If you want to be a great GP, you need to be online - official

The latest version of Good Medical Practice for General Practitioners, the official guide to being a good GP, emphasises the need for family doctors to embrace new technology. Fiona Barr reports.

The modern-day Dr Finlay needs to add a great website and email communication to his or her panoply of services in order to be a good GP, the profession has decided.

The latest guidance on what constitutes an “exemplary GP” was recently sent out by the Royal College of General Practitioners (RCGP) and the British Medical Association’s General Practitioner Committee (GPC).

The latest version of Good Medical Practice for General Practitioners takes full account of the growing use of web and email technologies in everyday life. Dr Steve Field, chair of the RCGP, is in no doubt that GPs need to embrace these changes. “The future is clearly that patients will want different ways of communicating with their GP,” he says.

Website options

Good Medical Practice for General Practitioners explains what the requirements of the doctors’ regulator, the General Medical Council (GMC), mean for family doctors. It includes a series of statements outlining the practise of “an exemplary GP” and “an unacceptable GP.”
“An exemplary GP has a clear and accurate website, while an unacceptable GP does not have a website or only has one that is untrue or self-promoting.”
Among these statements, it says that an exemplary GP has a “clear and accurate” website, while an unacceptable GP does not have a website or only has one that is untrue or self-promoting.

Dr Field sees websites as vitally important in the set of tools that a practice should have to communicate with its patients. He says: “Websites generally are so important in giving patients as much information as possible about their GPs.

“There are really good examples of this. For example, if a woman wants contraceptives or termination of pregnancy counseling, she can use a practice website to find a doctor to have an unbiased discussion with. It means the choices available to patients are much better.”

However, a pragmatic stance is taken by Dr Richard Vautrey, a GP in Leeds and GPC negotiator. He says that while the guidance lays out exemplary and unacceptable practice, many GPs will fall between the two.

Many GPs are now providing websites for their patients – sometimes with support from their primary care trusts, which can make use of technology from companies such as Microsoft to link them to live databases and unified communications tools.

However, Dr Vautrey advises GPs without sites to consider using the Department of Health’s flagship NHS Choices to communicate with their patients. Although NHS Choices had some early difficulties, the GPC is encouarging GPs in England to add information to their listing using an online form.

Website content

Good Medical Practice for General Practitioners says websites should include information about what services a practice provides and what its arrangements are for out-of-hours care. Websites should also clearly state when the surgery is open and when the phones are answered.
“Patients value being able to talk to a doctor or nurse on the phone or to consult through email.”
The RCGP and GPC also emphasise the growing place of telephone and email communication in daily practice life. Their guidance states: “Patients value being able to talk to a doctor or nurse on the phone or to consult through email.”

Dr Vautrey says email can be used very successfully for services such as repeat prescription ordering; but GPs need to be careful when communicating via email to ensure the security and confidentiality of patient information. This is also emphasised by the guidance.

Fewer home visits, better support

While no substitute for face-to-face consultations, Dr Field says email and telephone communication can be a way of helping patients to manage their conditions without the need for home visits.

He adds: “We are encouraged by some of the work that’s being going on with NHS Direct. Talking to patients over the phone regularly and using email for those with mobility issues, can remove the need for home visits because of the added reassurance it provides.”

In the practice where Dr Field works, there is a telephone surgery every day. The practice also uses email for results, if patients prefer it, in addition to a letter. Many patients across the country are also using the web to communicate with their practices for services such as repeat prescription ordering and appointment booking.

One in eight UK practices now offer online appointment booking via GP computer supplier EMIS and, while still in its infancy, more than 10,000 GP records have been viewed online via EMIS’s medical record viewer.

Putting patients in control

Dr Field highlights the potential of HealthSpace, Connecting for Health’s secure online portal for patients that the recent Health Informatics Review says will be developed so that patients can view part of their medical record and input data such as blood pressure readings.

He feels this will create features that will be particularly attractive to those with long term conditions. “It’s all about real-time sharing of information with patients,” he says. “That’s key to putting them in control.”

About the author: Fiona Barr is a former editor of MedEconomics. She now edits the E-Health-Insider primary care website, and writes on a freelance basis about general practice and technology.