We bring you the latest news from the healthcare about the health care in the United Kingdom.

vrijdag 29 juni 2018

RCGP: Apps and algorithms may 'support but will never replace' GPs, says RCGP

Apps and algorithms may 'support but will never replace' GPs, says RCGP

"No app or algorithm will be able to do what a GP does. Every day we deliver care to more than a million people across the UK, taking into account the physical, psychological and social factors that may be impacting on a patient's health; we consider the different heath conditions a patient is living with, and medications they might be taking, when formulating a treatment plan. Much of what GPs do is based on a trusting relationship between a patient and a doctor, and research has shown GPs have a 'gut feeling' when they just know something is wrong with a patient.

"An app might be able to pass an automated clinical knowledge test but the answer to a clinical scenario isn't always cut and dried, there are many factors to take into account, a great deal of risk to manage, and the emotional impact a diagnosis might have on a patient to consider. This is why the College's MRCGP assessment, which all GPs must now pass in order to practise independently in the UK, has three elements and is designed to test not just clinical knowledge, but also the ability to make evidence-based decisions, and to deliver person-centred care through effective communication with patients and colleagues.

"It is also the case that the exam-preparation materials, used by Babylon in this research, will have been compiled for revision purposes and are not necessarily representative of the full-range of questions and standard used in the actual MRCGP exam, so to say that Babylon's algorithm has performed better than the average MRCGP candidate is dubious.

"Babylon's GP at Hand service uses technology in a way that some patients like. But some don't, and the way it is being used risks undermining and damaging traditional general practice services. The College has publicly criticised GP at Hand for 'cherry-picking' patients, leaving traditional GP services to deal with the most complex patients, without sufficient resources to do so. We stand by this: we do not endorse Babylon, or its GP at Hand service, being used in the way that it is, in the NHS.

"Technology has the potential to transform the NHS, but it must be implemented in an equitable way, that doesn't benefit some patients, and not others, and is not to the detriment of the general practice service as a whole."

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3D model of patient-centred care 'beneficial' but more research needed, says RCGP

"For GPs and our teams, this makes delivering the care our patients need, tailored to their circumstances, incredibly complex. We have always taken a holistic approach to medicine in general practice, considering the physical, psychological and social factors that might be impacting on a patient's health when exploring different treatment options, in conversation with our patient, and we find that this is particularly important for patients with multiple, long term conditions.

"We are surprised, as I'm sure professionals from across health and social care will be, to see the results of this study. It certainly challenges current thinking, as well as anecdotal evidence based on what GPs see in their surgeries, around the benefits of this particular model of delivering patient-centred care on our patients' quality of life. This is high-quality research and mustn't be dismissed – but it is the first of its kind at this scale, so there is definitely a need for further research of this calibre, to see if the results can be replicated.

"Whilst we strive to improve the quality of life of our patients, we mustn't underestimate the importance of patient satisfaction with our service – this is the foundation of the GP-patient relationship, and why GPs are consistently rated amongst the most trusted healthcare professionals in the NHS – and it is clear from this study, that the 3D model of delivering patient-centred care was very beneficial in this respect.

"There is evidently no one-size-fits-all approach to delivering patient-centred care, and it is important that we don't give up on the concept as a result of this one study, but use it as a basis for further research into different approaches that do improve patients' quality of life. To this end, the RCGP has recently entered a collaboration with the Richmond Group of Charities and Guys and St Thomas's charity to establish a taskforce to investigate strategies and solutions to the multi-morbidity challenge and has an active Clinical Spotlight project on multi-morbidities, alongside ongoing work on person-centred care."

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Balancing continuity of care and access to GP services a 'huge challenge', says RCGP

"But general practice is currently facing intense resource and workforce pressures, which is making it increasingly difficult for patients to access our services and unfortunately, waiting to see 'their' GP means patients may have to wait even longer for an appointment. Some are willing to do this but often they cannot wait and seeing another GP or health professional in the practice team can speed up access in some situations.

"Many GP practices across the country are using innovative approaches to retaining continuity of care, for example, a patient might be assigned to a team consisting of several GPs and other healthcare professionals in the practice, all of whom will have full access to their records, allowing them to see and build trusting relationships with the whole team, not just 'their' doctor.

"Balancing continuity of care with timely access to GP services is a huge challenge for general practice, and ultimately the answer is more GPs and more resources for the profession.

"NHS England has already pledged £2.4bn extra a year for general practice and 5,000 more GPs by 2020 - and this must be delivered to safeguard the future of general practice and patient care. The Prime Minister has also announced a significant amount of money for the NHS, and it is essential that the role of general practice in delivering quality care to over a million people a day and alleviating pressure on hospitals and other services, is recognised as more details of her long-term plan are released. Resilient general practice is essential to the long-term viability of our NHS and to the health of our nation."

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