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Exclusive GPs in one area could be forced to spend up to £20,000 a year on sending text messages to their patients, after the local ICB decided to put a limit on the number of texts it will fund.
North East London ICB informed GPs of its intention to only fund seven ‘message fragments’ (approximately two text messages a month) per patient per practice for the remainder of the financial year, with practices having to pay for the rest of the messages.
It told Pulse that text messaging has become the principal means by which many GPs communicate with patients, including for large-scale and batch sending of messages, and that this has led to the costs ‘growing exponentially’.
But GPs said that their current text message usage reflects ‘appropriate’ targeted use, that improves both clinical efficiency and patient outcomes, rather than ‘misuse’.
They warned of a potential increase in patient waiting times as a result of this measure, as issues that could have been resolved via text will now require appointments or phone calls, if practices cannot afford to pay for the texts.
They also said that it will cause an increase in administrative workload, diverting GPs’ time from patient care, and could also affect A&E attendance.
North East London GPs also told Pulse that as we approach winter, it is ‘vital’ that flu, covid and other vaccinations are given in a timely manner to reduce pressures in A&E and hospitals and that text messaging is ‘crucial’ in enabling improved vaccination rates.
The ICB said it will work to develop further resources to help practices better understand ‘cost effective use’ of text messaging and the implementation of alternative forms of patient communication, such the NHS App or email.
It is part of nation-wide efforts to encourage the use of the NHS App rather than text message, with NHS England launching a campaign focusing on its functionalities including GP record access and test results, repeat prescriptions and viewing appointments already booked.
Tower Hamlets GP partner Dr Selva Selvarajah told Pulse that the cost of this measure could be between £10,000 to £20,000 depending on the size of the practice, and that this will add to the financial pressures that practices are already facing.
Pulse has seen communications asking practices to set up a Direct Debit to ‘support monthly payment processing’ in order to continue accessing Accurx services, including text messages.
Dr Selvarajah said: ‘Because of our use of text messages, we were able to absorb a lot more work, especially during the pandemic, with a lot more things being managed more efficiently.
‘This is going to take us back to pre-pandemic days. What this means is that we are going to end up doing a lot more phone calls and seeing fewer patients. It could potentially have some impact on A&E attendances and NHS 111.
‘Depending on the practice size, we are looking at £10,000 to £20,000 depending on the practice.’
Dr Sarah Foley, a salaried GP in Tower Hamlets, said that while this policy change may not directly harm patients, the resulting increased waiting times, ‘poorer’ communication and ‘reduced’ efficiency could indirectly lead to adverse outcomes.
She said: ‘Patients may experience delays in care, particularly for routine reviews or minor ailments that are currently managed promptly via text.
‘I think that the ICB should be fully aware of the impact this policy change is having on us as a workforce, as well as the broader implications for patient care.
‘Our high text message usage is not due to overuse but reflects appropriate, targeted use, that improves both clinical efficiency and patient outcomes.
‘The volume of text messages correlates directly with the high workload and patient demand we are managing, not inefficiency or misuse. Restricting this valuable tool will increase the burden on GP services.
‘Focusing solely on the cost of text messages misses the bigger picture. For instance, we frequently use texts to communicate test results, reducing the need for full 12-minute consultations. This is not only cost-effective, but frees up appointment slots for patients, reducing waiting times.’
A spokesperson for NHS North East London said: ‘We understand that SMS text messaging is a helpful and effective way for GP practices to communicate directly with their patients, and we have funded the software licence, digital tools and associated costs for this service for a number of years as an integral part of modern primary care provision across north east London.
‘This funding is being maintained at the same rate as the previous financial year, and the budget for text messages is not being reduced.
‘However, text messaging has become the principal means by which many GPs communicate with patients, including for large-scale and batch sending of messages, and this has led to the costs growing exponentially.
‘We are therefore working closely with practices to better understand effective SMS use in general practice to ensure that this service is used in a way that makes the best use of limited NHS resources while supporting them to deliver high quality patient care.’
Earlier this year, NHS England claimed that up to 20% of calls to GP practices ‘could be resolved’ through NHS App features for referrals.
And the commissioner also said that sending messages to patients via the NHS App rather than over text or letter has saved the NHS £1.1m.
27 November 2024
18 November 2024
21 November 2024
Please note, only GPs are permitted to add comments to articles
When will they start charging hospital consultants the postage to send out letters? Or hospital deparmetments for text reminders to patients billed directly to all staff who work in the department looking after patients ? No. Thought not, bully and harass the GPs. Not the hospital consultants
Probably not a bad idea – better to target the use of text messages to surgeries regular patients with helpful reminders to improve their health and wellbeing. As a patient I would estimate that more than 90% of the texts I receive from my local surgery are about practice not doing stuff because of being busy, short staffed or closed and so on. For most patients who hardly go to the practice all these texts are fairly pointless and just give the practice an undeserved poor image.
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