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The pros and cons of using telehealth services

Telehealth consultations are innovative, but feature some potential drawbacks

When ‘GP at Hand’ was first launched, I thought this was a fabulous opportunity for people to access GP services without the need to attend a surgery or navigate the challenges of a GP appointment system. Then came the news that in order to use the service, people needed to de-register from their local GP and register with GP at Hand.

But the shiny new service is very convenient though for those who have little or no need for an ongoing relationship with their local GP service. Having a GP readily available on a smart phone for a video consultation is efficient and effective for all parties. Those relinquishing their GP registrations to join GP at Hand are therefore likely to be the healthy, younger, mobile population who only access GP services intermittently.

It was only when I found myself away from home last week and in desperate need of antibiotics that I appreciated how inaccessible traditional GP services can be for those spending several nights a week working away.

After I tried and failed to self-manage a urinary tract infection (UTI) with over-the-counter medication for 24 hours, I called my GP surgery to ask for the antibiotics to be prescribed. It was Tuesday at 4pm. I was 150 miles away from home and standing in a railway station. I did not need an appointment and believed that the protocol for those like myself who suffer regular UTIs was to prescribe antibiotics as a matter of urgency.

The request was declined and I was offered the opportunity to come into the practice at 6.30pm to be seen at the end of the surgery.

I explained that I was 150 miles away and asked to speak with the GP at 6.30pm so that the prescription could be collected at that time by a member of my family who lived locally. This was not possible and I was asked instead to call at 8am the to see if an appointment would be available.

I put the phone down and spoke with my colleagues about calling 111 to find the nearest walk-in-clinic in the city where I was awaiting the train home. I was fortunate to be travelling with a colleague who told me about Push Doctor.

I registered at 4.45pm and was video linked to a GP based in London by 5.05pm. We agreed the antibiotics and I was asked where I would like the prescription to be sent. I requested the pharmacy in Euston station as my train terminated there. My appointment lasted 7 minutes and I then received a text at 5.25pm to tell me the antibiotics were ready for collection at the pharmacy of my choice. By 6.45pm I had taken my first dose.

I was fortunate to be able to afford £30 for the service but I also reflected that if only this was available in addition to the GP service for circumstances like mine, this would relieve the pressure on appointments in GP surgeries, reduce calls to 111 and attendance in walk-in centres. This is a debate which will be ongoing.

Dr Crystal Oldman CBE, Chief Executive, Queen’s Nursing Institute