eConsult Health and Brownlow Health (Liverpool)

• The Brownlow Health group of GP practices in Liverpool commissioned eConsult as their online consultation provider and launched the service in September 2019.
• NHS login (both via the NHS App and later the eConsult portal) provided the high level of patient authentication needed to ensure a secure and seamless linkage to medical records.
• When Covid-19 struck, the now established online service played a crucial role in enabling the practice to provide essential healthcare to its local population.
• Being already established with patients and having the reassurance of the NHS login button and the NHS brand meant the enforced transition to on line services was much easier and smoother during the pandemic.

• Brownlow Health consists of 4 GP practices across Liverpool with a diverse patient audience.
• All GP practices in England were required to offer a percentage of appointments online by April 2020 as part of the NHS England contractual framework for General Practice (currently suspended due to Covid-19).
• eConsult was commissioned to provide online consultations for Brownlow Group as a pilot in March 2019 which was then rolled out further in September 2019.
• The Patient Participation Group (PPG) noted patients were initially anxious about sharing personal data with a private company with no familiar branding.
• Primarily, patient concerns were around system and data security, where the data is stored or held, how can they trust the system, will the data be sold on and is there a financial cost?

• NHS login provides a high level of identity verification and assurance of patients who want to access digital healthcare services and apps.
• It also gives healthcare professionals the confidence that the user is who they say they are.
• NHS login provides the patient the confidence that when they access sensitive information on their medical records, the data and security are strongly protected.
• eConsult Health enabled NHS login in their eConsult product on 13^th May 2019.
• The practice actively promotes the NHS App, which also uses NHS login. eConsult are integrated via a Single Sign On in the NHS App.
• Having the NHS branding and the NHS login functionality on the service gave patients more confidence and reassurance to switch to online consultations.
• Feedback was positive and there was an increase in uptake as a result.

The practice group is very proactive in promoting digital healthcare services – and to support the launch of the eConsult service they enabled several marketing initiatives including:

• awareness raising adverts and media activity
• an updated website and postcard communications campaign
• iPads for staff to help guide patients through the NHS App and the NHS login authentication process
• branding the eConsult service as part of the practice

• The initial benefit for the practice was access to secure patient data which they could confidently link to the right medical record. This enabled clinical staff to triage patients more efficiently and effectively.
• A secondary, cost saving benefit was the reduction in ‘Did Not Attend’ (DNA) appointments as patients were more likely to attend an online consultation.
• However, when Covid-19 struck the benefits of having the NHS login on the eConsult service were realised even further. Patients were familiar with the service and reassured with the NHS branding, enabling a faster and more efficient transition to online services, saving time and money for the practice.
• NHS login is also triggering innovation in the digital health market.  With the high level of verification, it gives, GPs are now requesting increased functionality of the service to include 2-way exchange of data between GP and patient.

Learnings from Brownlow Health and eConsult for developers wanting to integrate an online service within the NHS include:

• providing an implementation team to process map with the practice, show the user journey and process flow and working with the local informatics team.
• providing a WhatsApp channel (or similar communications channel) for requests and shared learnings amongst practices implementing eConsult
• quickly informing of any updates regarding developments and improvements being made.
• listening and actioning, where relevant, practice feedback and suggestions for improvements.