Man on phone

GP appointments should be no waiting game


24 October 2016


AXA Doctor at Hand

With our AXA Doctor at Hand service, delivered by Doctor Care Anywhere, everything they need is in one place, from booking appointments and seeing a GP when it suits; to having a specialist referral sent straight to our Fast Track Appointments team. 

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We’ve all become familiar with worrying news of lengthening waiting times for GP appointments. But it still comes as a shock to see a prediction from the Royal College of GPs (RCGP) that by 2020, patients will be forced to wait over a week on nearly 100 million occasions a year.

The RCGP’s analysis also warns that that there will be an increase of occasions when patients won’t be able to see a GP at all, to 52 million per year.

At AXA Health we’ve always firmly believed that fast access to diagnosis, advice and treatment matters to people’s health, so we’re especially concerned to see this deeply worrying analysis. Despite developing a number of pathways where a GP referral may no longer always be required (e.g. AXA Health’s Working Body and Stronger Minds pathways), the fact remains that a GP open referral is still a necessity for the majority of initial diagnosis and subsequent health insurance claims. So, we are at risk of devaluing private healthcare if we don’t provide options for employers and individuals to more easily access that first, essential part of the patient journey.

AXA Doctor at Hand (our online private GP service) has helped employers to do exactly that. But it has not just been about helping our clients get greater value from private health insurance. It is also helping employers more effectively manage day to day absenteeism and presentism so often caused by the distractions, hassle and delay of booking appointments, attending consultations, picking up prescriptions and waiting for the paperwork if next steps are needed.

The knock-on effects for health

There are many potentially harmful consequences for patients forced to wait to see their GP. For example: 

  • GPs may be unable to prevent illnesses (such as secondary infections) from occurring in the first place, leading to long-term effects for their patients.
  • Conditions may progress to the point that patients need to be treated in hospital instead of at home, increasing treatment costs.
  • Patients may spend more time in pain, which can mean longer recovery times too.
  • Patients may be off work for longer, which can affect their own income as well as their employer’s business. 
  • Patients may inadvertently spread infections to others. 
  • Patients who are worried about a symptom must endure that anxiety for a prolonged period, which can become a problem by itself.

In some cases, the consequences can be very serious. Several research studies have suggested that delayed diagnosis could be one of the reasons for the UK’s poor cancer survival rates compared to the rest of Europe. Making a cancer diagnosis early will generally mean that a patient has a greater chance of a positive treatment outcome.

The RGCP analysis also showed that when people cannot get a GP appointment quickly, many decide not to seek medical attention at all. In 2015, this happened on 9.4 million occasions. They predict this could rise to 46.8 million occasions by 2020. That could represent a staggering number of people who do not access healthcare at all, with untold consequences in terms of unnecessary worry and pain, missed diagnoses and delayed treatment. 

Impact on other health services

As well as the knock on effects for people’s own health, there’s also an impact on other health services affecting the wider community. 

For example, if people cannot access their GP, they may feel they have no choice but to go to A&E. While the evidence on how much difference this makes to A&E waiting times is mixed, any increase to the number of people attending A&E will in turn increase waiting times for people in need of the most urgent care. 

It feels like we are approaching a tipping point with regards to an increasingly strained NHS GP service. Patient demand is only set to increase with the empowered and increasingly health aware consumer amidst an ageing population and significant advances in early diagnosis and long term condition management. 

Making it easier to access fast health services

So how best to meet the demand for GP appointments? 

We think the answer lies in providing a combination of different ways to access trusted expert resources that deliver the fast diagnosis, advice or guidance people need.

For some businesses, that might mean offering in-house GP services, making it easier for staff to get appointments without the wait they might face at their local GP surgery.

We are seeing more expansion and innovation of private GP services from physical to virtual clinics, from one-off appointment services, to end to end primary care and health concierge models. Some of this is driven by consumer demand, but also perhaps by increasing pressures on NHS GP contracts leading to more innovative alternative private GP models

Technology now makes it possible to provide GP services online or by phone. There are several advantages to an online service: you can provide access to more GPs more of the time, and it also works really well when a workforce is spread geographically. For example, our AXA Doctor at Hand service makes it easy for our members to talk to a GP within hours, 365 days a year, without needing to leave home or work.

Of course, it’s not always a diagnosis people are looking for. Many patients are seeking expert reassurance, guidance or advice. Some years ago, we took the decision to offer our members 24-hour phone access to expert help from nurses, counsellors, pharmacists and other health professionals. The Health@Hand service has proved popular and effective because it saves people having to go to see their GP about issues that other health professionals can handle just as well, if not better in some cases.

There are other services that offer an alternative for specific types of GP appointments. Pharmacies, for example, offer a huge range of advice, including confidential consultations and help to decide whether you need to see a doctor at all. 

One resource we definitely suggest is treated with caution though is ‘Doctor Google’! Although the web is packed with medical information, its unfiltered nature can increase health anxiety and lead to wrong self-diagnoses – either positive or negative. That’s why we offer free, trusted and expert medical information that everyone can access, whether they’re members or not.

What’s next?

We anticipate more innovation and noise in this healthcare space in the next 6-12 months. But we also see challenges as insurers, employers and employees consider the value they place on improving upon, and paying for what has been until now, the promise of a “free at the point of delivery service” via the NHS. Perhaps the tipping point is also approaching fast for this unilateral NHS promise with the mix of NHS and Private Dental care being the footprint? 

What isn’t in question is the significant opportunity for primary care innovation to deliver better value, experience and health outcomes - something our Doctor@Hand client and employee feedback suggests we have already made a great step towards achieving.

If you’d like to find out more about any of the issues in this article or the services we provide, please speak to your AXA Health account manager.