On call: the changing role of telephone systems in post-Covid general practice

Female nurse on telephone in GP practice

While every one of your patients is unique, there is one big concern that they all share – and it affects every member of your team, every day.

It’s the challenge they face when calling for an appointment – and all that goes on behind the scenes to respond to that call.

Of course, as long as phones have been in practices, they have been both a blessing and a burden. But the pandemic has only compounded this, making your phone system less of an item on the long-term technology agenda and more of a critical priority.

Official figures bear this out. For example, one study by the Royal College of General Practitioners found that during the first lockdown of 2020, more than 70 per cent of GP consultations were through phone and video – a complete reversal of life before the crisis, when 70 per cent of GP appointments were face-to-face.

Although this dramatic U-turn demonstrates the importance of telephone systems and internet connectivity in practices, the figures will probably come as no surprise to you. After all, the only constant in healthcare is change – and you were at the front line, supporting patients through the pandemic and seeing these changes with your own eyes.

But the difference with these enormous shifts is how, due to the pandemic, healthcare has arguably reached the point of no return – described by the College as “the potential to change general practice dramatically and permanently”.

Naturally, technology providers to general practice have a role in helping you recover from the pandemic. But, as this blog explores, a telephone system for the GP practice of 2021 – and beyond – is not a case of ‘business as usual’. Instead, it must address the nuances that have surfaced in light of this extraordinary turning point.

For this blog, I’ll be referring to GPs. But I fully appreciate that all staff – both clinical and administrative – have a stake in your practice’s telephone system.

It’s about much more than inbound calls

Chances are you’ve had to pay a lot more attention to your telephone system over the past 18 months – and that’s an understatement. You might have found yourself wrestling with new challenges – such as needing more phone lines to accommodate more calls. You might also have had to turn to features you never needed before 2020. And you might have looked to other providers for help.

If you did, you might have noticed the same thing I have: providers of telephone systems tend to focus on inbound enquiries. And in doing so, they extol the ways their system can help with the tidal wave of calls your reception team handles every day (an issue which I’ll explore later).

This makes a lot of sense. After all, how you manage the calls into your practice doesn’t only affect staff workloads and morale – it can make all the difference in a patient getting the right help, from the right clinician, and in the right way, too.

But the management of inbound calls is only half the story here. A telephone system for the post-Covid practice must also work for outbound calls, since they’re now a huge part of your day. 

To do this, technology providers must consider the dynamics between the GP and the patient. Namely, phone consultations are great in principle but much more nuanced in practice.

For instance, when a patient gets in touch, it isn’t immediately obvious which kind of appointment is most suitable. This is because patients can’t always articulate their complaint on a call – and telephone triage can only go so far to help in this respect.

Consequently, there’s no guarantee a phone call is appropriate – but it may only be through a GP call that the need for face-to-face consultation becomes apparent. This can be frustrating for the patient and the GP – both of you want to get to the bottom of the patient’s concern in as few appointments as possible.

One way we’re helping practices overcome this challenge is with a telephone system that, with the click of a button during the call, can switch from standard voice to video. Through this system, the patient does not need to install any unique phone apps – but can use their phone’s camera so you can visually assess symptoms.

Of course, you do not rely only on sight to evaluate a patient. Touch and even smell are also involved, as is the unique intuition that can only happen by seeing someone in person. So video calls can be of great help – but only if they work for the real world, where not all calls begin as a video – and not all patients are willing to install more apps.

Outbound and inbound, but not office-bound

We all know how the pandemic has changed how and where we work. You may have been calling patients from places other than your usual desk, including your home.

However, not all phone systems are designed from the ground up for such arrangements – and especially for GPs and patients. While some get the basics right – allowing you to be flexible to an extent – I have found that the devil is in the details where general practice is concerned.

Some of the features that our GP clients look for and value include those that allow them to make calls from personal mobiles, without any compromise to confidentiality and security, or risk of incurring network costs.

Similarly, being able to make calls from a computer is just as important – holding a phone to an ear for long periods can cause arm and neck aches. And, to be a stickler for detail, the ability to control the phone number displayed to the patient – though a seemingly minor point – can prevent the patient from ignoring the call, which in turn can generate more work.

The whole picture of the patient

As a consumer, have you ever called a company’s customer services only to repeat your complaint because the telephonist can’t see your past enquiries?

Often, these awkward calls are not a reflection of the staff. Instead, they result from disparate IT systems: telephony does not ‘talk’ to customer record systems and vice versa. So staff answering the call find themselves flitting between applications trying to see the whole picture while you’re put on hold with your patience wearing thin. Staff may also have to manually update your records after the call, which obviously takes time.

This scenario is frustrating for all involved – and it isn’t unique to the private sector. In fact, in general practice, disjointed systems can have a real impact on patient outcomes – because being able to easily see the whole picture at the point of the call can help in several ways. These include making a diagnosis, assessing medicine interactions and sensitivities, and reassuring the patient that they are being treated as individuals with a unique history.

Consequently, telephony that integrates with clinical systems, such as SystmOne and EMIS, can be of great help. So how about telephony that lets you call the patient through a single click on your clinical system, where you’ve been viewing their records? Or a system that automatically and securely saves call details, including an audio recording, directly into the patient’s records once the call is over? There is a telephone system with precisely these features – and we’ll come to it shortly…

Making inbound calls better for all

Through my professional experience with GP practices, the daily rush of inbound calls can be one of the most stressful challenges for staff. My impression is that managing these surges can often feel like a full day’s work in itself, all condensed into a short and intense period.

NHS England’s findings that four in ten people were reluctant about contacting their GP during the pandemic suggest these surges may have lessened during the crisis. However, given the other exceptional demands of the crisis, I’m not convinced that such a reduction would have made any real dent in your workloads.

One thing I can say with more certainty is that with the return of relative normality, it seems a vice-like pressure on GP practices has emerged. Not only is the NHS ordering GPs to return to business as usual, but inflammatory media coverage has also fuelled patient demand for the same.

As a result, a telephone system that offers smarter ways to manage inbound calls could help ease these pressures. For example, features such as providing a callback instead of making the patient wait on the line at busy times can be of great value to patients and staff alike. Likewise, an automated system that allows patients to book appointments by phone without actually speaking to staff can also ease the surge of inbound calls.

Essentially, good inbound call management is not only about improving patients’ experience but about technology that is just as helpful for staff, too. Not all telephone systems are built this way.

In general practice, technology should augment, not replace

So far, I’ve described how telephone systems must work for life beyond the pandemic. But even though we’re a technology company, we don’t believe that technology has all the answers, especially in healthcare.

I say this because the pandemic has been a painful reminder of the value of the personal touch, underlining some timeless truths of work in general practice.

Firstly, no matter how sophisticated technology becomes, there will always be patients who want to, can only, and should, be seen in person.

Secondly, despite the age of ‘digital transformation’, it is in the interests of everybody’s physical and mental health to ensure people get out and socialise. And that includes routine trips out.

Thirdly, people working in your practice – from the reception team to senior partners – did not choose to work in healthcare only to find themselves spending every working minute stuck on a phone.

And it’s for these reasons that we don’t regard technology as a panacea. Instead, we look to help general practice with systems that will save time, increase efficiency, improve patient experience and boost staff morale. But to do all these in the most simple way possible – for the benefit of people, and not to replace them.

Introducing Surgery Connect, from X-on

With the points in this blog in mind, we have recently joined forces with X-on, the company behind Surgery Connect, a telephone system specially built for GP practices.

When forming such a partnership, we look at vendors with the same fine-tooth comb you use when evaluating technology providers. So as well as the unique benefits of Surgery Connect that I’ve touched on above, it’s worth highlighting a few other reasons why X-on stands out:

・Being cloud-based, Surgery Connect can easily grow to meet changes to your organisation. For example, if you open new practices with traditional telephony, you might find it tricky and more expensive to add extra phone lines. As cloud telephony doesn’t rely on physical technology in the same way as conventional phone systems, it doesn’t pose this problem.

・At the same time, X-on has given extensive consideration to practices’ concern about the security of cloud technology. So Surgery Connect has a raft of security accreditations, including ISO 9001, ISO 27001, ICO data compliance, and NHS data security standards, including HSCN compliance.

Furthermore, the system has a triple level of contingency. The cloud data is encrypted and stored in three UK sites, meaning it runs 24/7. A traditional telephone system, with on-premise technology, cannot make this kind of guarantee.

X-on is also an approved Crown Commercial Service supplier, with partner access to the RM3808 ‘Network Services 2’ framework’.

Surgery Connect has an intentionally simple pricing structure. What you pay for is what you get – with no hidden costs. And all aspects of your plan are bought together in one simple bill – because you need a telephone system with lots of great features, not lots of paperwork.

Support is designed for the modern practice, particularly in light of the extended opening hours you may now be offering. It is available 24/7, and critical issues are resolved within an hour at most.

And what about AdEPT?

As you’ll see from the X-on’s website and the links below, the company specialises in communications technology for general practice. So what about AdEPT?

We’re an independent technology company with a long history of working with the public sector. So as well as helping GP practices like yours, we also work with the NHS and other health and social care organisations.

One example of this is our work in Kent, where we upgraded the internet connectivity for the entire county’s NHS, hospitals and GP practices. We also work with Great Ormond Street Hospital, having migrated all of its legacy network to the new HSCN. And more generally, we help more than 250 GP practices with their individual technology and telecoms needs.

Additionally, like X-on, we are an approved Crown Commercial supplier. We are accredited on eight of the 13 lots of ‘Network Services 2’, RM3808, and on three of the eight lots of ‘Technology Services 3, RM6100.

With all this in mind, the partnership between X-on and AdEPT means you’ll get highly specialised advice, technology and support, but also with a close eye on the bigger picture of public healthcare – a real breadth and depth of knowledge.

I hope you found the information in this blog useful – and if you have any questions, do get in touch. You can find me here on LinkedIn, or can call on 0333 4002490 or email enquiries@adept.co.uk.

Further reading

・Why X-on is different: more about Surgery Connect.

・Words from your peers: other health professionals’ experiences of Surgery Connect.

Answering your questions about Surgery Connect.

・Ensuring your team is confident with Surgery Connect: easy-to-understand training materials.

Written by Tracy Jackson

Divisional Sales Director