As the Mail announces ‘Victory for Mail’ in its war against digital doctors and securing petrol continues to be a hit and miss game; it feels like we’re moving into a seismic shift of contradictions in our ‘progress’ as a nation.
Capturing this mood of the moment quite incandescently, the Daily Mail belted out a blinder of a campaign with its recent incantation of a faithful tabloid favourite topic: patient vs. technology. Longing to take us back to the ‘good old days’ when the local doctor was more like Dr Brown Bear – popping round to dish out the medicine to Peppa Pig and George when they had a cold – the Mail bemoans the faceless impersonality of virtual access to the NHS.
Such sentimentality is often contained in the red tops, but right now it’s spreading. I was surprised to see Mind jumping in on it in The Times last week with a survey-based release attesting to digital therapy as a potential harm to children’s mental health. The press release behind the story pointed to NHS job ads for ‘virtual therapists’ as a harbinger for an increasingly remote National Health Service that fails to meet young people’s mental health needs. The only nod towards a potential benefit of virtual, contained in the release rather than much of the coverage, is that ‘Virtual appointments offer a way for the health service to see more people at a lower cost’. Nothing about how services such as Kooth and Togetherall have provided an absolute life-line to both young people and the NHS through a digitised approach to mental health that has seen excellent outcomes for young people at earlier stages of mental ill-health. Relieving the system upstream for more acute cases where younger people need urgent face to face care.
As with most societal shifts, we crawl until we fly. I have spent the past 15 years of my life clawing my eyes out in frustration at the snail’s pace of digitisation within healthcare. As we’ve moved from CDs to Spotify; printed estate agent pamphlets to Right Move; queuing for 20 minutes to bank a cheque to opening a business bank account via an app – I have steadfastly continued writing and campaigning about replacing hospital fax machines with email and doctors’ bleepers with text-based apps.
As excited as I am personally about the potential for digital to transform equity of access and quality of care within the NHS, I am deeply concerned that this opportunity will be hamstrung by the stories that are coming out now. They are completely failing to capture the essential elements of the digital vs. face-to-face debate. Where is the NHS’ voice in this? Where is the other side of the debate? It’s not being given a right to reply by the journalists writing this story, despite organisations like Digital Healthcare Council being ready with it.
The fact is we did not have enough trained clinicians nor the funding within our healthcare system to see everyone face to face pre pandemic. The UK has been shy of recruitment targets on GPs and mental healthcare clinicians since I started writing about workforce issues at the Health Service Journal in 2005. Throw a global pandemic on top of this, with a two-year backlog of patients, and the system is set to break.
But it doesn’t have to. Digitising care for those with less acute needs, those people who don’t need to see a clinician – such as the 20% of people who saw their GP for dandruff in 2019 – (Healthily poll, by ZPB) relieves the all-important face to face appointments where they’re needed. The NHS is not an ever-flowing spring. Each of us needs to carefully consider how we use it and whether self-care, an e-consult or a phone call might suit everyone better.
Certainly, what strung out, tired, under-paid and over-worked clinicians could do without right now is a media led hate campaign about how they’re failing patients. Local practices are reporting increased violence and abuse of staff in their practices since the Daily Mail’s campaign. As other industries report raging salary inflation and NHS employees look set to pay for their own pay-rises out of their NI increases, retaining the clinical staff we do have is looking increasingly precarious.
So, before more fuel is poured on the bonfire of the digital doctors it might be prudent to ask – who will be to blame when patients in desperate need of face-to-face acute care can’t get it, as the worried well fill their jerry-cans with all available appointments? Is it because of the government, NHS providers, public or media?