Phone consultations don’t save NHS money

NHS plans to force patients to have phone consultations with GPS will fuel more hospital admissions instead of easing pressures, a new study suggests.

Research by the University of Cambridge shows that those GP practices which insist on a phone conversation with a doctor to decide who gets an appointment create both a greater workload and higher hospital costs.

Health officials have said such schemes are key to reducing strain on the NHS at a time of unprecedented demand. However, the study of 147 practices with “telephone first” schemes found they saw a 2 per cent rise in hospital admissions – along with a sharp increase in the amount of time that GPS spent on consultations.

While the approach meant fewer face-to-face consultations in total, almost half of the patients who had a telephone conversation still had to be seen in person. The combination of this and all the extra time on the phone meant that, overall, GPS spent around 8 per cent more time in consultations, the research found.

The findings, published in the British Medical Journal, fly in the face of health officials’ claims that the schemes could bring significant savings and cut Accident and Emergency (A&E) usage by one fifth. The savings from a 2 per cent drop in A& E attendance were dwarfed by rising costs from extra numbers being admitted to hospital, the new study found – amounting to almost £12,000 extra per 10,000 patients.

“There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary care,” researchers Dr Jennifer Newbould and Prof Martin Roland found.

In a linked editorial, Prof Brian Mckinstry from the University of Edinburgh wrote: “The study … should cause practices to think carefully about the wider, possibly unanticipated, consequences of a switch to a telephone-first system and should lead policy makers to reconsider their unequivocal support for such systems.”

Surgery staff in London, Devon, Birmingham, East Lancashire, West Yorkshire, Tyne and Wear and Manchester are being taught how to direct patients to other health professionals, such as nurses and pharmacists.

Prof Helen Stokes-lampard, chair of the Royal College of GPS, said: “Telephone consultations can be convenient but as this research has shown they don’t necessarily reduce GP workload in the end as 10 minutes are 10 minutes whether spent speaking to patients over the phone or face to face.”