This article covers:
What are clinical eConsults?
Most patients contact the practice, either through eConsult or any other channel, because they have a need that is either clinical or administrative in nature.
Patients can be signposted to three types of clinical eConsults:
I want help for my condition (advice about specific conditions like back pain, coughs, mental health concerns and more).
I want general advice (advice about general symptoms like tiredness, bleeding, pain or weakness).
Review questionnaires (to support the practice with regular reviews for patients who have long term or chronic conditions). More information about our review questionnaires can be found here.
Our clinical eConsults are built firmly on the principle of patient safety - that's why we have, over several years, developed very robust questionnaires. There are several benefits to this:
You collect a rich patient history in the patient's own time.
You can use the structured information to triage the patient's needs.
You are provided with a lot of information to make a management decision without needing much, or any, follow-up.
Accessing clinical eConsults (patient journey)
Each practice's eConsult landing page will have several boxes at the top - from here, patients are signposted to two types of clinical eConsults:
I want help for my condition (advice about specific conditions like back pain, coughs, mental health concerns and more)
I want general advice (advice about general symptoms like tiredness, bleeding, pain or weakness).
Scrolling further down the page, or if a patient clicks that they want help for a condition from the above boxes, the patient can decide how to find the most appropriate condition:
Searching for keywords, conditions, symptoms or topics
Reviewing all conditions by condition group
Reviewing all conditions by alphabetical order
Reviewing condition questionnaires by body area
Before the patient can start a consultation, they are signposted to different types of help and advice on the platform. We know that often patients can help themselves and so we actively signpost them to existing resources, such as local self-referral services which can be configured for your practice.
The final option is to get treatment and advice from my GP, in which case they would start a consultation questionnaire.
Clinical eConsults can also be accessed via the NHS App - find out more on our NHS App article.
Structured questions
These structured questions have a set number of possible response options. These help us to flag important information within the eConsult report and also to redirect patients to more appropriate care settings if they are indicating urgent or worrying symptoms.
One example of these is our functional pain scores - these ask the patient to detail how their pain affects them, instead of asking them to rate their pain on a scale of 0-10, as we know that pain is subjective.
Open questions
We include a mix of structured (closed) and open (free-text) questions to add extra detail and allow the patient to express themselves in their own words. For example, to find out more about what they might have already tried to treat or manage their symptoms or condition. These questions have a 500 character limit.
We have also developed suicidal checking mechanisms into some of our open questions - find out more here.
Integrated screening question sets
Clinical eConsults include relevant screening questionnaires and these are marked on the eConsult report received by the practice, as below:
Some examples include:
All mental health conditions - PHQ-9 and GAD-7
Back problem - STarT Back Screening Tool
Who can process clinical eConsults?
Clinicians such as GPs, Nurse Practitioners and other Allied Health Professionals can process eConsults assuming that the eConsults they deal with fall within their level of expertise and qualifications (scope of practice).
The practice will need to ensure that non-GP clinical staff have the appropriate insurance coverage and are working to the same patient presumption as GPs. They should seek guidance from a GP if at any time they are unsure as to how they should deal with an eConsult.
If you have any questions or you feel that this article could be improved, please feel free to give us some feedback by emailing us, pressing the emojis below or using the chat button on the bottom right-hand side of this page to speak to one of the eConsult team.