Patient awareness and use of online services in general practice: the Digital Access Now Survey.

Problem

There is international interest in the potential role of digital and communications technology to improve access to healthcare. Digital routes of access to both book, and have, a face to face consultation are increasingly encouraged as a route to help manage demand, and patients can variably contact their GPs using a range of methods, including phone, email and online triage systems. Without understanding whether patients are aware of, or interacting with, the full range of online services, and how such awareness and behaviour is associated with sociodemographic characteristics and health status, it is not possible to shape services to suit patients and their needs. There are key unanswered questions about the characteristics of patients who currently do and do not engage with these services. We have conducted a survey to better understand awareness and use of online services and consultation types.

Approach

We used a cross sectional survey design. The survey instrument covered several key areas; use of online services, use of alternatives to a face-to-face consultation (e.g. video consultation) and use of NHS 111 services. The survey also collected data on internet use, health status and demographics. We have recruited 40 general practices across the West Midlands and these have a range of characteristics, from rural to urban, from small through to large list size, deprivation scores ranging from 1-10 and differing numbers of patients in ethnic minority groups. Each practice recruited randomly sampled 5% of patients from their list and sent out the survey. A total of 15,000 surveys were sent out in February. Each participant received a paper copy and were given the option to complete the survey online via a link or QR code. Once responses are collated we will report the proportion of patients aware of and interacting with digital GP access. Using multivariable statistical analyses we will identify the key predictors of these outcomes to assess whether differences across population subgroups are explained by other characteristics.

Findings

The survey is currently being administered and initial responses are expected in late February. Based on estimates from previous surveys conducted in general practice we expect to see a 25-30% response rate, which would total 3750-4500 responses. We will present the full findings at the conference.

Consequences

Understanding awareness and use of digital services has the potential to influence the design and commissioning of services in general practice, given the current push for their introduction via the new GP contract. The results of the survey will be used by healthcare commissioners to help them shape their services. The findings will also provide the first data on how patients are using private online general practice services. These private online services have potential implications for NHS general practice by segmenting care.