Publication - FOI/EIR release

Monitoring GP practices provision of online services to patients: FOI release

Information request and response under the Freedom of Information (Scotland) Act 2002.

Published:
17 Sep 2019
Monitoring GP practices provision of online services to patients: FOI release
FOI reference: FOI/19/01994
Date received: 15 Aug 2019
Date responded: 12 Sep 2019
Information requested

The 2018 GMS contract stated " Under the proposed new contract, GP practices will be required to provide online services to patients such as appointment booking and repeat prescription ordering, where the practice already has the existing computer systems and software required to implement online services safely."  As this is a stated aim within the contract, what is the Scottish Government doing to monitor the provision of such facilities. 
What data does it hold on the ability of patients across Scotland to do so.   How many, and what percentage of  GP surgeries in Scotland offer a)  online appointment booking,  b) repeat prescription ordering, c) both?

The Health and Care Experience Survey 2017/18 highlighted a " significant decrease" in the number of people who were able to book a GP appointment in advance.  The survey notes that this continues to be below the LDP standard.  The report is a survey of some patient experiences and not an actual monitor of what is going on in GP practices.   What is the Scottish Government doing to ensure patients actually have the ability to secure an appointment in advance?  What data is being recorded on this activity?  Given the continued failure to meet this target in successive experience surveys, what action is the Scottish Government taking?  How many, and what percentage, GP surgeries in Scotland allow patients to book an appointment in advance.
What rights do patients have/ what can they do if their GP practice will not allow an appointment to be booked in advance?What rights do patients have/ what can they do if their GP practice will introduce online appointment book and online repeat prescription ordering?  

 

 

 

Response

The 2018 GMS contract stated "Under the proposed new contract, GP practices will be required to provide online services to patients such as appointment booking and repeat prescription ordering, where the practice already has the existing computer systems and software required to implement online services safely."
As this is a stated aim within the contract, what is the Scottish Government doing to monitor the provision of such facilities.

The Scottish Government negotiated the new contract with the Scottish General Practitioners Committee of the British Medical Association. After the profession accepted the framework set out in The 2018 General Medical Services Contract in Scotland, legislation to create The National Health Service (General Medical Services Contracts) (Scotland) Regulations 2018 and The National Health Service (Primary Medical Services Section 17C Agreements) (Scotland) Regulations 2018 was passed by the Scottish Parliament.
This legislation regulates the agreements Health Boards can enter into with general medical practitioners to provide primary medical services under the National Health Service (Scotland) Act 1978. The resulting agreements are between Health Boards and GP contractors and as such it is the responsibility of Health Boards to ensure that their contractors are upholding the terms of their contracts. The Scottish Government does not monitor the provision of the above facilities.
What data does it hold on the ability of patients across Scotland to do so?
How many, and what percentage of GP surgeries in Scotland offer a) online appointment booking, b) repeat prescription ordering, c) both?

The Scottish Government does not hold data with regard to the ability of patients to access online appointment booking and repeat prescription ordering.
The eHealth Strategy 2014-2017 published by the Scottish Government in March 2014 encouraged all GP practices in Scotland to offer repeat prescribing and appointment booking as online services, with a view to at least 90% of practices offering this service by the end of 2017.
At the end of 2018, 94% of GP practices in Scotland have the facility to offer an online means of accessing either repeat prescriptions or appointments via GP IT system functions or practice websites.
The Health and Care Experience Survey 2017/18 highlighted a "significant decrease" in the number of people who were able to book a GP appointment in advance. The survey notes that this continues to be below the LDP standard. The report is a survey of some patient experiences and not an actual monitor of what is going on in GP practices.
What is the Scottish Government doing to ensure patients actually have the ability to secure an appointment in advance? What data is being recorded on this activity? Given the continued failure to meet this target in successive experience surveys, what action is the Scottish Government taking?

The Scottish Government is implementing the new GP contract which will make general practice a more attractive profession by reducing workload and removing risk from GP contractors as employers, providers of premises and data holders. The wider multidisciplinary care team is being expanded to allow GPs to focus on their role as expert medical generalists whilst ensuring patients can be seen by the right person, at the right time and in the right place.
The Scottish Government is also funding NHS 24 to deliver a scalable GP website solution for Scotland. Currently GP practices provide their own websites at their own cost which support varying degrees of online functionality; the new website will be free to them, and will support online appointment booking. Practices with capacity taking up the website will then be contractually required to provide online appointment booking (and online repeat prescription ordering).
It will remain for GPs as independent contractors to make their own appointment arrangements based on their understanding of the clinical needs of their patients.
The National Monitoring and Evaluation Strategy for Primary Care in Scotland sets out the overarching approach and principles for how we will use evidence and analysis to track and understand the reform of primary care between now and 2028. This will help us better understanding the impact of the GMS contract, including monitoring patient experiences of accessing general practice.
Find more information at: https://www.gov.scot/publications/national-monitoring-evaluation-strategy-primary-care-scotland/
What rights do patients have/ what can they do if their GP practice will not allow an appointment to be booked in advance?
Everyone the right to receive healthcare that: 

  • considers their needs;
  • considers what would most benefit their health and wellbeing; and
  • encourages them to take part in decisions about their health and wellbeing, and gives them the information and support to do so.

Patients do not have rights to particular appointment arrangements at particular GP practices.

Patients do have a right to give feedback and make comments, and raise concerns or complaints about the care they have received.
What rights do patients have/ what can they do if their GP practice will introduce online appointment book and online repeat prescription ordering?
Patients do not have a right to online appointment booking or online repeat prescription ordering. Patients have a right to give feedback and make comments, and raise concerns or complaints about the care they have received. Patients also have the right to ask for a judicial review if they think they have been directly affected by an unlawful act or decision of an NHS organisation
The Charter of Patient Rights and Responsibilities (the ‘charter’) summarises what you are entitled to when you use NHS services and receive NHS care in Scotland, and what you can do if you feel that your rights have not been respected. It can be accessed at: https://www.gov.scot/publications/charter-patient-rights-responsibilities-2/pages/2/

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