Pre-publication: For more information contact: mary.amanuel@nhsx.nhs.uk
6th August 2021 | Mary Amanuel & Craig Shenton (NHSX Analytics Unit)
- Remote appointments are now as common as face-to-face appointments. While most patients are comfortable with online appointments, many would still prefer face-to-face appointments in the future.
- Almost half (44%) of patients have used an online GP service in the last 12 months. Patients will long term health conditions are more likely than average to use online services.
- Patients aged 75 and over are the least likely to use online GP services over all, with more that two thirds (68%) not using any online service in the last 12 months.
- In terms of web accessability, patients are finding it more difficult to use their GP practice website, particularly for those aged 75 and over.
- Table of Contents
- Introduction
- Appointments
- Online Services
- Web Accessability
- Conclusion
- References
As more people use digital tools and websites to manage their physical (37%) and mental health (25%) in 2021 [1], access to quality online health services is more important now than ever. Given that 89% of consumers use digital tools for online banking and 60% for accessing local council information [1], there is great potential to expand digital health services in the UK.
Our analysis builds on the GP Patient Survey 2021 — a national survey of patients’ experiences of general practice — to shed light on the use of, and barriers to, accessing online general practice services in England since the coronavirus pandemic [2].
For the first time, more remote appointments took place in April 2020 than face-to-face appointments [3]. In previous surveys, face-to-face appointments were the dominant appointment type, making up 90% of the patient appointments. In 2021, however, 50% of patients reported having a remote appointment (compared with 10% in 2020) [3].
Figure 1. Type of appointment attended by patients, where 'Remote' includes both Telephone and Online appointments. Source: GP Patient Survey 2021.
{% include remote_appts.html %}
Patients are more likely to say their needs were met in their last face-to-face appointment (95%) than in their last remote appointment (92%) [2].
Research from the Office for National Statistics found that, in August 2020, 64% of people said they would be ‘comfortable’ or ‘very comfortable’ attending an online appointment with a health professional [4]. However, so over 70 (53%) or with an underlying health condition (57%) weren’t as comfortable with online appointments [5].
Ordering repeat prescriptions was the most popular activity among those who used an online service (26%), followed by booking an appointment online (19%). Yet, online GP services haven't fully taken off. More than half (56%) of all patients surveyed have not used any online service [2].
Table 1. Patients' use of online GP services in the last 12 months. Source: GP Patient Survey 2021.
| Online Activity | Percent (%) |
|---|---|
| Ordering repeat prescriptions online | 26% |
| Booking appointments online | 19% |
| Had an online consultation or appointment | 18% |
| Accessing my medical records online | 7% |
| None of the above | 56% |
Figure 2. Online GP service use between survey respondents (with and without long-term conditions) that used an online services within the last 12 months (as of March 2021). Source: GP Patient Survey 2021.
{% include online_activities_ltc.html %}
The over 75s are 12% less likely to use online services than average, with more than two thirds (68%) having not using any online GP service in the last 12 months [2].Figure 3. Online GP service use between survey respondents (by age group) that used an online services within the last 12 months (as of March 2021). Source: GP Patient Survey 2021.
{% include online_activities_75.html %}
Interestingly, 16-24s were second least likely to use online GP services, with 41% using an online service in the last 12 months (compared with 44% nationally) [2].
Figure 4. Online GP service use between survey respondents (by age group) that used an online services within the last 12 months (as of March 2021). Source: GP Patient Survey 2021.
{% include online_activities_25.html %}
In a recent report on digital inclusion, Age UK found that 42% of aged 75 and over do not use the internet [6].
Furthermore, a lack of digital skills among the over 75+ age group (79%) was the most common reason for not using the internet. The next most common reasons were a lack of trust in the internet (39%) and not having good enough access to equipment and/or broadband (30%) [6].
Ofcom's Digital Exclusion survey also found that 18% of digitally excluded adults aged 75 and over would be willing to go online to access health services [7].
A quarter (25%) of patients who used their GP practice's website found that it was 'not easy' to look for information or access services, compared with 22% in 2018. This increase was sharper for those aged 75 and over [2].
Figure 5. The proportion of survey respondents aged 75 and over that found it 'not easy' to use their GP practice's website to look for information or access services (where 'Not easy' = 'Not very easy' + 'Not at all easy') Source: GP Patient Survey 2021.
{% include ease_of_use.html %}
Furthermore, those patients with learning disabilities found it significantly more difficult (31% responded 'not easy') to look for information or access services on their GP website [2].
Patients have seen a fundamental shift in how general practices deliver primary care services. The GP Patient Survey has shown that patients are getting more familiar with online GP services such as remote appointments and ordering repeat prescriptions online.
And yet, some barriers remain: more than half of patients haven’t used any online GP service in the last 12 months, more patients felt in-person appointments met their needs, and GP practices websites need to be more accessible.
Moving forward, accessible, inclusive, and personalised healthcare services will be key to overcoming these barriers, building a solid foundation for further digital transformation.
[1] Lloyds (2021). "Consumer Digital Index". Available online [Link].
[2] Ipsos MORI (2021). "GP Patient Survey 2021". The survey contains data collected from patients aged 16+ registered with a GP practice in England. Available online [Link].
[3] NHS Digital (2020). "Appointments in General Practice". Available online [Link]
[4] ONS (2021). "Corona virus and the social impacts on Great Britain". Available online [Link].
[5] ONS (2021). "Corona virus and the social impacts on Great Britain". Note: the ONS Glossary of what is considered an underlying health condition may be different to how the GP Patient Survey 2021 defines a long-term health condition. Available online [Link].
[6] Age UK (2021). "Digital inclusion and older people – how have things changed in a Covid-19 world?". Available online [Link].
[7] Ofcom (2021). "Adults’ Media Use and Attitudes report 2020/2021". Available online [Link].