

Following the FHIR standards, we built an API that can talk to multiple suppliers and the data they send us. If a supplier builds a Clinical Decision Support (CDS) API following the FHIR standards, we can consume their solution in one integration.

This allows us to easily add in new suppliers with limited additional work. It also allows practices to switch suppliers without needing any rework on the solution. This gives them the flexibility to link with locally commissioned digital services, because we know that local areas often know what is best for them and their patients.