Why are we using eConsult for Llan Healthcare?
NHS Wales has mandated that GP surgeries provide access to online appointments for all their patients.
In response to this, a growing list size and feedback that Llan Healthcare have received from its patients, we have undertaken a comprehensive review of our appointment system. Patients felt they were waiting too long on the phone to get through to make an appointment and all too often the appointments were fully allocated and they were added to our cancellation list.
To improve the situation, one of the changes we are making is to deploy a system using eConsult.
eConsult may be completed at any time and from any internet device. It can be completed from the comfort of your own home, on a tea-break, or on the train to and from work. The review of the health questionnaire by a Clinician takes place during normal Surgery working hours.
If the condition can be managed without contacting the Surgery, eConsult can guide towards trusted medical advice as well as relevant local services, such as pharmacy support.
Requests made on eConsult may be clinical or administrative in nature. In many cases the condition may not generate the need for a face-to-face appointment. This frees-up more GP time and appointments for those that really need to see a GP.
The eConsult service can be trusted and is completely confidential. It was built for NHS GPs by NHS GPs, and is the leading online consultation provider across the UK.
We believe that eConsult will allow us to offer more convenient access to information and advice. It will also allow us to prioritise patients who need more urgent care, or need to be seen face-to-face, whilst still enabling us to provide advice to patients who have less urgent needs.
Is eConsult safe?
If a patient wants to use eConsult to contact their medical practice, the system is safe for use. After filling in their contact details, patients will be asked what help they are seeking and asked to describe their symptoms. They are also able to attach photos, if relevant, for even more accurate help. If a patient answers a question in a way that may indicate that the problem is urgent and cannot wait for a GP appointment, the platform will prevent further information being included and urge the patient to take immediate action, which could be calling the practice for an emergency appointment, calling NHS Direct, or visiting A&E.
The questions on the form have been written by GPs and will intuitively react to the answers inputted with the questions a GP likely would ask in a face-to-face appointment. Therefore, as well as being a useful tool alone, it means that, if a face-to-face appointment is required, a GP will be able to understand the problem much more quickly.
How will you benefit from eConsult?
- eConsult allows patients to seek advice from the Surgery or help manage their own condition or symptoms at all hours of the day, from any location.
- The service will make interacting with the Surgery more convenient. Patients may not have to come into the Practice to get help. This could avoid unnecessary leave from work or if feeling poorly at home, patients may avoid the discomfort of an unnecessary journey to the Surgery
- Patients will not have to queue on the telephone. They will simply complete the request online to tell the Surgery why help or advice is needed. The Surgery will respond if a face-to-face appointment is needed, and ring the patient to arrange this.
- If the problem can be treated without an appointment, it can save a trip to the Surgery. Instead a Clinician may call to discuss the next steps, arrange for tests before a face-to- face appointment, or send a prescription to the local pharmacy to be collected
- Patients with the most urgent issues will be identified quickly and dealt with earlier than the current system allows. This is because the Surgery will already have an idea of why help is needed. This will improve safety by ensuring those who need help quickly get it.
- Patients who have appointments will more likely be seen on time because we will have allocated the correct amount of time to patients appointments.
- Patients who cannot use eConsult will be able to get through on the phone quicker because a majority of our requests are being sent electronically.
- A GP may not be the most appropriate person to see. eConsult assists the Surgery to identify the problem, determining the most appropriate member of staff to conduct the consultation.
- Using the information provided, together with knowledge built into eConsult and with a Clinician reviewing the questionnaire; a decision can be made on how urgently a patient needs to be seen.
What if the eConsult system is telling a patient to stop completing the form and ring the surgery to speak to a doctor?
If this happens you should call the surgery and one of our trained administrators will complete the form again with you and then book a telephone appointment if it is required.
What if the eConsult system is telling a patient to access urgent care such as NHS111 and A&E but they know they have seen a GP correctly for it in the past?
All patients are advised to follow the advice given by eConsult as this is correct on the back of the information a patient has given the system.
If you disagree with the advice given patients are given the opportunity to amend their answers.
Patients are recommended to be honest when answering the questions and it is important to understand that eConsult has been designed to advise ALL patients; from those who are fit and well to those who need urgent and in some cases emergency care.
What if a patient has no way of accessing the website or cannot use technology?
We would encourage all our patients to try and complete the health questionnaire on our website, either by themselves or with help from a family member. This saves time for you and us.
If not, please phone the Surgery and one of our trained receptionists will take you through the health questionnaire, and complete it with you over the phone. If everyone is busy helping other patients, someone will call you back. You will not be penalised because you were not able to complete the health questionnaire yourself.
Calling the Surgery to complete a health questionnaire over the phone will not mean patients are seen quicker than those who complete the health questionnaire on our website. All the health questionnaires will be seen by our clinical triage team and dealt with in the same way.
Important Notice – If a patient cannot use the internet, they should be prepared to provide information to our receptionists in order for them to complete the questionnaire on their behalf.
What if the patient receives a text message with an appointment time and date that they cannot attend?
If this happens don’t worry we advise all patients via text that they can contact us and our receptionists will look to move their appointment to a time that is suitable.
Always let us know if there is a time that you cannot take a call or attend the surgery in a free text area of the eConsult questionnaire. We cannot guarantee that we will manage it but we will always look to accommodate.
What if the patient receives a text message asking for more information, do they need to complete another eConsult?
Yes and where possible the clinician reviewing your eConsult will guide you to the necessary questionnaire to complete. We recognise that this is a new system but the more information you write in the form the easier it is to process your request quickly and efficiently.
Always use the search box in the first instance to find the correct questionnaire for you, i.e. back pain.
How do I access eConsult?
eConsult will be available on the practice website (https://www.llanhealthcare.co.uk/) from any device and at any time of day. On the opening page of the website there are a set of blue boxes to select from. Having done this a set of questions that invites the patient to submit concerns or conditions will need to be completed. At the end of the questions, upon submitting the questionnaire, the form will be received by the Surgery via this online system.
Once the form is submitted on eConsult, the patient will receive a copy via email. This email will contain the unique reference number relating to the form and is for possible future use in the event of the Surgery having to be contacted at a later date.
The Practice will aim to respond to urgent requests the same day and routine requests by the end of the next working day.
The Practice may respond in a variety of ways, based on information provided or the urgency of the condition:
- If appropriate, an appointment with a Clinician may be offered, either on the day or for a later date.
- The patient may receive a phone call from a Health Professional at the Surgery; this is because a face-to-face appointment may not be needed to resolve the issue. This will save a visit to the Surgery
- Patients may be referred directly for investigations or a hospital appointment to further investigate symptoms
- Patients may be directed to another Health Professional outside the Surgery, as they may be best placed to offer the advice or support needed. This could include local pharmacy support, a minor injuries unit or other services such as physiotherapy
- Patients may be directed towards the appropriate self-help advice
Note: At all times the Surgery will protect patient privacy and cannot discuss personal matters unless the Surgery is certain they are speaking to the correct patient, or someone authorised to speak on their behalf.
What if I can’t or don’t want to use the eConsult service and just want to see a doctor?
Our appointments for all clinicians are now triaged using the eConsult system. Whether that be by the patient completing the questionnaire themselves or; when patients are unable to use or access eConsult our Patient Advisors will complete the eConsult health questionnaire with the patient.
The fastest way to complete a request will be for the patient to do this themselves online. Once completed, whether online or on the phone, all requests will be reviewed by our clinicians in the same time frame (within 24 hours). Method of contact is not given priority over another i.e. phoning a request will not mean patients are seen any quicker than if completed the request online themselves.
Can I submit an eConsult for someone else?
Generally, patients using the eConsult service should submit requests based on their own symptoms or conditions.
As a parent or guardian of a child between the ages of 6 months to 18 years, you will be able to submit requests on eConsult about symptoms or conditions of their child.
In some cases, people need help submitting their requests on eConsult. Friends and Family can assist in completing the form provided consent has been obtained.
Can I still book an appointment with my GP for a future date?
If a Clinician has advised they would like to review you in a follow up appointment please complete an eConsult the day before you want to see your clinician.
This is really easy to do. Type ‘General Advice’ in the search box, fill out the necessary questions and then choose the option that says ‘This is a problem that my GP knows about’. This will be checked against the patient record prior to arranging the appointment and where possible we will try to book an appointment with the same GP to allow for continuity. You must ensure that you specify in a free text area that you were seen previously, by whom and how your symptoms are looking. We will always look to accommodate this request.
At what time will the Surgery review patient health questionnaires each day, and what happens if a patient submits a health questionnaire after that time?
During Surgery opening hours, clinical staff will review submitted health questionnaires throughout the day. The Surgery will respond to each patient within 24 Hrs, prioritising patients by their clinical need.
Patients can complete and submit a health questionnaire at any time. As you complete your health questionnaire, the system is deciding which questions you need to answer next. If your answers to these questions indicate you need to be prioritised, the system will flag your case to be dealt with as a priority. During Surgery opening times, any health questionnaires submitted, and determined to be a priority, will be seen by a clinician that day.
Will all health questionnaires submitted on behalf of a child receive a call back from a GP?
Children will always be prioritised and the parent or guardian will always receive a call back or a text message with an appointment time where necessary or advice on how to care for your child. Always let us know if there is a time that you cannot take a call or attend the surgery in a free text area of the eConsult questionnaire. We cannot guarantee that we will manage it but we will always look to accommodate. We endeavour to give our children under 5 a call back on the same day.
If a GP decides that a patient needs to be seen again in about a week, how does this work?
Patients that require a follow-up appointment need to complete an eConsult health questionnaire to request this. They should type General Advice in the search box, fill out the necessary questions and then choose the option that says ‘This is a problem that my GP knows about’. This will be checked against the patient record prior to arranging the appointment.
Patients are advised to submit their heath questionnaire for a follow-up appointment as soon as possible after their previous appointment.
Can a patient with a complex condition see the same doctor for each follow-up appointment?
If the triage team believes a patient’s clinical condition can wait until a preferred GP is available, they will try to place the appointment with that GP. We always aim to provide our patients with continuity of care.
Can a patient request a date and time for an appointment/ call back?
At present there is no facility for this however we are recommending our patients let us know times you are UNAVAILABLE to take a call or attend the surgery in a free text area of the eConsult questionnaire. We cannot guarantee that we will manage it but we will always look to accommodate.
Llan Healthcare has been using the eConsult for a number of months now. How are their patients getting on with it?
The eConsult system has been used successfully for two months at Llan Healthcare as well as many other Practices in Wales. Feedback has on the whole been very positive. Especially considering it has not been in use long. Please read our Facebook page for further details.
If a patient has begun filling out a health questionnaire but suffers internet or computer problems before they are able to click ‘Submit’, what should they do?
Please start the health questionnaire again.
Do patients need to register to use the eConsult system and do they need a password?
No, patients do not need to register to use eConsult and they do not need a password. After the eConsult system is launched, patients can use it by visiting our Practice website www.llanhealthcare.co.uk. On the front-page of our website, patients will see a big blue box with four darker blue boxes inside. Click on the darker blue box you believe will answer your enquiry and then start the health questionnaire.
Can computers at a library be used to complete the form?
Yes. Patients can use a computer at a library to access eConsult if they already have a library card. Patients without a library card can enrol, bringing along a form of identification with their name and address. For example, they can use a driving license, utility bill or property agreement.
Should patients use eConsult for Travel Clinic enquiries?
Yes. There is a comprehensive travel form available on eConsult. You can access this by typing ‘travel’ into the search box on the conditions page. Once submitted a patients form is passed to our Practice Nurse for review. The Practice Nurse will then contact you to discuss your vaccination requirements. We need at least 4 weeks to accommodate these requests. It you are travelling sooner than this you will need to attend a private travel clinic.
What if I have hearing difficulties?
Your current arrangements will not change.
What if I have sight and reading difficulties?
Please contact the surgery to discuss this with our receptionists.
When we receive call backs from the Surgery, the call display on our phones show as ‘Unknown’. Can this be changed?
Unfortunately, this cannot be changed. Important Notice – If you have call minder please leave alternative contact details.
I have to hand in my phone when I start work, so how can answer if you call me back?
We are recommending to patients that they let us know times that they are UNAVAILABLE to take a call or attend the surgery in a free text area of the eConsult questionnaire. We cannot guarantee that we will manage to arrange an appointment or call at this time, but we will always look to accommodate.
If a patient has a long-term medical condition and receives a letter or text message requesting they book an appointment with a nurse, should they use the eConsult system?
The letter or text message will say whether to book an appointment with the nurse or to complete a review using the “review” section of the eConsult form.
If I do not need to use eConsult for a specific Nurse Appointment, when can I call the Surgery?
Our opening hours are Monday to Friday, 08:00am – 18:30pm. You can call us during these times.
What if a patient has more than one condition to report?
If the conditions are related, there is somewhere to record this on the health questionnaire. If not, patients will need to complete a separate questionnaire.
What happens when you need a repeat prescription but haven’t got the slip? Is this an option on the form?
We would encourage patients to continue to use “my health online” for one off or repeat medication requests. Alternatively log on to our website and select the darker blue eConsult box which says ‘Request sick notes and GP letters, or ask about recent tests’. When you reach the question, which asks ‘What administrative issue can we help you with?‘ select ‘Other requests for documents or paperwork” and then write in the free text box that you are requesting a repeat medication prescription but you have no slip. Please provide as much information as you can. Complete the questionnaire and then submit. Please note that our usual prescription policy of 48 hours still stands when for a repeat prescription to be completed.
If you contact NHS111 on recommendation of eConsult and the staff at NHS111 tell you to contact the GP surgery we MAY still ask you to complete an eConsult.
NHS111 use similar templates to those available in eConsult and so please ensure you answer the questions asked by eConsult in a similar fashion.
Can eConsult be used for Mental Health concerns?
Yes and It is very important that patients with mental health concerns do use the eConsult questionnaire. The questionnaire asks the Patient sensible questions that a clinician would ask the patient in surgery. Completing the questionnaire in advance allows patients to take their time and answer the questions carefully and truthfully without feeling pressured in a 10 minute appointment. There are dedicated templates for depression and anxiety within eConsult that can be found using the search facility.
How can patients vulnerable adults get appointments to see their GP?
Thank you for your concern for these patients. Our trained receptionists know the process on how to help these patients.
I feel that I need an appointment today and cannot wait until the next working day, how can I arrange an appointment?
Please contact our receptionists and let them know. They will complete the eConsult with you over the telephone and ask the duty doctor to review your request. In these circumstances you will be expected to give as much detail on your condition as possible.