In a matter of months, use of NHS Near Me has soared from 300 consultations a week to 19,000, and half a million appointments have now been carried out online. Medical practice will never be the same again

Appointments with destiny


Before Covid-19 hit, a little- known video consulting platform was used by doctors to connect with patients in the more remote areas of Scotland. NHS Near Me, or the Attend

Anywhere service as it was known at the time, had regular weekly traffic of around 300 con- sultations per week, and it was considered a success. As of December 2020, that fig-

ure is now running at 19,000 con- sultations every week, with more than half a million appointments now having been carried out online. And it is not just GP use; the platform has been expanded into social care, mental health, nurse practitioner and community health work as needs have arisen. Hazel Archer, from the Scottish

Government’s Technology Enabled Care Programme, who heads up the service, said: “Having carried out over half a million appoint- ments is a significant and symbolic milestone. A scale-up of such mag- nitude has not been seen before and it’s testimony to how it’s been co-designed and delivered. She adds: “I would like to thank

everyone across all the health boards and health and social care partnerships, social care, and third sector who have worked so hard to make this happen. We have been focused on offering

choice and making services more accessible. We have made a lot of progress but we are focused on continuous improvement.” Such has been the impact that

it is unlikely that medical practice will ever return to the normal way of doing things. Health secretary Jeane Freeman signalled as much when she told the Health and So- cial Care Alliance Scotland’s annual conference that the digital means of communication was here to stay. She didn’t go as far as Westmin-

ster health secretary Matt Hancock, who had called for appointments to be “digital by default” but she said the gains that had been made through Near Me had been “hugely positive” as an alternative to face- to-face appointments which had become extremely challenging to fulfil in a pandemic. Freeman said: “So the BMA

[British Medical Association] are are very clear on this, the Royal College of General Practitioners are very clear – and I think they’re right – there is a big space for digital that works for very, very many patients and GPs, but that shouldn’t knock out face-to-face.” Dr Andrew Cowie, deputy chair

of the BMA’s Scottish GP Commit- tee, added: “It’s fair to say that we will need to embed the kind of digital innovations that have sup- ported more remote consultations throughout the past few months. Tese are necessary to cut down

18 | FUTURESCOT | WINTER 2020/21

footfall in GP practices, and reduce the risk of transmitting Covid-19 in waiting rooms. “However in some cases the

only really effective way to as- sess a patient is face-to-face, for example patients who require physical examinations, or those who are hard of hearing. Tere are also patients who do not have easy access to the devices neces- sary for consultation at a distance. “For all these reasons, as well

as patient preference, we hope to gradually increase the number of face-to-face consultations as it be- comes safe and possible to do so. In those circumstances GPs need continued and assured supplies of PPE for the long-term – something which improved significantly after a slow start earlier this year.”

Near Me was given a shot in the arm when it received a £25m funding boost as a result of the Scottish Government’s infrastruc- ture investment plan. Te investment was earmarked

for the system development required in response to the surge of usage for the service, which is based on Australian technology platform Attend Anywhere, which launched in that country in 1998. It represented a spending com-

mitment in excess of 100 times over and above the sum the service received for its largely rural de- ployment in 2019. In that year, GP

practices across Scotland received £9m to upgrade their premises and IT systems, of which £200,000 was assigned to supporting the deploy- ment of the platform. Te Skype-like service has

been used remotely by a range of clinicians, including GPs, physio- therapists, nurses, psychologists, dieticians, occupational health and community care workers. It is also being expanded into acute medicine with a growth in use by hospital-based clinicians for out- patient appointments.

The rollout has been further supported by a digital programme being carried out by NHS 24 – the inbound response handling service for the NHS in Scotland – to equip GP practices around the country with the design of local practice websites. Dr Laura Ryan, medical director

of NHS 24, told the health and sport committee at the Scottish Parliament this week how the resource has now reached 60 practices in Scotland. She said:

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