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Practice workloads increase more than 10%, e-consultation finds

Trialling the use of online consultation systems in monitoring and improving general practice workloads

Trialling the use of online consultation systems in monitoring and improving general practice workloads

General practice workloads have increased 16% over the past decade.


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One solution to rising patient demand has been online consultation systems which are thought to help with timely access and efficiency for patients and professionals.

This mixed method evaluation investigated patient and staff views, experiences and acceptability of a pilot e-consultation system in 36 south west England practices.

Interviews, surveys and analysis of anonymised patient records were conducted. An e-consultation was completed by 7,472 patients, most frequently on weekdays and during traditional working hours. There were different expectations between patients and staff in how to use the system ‘appropriately’. Some patients used it to try and save time for themselves and staff, but others used it when no face to face appointment was available. Most e-consultations resulted in another contact – either face to face (38%) or by phone (32%).

Staff considered this increased their workload rather than saved time, although sometimes it was also viewed as focusing the second contact appropriately. The e-consultations were thought to work most as intended when dealing with clinical administrative matters for example, fitness notes. Patients’ satisfaction with the system was high, although a few were dissatisfied with the practice communication about their e-consultation.

Overall, the e-consultation system could improve access for some patients, but in its current form, it was not perceived by practices as creating sufficient efficiencies to warrant financial investment.


Farr M, Banks J, Edwards HB et al (2018) Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production. BMJ Open. doi: 10.1136/bmjopen-2017-019966.

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