One of the biggest booms in private healthcare over the last three years has been the role of virtual and remote GPs, but there are serious concerns these services may not be sustainable.
The Health & Protection Roundtable in association with Vitality discussed why these services face being overwhelmed and may not be the silver bullet for treating patients.
The prospect of introducing mandatory excesses to help control their use, the need to address preventative care, and greater use of directed care pathways for specific conditions and symptoms without going to a GP first were all cited as possible solutions.
“We’ve all seen the explosion of outpatient consultation claims through PMI schemes from an explosion of digital GP usage,” said Broadstone head of health and protection Brett Hill.
“We know there are limits to what a digital GP can do; the one thing they can’t do is physically examine you, so if there’s anything there that is of potential concern for referral they do.
“So that’s going to continue impacting claims experience and needs to prompt a debate around whether we start moving towards mandatory £250 excesses just to take that first line of consultations out of the claims fund.”
Dilemma for employers and insurers
Hill also asked more generally, how many high blood pressure cases or cancer symptoms were not being picked-up by the lack of in-person GP appointments.
With significant delays for in-person GP appointments, referrals from virtual services can risk hitting a dead end.
Aon principal Rachel Western noted her clients were starting to face a dilemma here, citing an example of one firm she was working with where an employee faced a lengthy delay for an in-person appointment.
“The client said they needed to support their employee and get them seen and asked what they can do?” she said.
“Their only option was to pay for them to go to see a face-to-face private GP and that then starts to carry taxable elements and it creates issues for the client.
“So private medical provision has got to be relooked at a bit as to whether that primary and tertiary care needs to form a much bigger part of it.”
Increasing virtual GP use is not the answer
IHC senior consultant Paul Roberts issued a more stark warning about the sector, emphasising that GPs were not the answer to solving demand and capacity issues in insured care.
“If we keep filling the glass with more and more bodies going through this easy access, no barrier, no cost to them, it will break,” he warned.
“There aren’t more GPs in the UK, so just stuffing people into a virtual GP scenario, you can very easily see that system is going to break as well.”
Instead, he suggested using a wider range of specialists and healthcare practitioners more directly.
“I believe a lot of that virtual GP work is not needed,” Roberts continued.
“We’re now saying this is so easy to go to it that we go there for everything, whereas actually we should be going to a physiotherapist, we should go to a pharmacist, we should go to a nurse practitioner or an occupational therapist.”
Effective signposting and triage
This was acknowledged by Vitality UK director of corporate business Pippa Andrews as a key approach for the insurer.
“Signposting that triage of where people should go is critical and that’s absolutely something insurers should do – we’re absolutely doing that in our in our care hub, making sure people understand that,” she said.
“We do see a small percentage of people who are going into a virtual GP environment who don’t need to and could more appropriately go straight into some of the other pathways.
“So we’re doing what we can to make sure we signpost people as effectively as possible into those so that we don’t just push everything to the virtual GP.”