The doctor can see you now: how technology can help in under doctored areas

Digital Doctor

The move to ‘patient centred care’, putting the patient at the heart of their own treatment, also frees up clinicians. By valuing a patient’s time instead of revolving the process around the practitioner, as is still massively prevalent in hospital emergency departments, for example, waiting times can be cut and patients can be more involved, and better informed, about their health.

Across all the indicators used to measure deprivation, those living in the most deprived areas experienced a worse quality of care than people living in the least deprived area.

The Inverse Care Law, which states that access to good quality care was worse in areas of greatest need is sadly still persisting in primary care as a result of pressures on the workforce and a growing number of people living with multiple health problems. This may be affecting deprived areas to a great extent, resulting in a double deficit, where people in these areas have greater needs but also poorer access.

And trends have shown that the inequality gap is widening in areas where the general data shows a worsening, for example in A&E waiting times or making a GP appointment.

But rather than exacerbate inequalities, the use of technology in healthcare can actually bring down these disparities by allowing clinicians to work at the top of their skill set and see more patients. 

Research by the Nuffield Trust[1] showed the inequality gap is greatest for measures such as avoidable mortality and emergency admissions to hospital whose determinants are based on a broad health spectrum. This includes living conditions, access to primary care, diet and exercise and social and community support. The NHS has less influence over these measures but primary care can make a real impact.

People from deprived areas tend to have more complex health needs. They may have multiple long term conditions, such as asthma or hypertension, for which they are entitled to an annual review by their GP practice. However in reality, particularly with the impact of the pandemic, access to GP services has been cut back. GPs moved to essential services only at the beginning of the third wave of national measures to combat COVID-19 and deliver the national vaccine programme.

There is also a mismatch of supply and demand in trained practitioners in areas of deprivation. CCGs covering areas of greater poverty tend to be ‘under doctored’. These are the places where a digital first strategy can make the biggest difference.

The elasticity of supply of trained staff is inelastic. It takes a long time to train up nurses, doctors and other therapists. During this time, millions of people are going without the level of service which is available in wealthier areas.

Whilst there is always a need for a constant supply of medical professionals, the digital age has brought with it solutions which allow health care professionals to work at the top of their skill set and allow technology to take over automative processes.

The move to ‘patient centred care’, putting the patient at the heart of their own treatment, also frees up clinicians. By valuing a patient’s time instead of revolving the process around the practitioner, as is still massively prevalent in hospital emergency departments, for example, waiting times can be cut and patients can be more involved, and better informed, about their health.

According to research published in the BMJ, GPs are more concentrated in the North, the Midlands, and the South West. GP nurses are spread more evenly across the country, and levels of hospital staff are higher in the South and South East, with the lowest values observed in the coastal areas of the East Midlands and the North East of England.

Medloop has been working with GP practices in less privileged areas of England to develop it’s Patient Management Optimiser. 

The PMO is a tool designed to allow GP practices and primary care networks to carry out reviews for their patients who have long term conditions which reduces both administrative and clinical workload for primary care staff. 

It has been designed to support the needs of the primary care workforce and their patients in helping them deliver a higher number of quality chronic disease condition reviews.

The PMO not only helps GPs and practice staff, it helps improve patient outcomes particularly for practices in under doctored areas. 

Many practices have had to put reviews on hold during the pandemic because of infection prevention and control and the additional workloads which COVID 19 has brought.

Consequently, there will be a patient backlog as well as the ongoing work load for this coming year. Medloop’s Patient Management Optimiser can help GP practices in delivering their long term condition reviews using a digital first approach and help deliver real changes to a patient population at a very difficult time. 

 

[1] Scobie S and Morris J (2020) Quality and inequality: digging deeper. QualityWatch briefing. Nuffield Trust and the Health Foundation. 

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