The NHS appointment booking website mainly offers private healthcare

More than once, Rachel has found herself waiting up to three-quarters of an hour to make an appointment with her South East London GP – just when she has a school run to run. “You call at 8am – at 8:28 am, you think we have to go to school in two minutes, do I hang up now? “

So Rachel took the advice of the recorded message over the phone line and turned to her firm’s website. This encouraged her to “book your appointment online 24/7 with Patient Access”.

But when she clicked the reservation button on the Patient Access site, the site informed her: “Sorry, your practice does not offer this service.”

Instead, underneath, he offered her a long list of private, paid tests and procedures “outside your GP office.”

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Rachel’s experience is far from unique. Patient Access is one of the largest providers of general medicine services for patients at a time when digital delivery has been massively increased due to COVID. openDemocracy has seen complaints from a number of users and spoke to several who have all told a similar alarm story landing on a private test market, when all they were trying to do – often in vain – was to make an appointment with a general practitioner.

“Backdoor privatization”

Scrolling through the 132 different choices on her patient access screen, Rachel was offered COVID testing first, then a long list of treatments, tests and assessments for everything from acne to ” serious mental illnesses and personality disorders ”, not to mention irritable bowel syndrome, sore throat, shingles, premature ejaculation, fatigue, vitamin deficiency, hearing loss, hair loss, physiotherapy,“ jet lag medication ”and slimming tablets and injections.

All 130 treatments offered on Patient Access, except five, are chargeable | Screenshot: Patient access

All but five of the 130 treatments offered were chargeable. Thyroid tests, for example, cost over £ 80 in Rachel’s area. According to Rachel, this is a “backdoor privatization”.

The site tells users to “please note that the following services are not provided by your GP office and include treatments that you will have to pay for as they are provided on a private basis”.

36 million pounds in profit

Patient Access is a product of Leeds-based healthcare IT giant EMIS, one of the three largest companies providing digital back office services to GPs.

At the start of the pandemic, EMIS was one of 11 companies selected to provide remote access to general practitioners, including video and online patient assessment services, after a competitive bidding process that did not ‘lasted only 48 hours. In 2020, its profits rose sharply to reach £ 36million.

Phil Booth, MedConfidential coordinator, raised potential privacy concerns. “How can a patient know the legitimacy of the test or of something else that they are purchasing and providing it? If you encourage the most worried people to self-diagnose or look for additional tests, and that involves handing over a whole bunch of data to unknown companies, that’s not the safe and dignified relationship. trust that you would expect to have with your GP, and will hurt trust.

A spokesperson for EMIS said: “If a third party misused an individual’s data, it would usually be a matter between those two parties – the same as if they had approached the healthcare provider. directly, or found them through an Internet search, etc. . “

The spokesperson added: “It would really depend on the facts of the case… depending on the circumstances, we could take action ourselves directly… we have agreements with the healthcare providers which include a number of ‘obligations for them to act appropriately and in a compliant manner.

The fine print

Another patient, Pam, herself a retired general practitioner from Sunderland, thought the website’s warning that users should pay for the services offered was easy to miss.

Pam was directed to Patient Access when she wanted to make an appointment, with her general surgery website stating that it is “faster and easier for you to make your own appointments via online booking. line “.

She said: “Physiotherapy seemed to be available, but when I clicked on physiotherapy appointments, I was appalled that there was a charge. I went back to [Patient Access] website only to find that there is a column that says, “Services outside your GP office,” which I hadn’t noticed at first in my rush to book.

“There is no direct access reservation available for NHS physiotherapy, which was the case previously. “

Patient Access also offers a “counseling assessment – severe mental illness and personality disorder”. Clicking on the link takes you to an information page with a prominent link to a form to fill out your card details and pay £ 160 to get a first session with an unnamed ‘private therapy provider’.

The information page contains a list of exclusions of people for whom the service is not suitable. It says at the bottom: “Some talk therapy services are available on the NHS. However, depending on your situation, you may not be eligible for therapy and if you are, the wait times can be extremely long.

Patient access screenshot
Thyroid Tests Offered Via Patient Access For Over £ 80 | Screenshot: Patient access

Other services on offer include Harley Street appointments for the hearing impaired and cervical cancer vaccinations for certain age groups for £ 140. In both cases, the site states at the end of the information pages that the service may be accessible to some via the NHS.

A spokesperson for EMIS told openDemocracy: “All non-NHS services undergo a rigorous clinical review before they are approved for inclusion in patient access and each person who wishes to access a service undergoes a process. robust clinical screening to ensure that any service is appropriate for them. , including signage where the service is accessible from the NHS, if applicable. “

“This shouldn’t happen”

Pam was “shocked and appalled” by the long list of private services promoted by this website – which appears to be the exact same list Rachel was directed to – and complained to her commissioning group local clinic.

She told openDemocracy: “I have been assured that this should not happen – it clearly still is.”

She also believed there was “no information on how to access these services on the NHS – presumably via a phone appointment with a GP and a long wait!”

The fine print on some pages viewed by openDemocracy indicates that “your GP may arrange” such a test.

But patients end up on this site because they couldn’t find another way to access a GP appointment.

“That does not make any sense”

For Rachel, trying to make an appointment at the Patient Access site, as noted, has led to a long list of private tests and treatments, and nothing else. Back on the site of her general practitioner, despite initial appearances, she was also unable to make an appointment online.

The appointment booking service had been disabled on its NHS app, and the online form offered by the doctor’s office appeared to be designed for complaints, not reservations.

Rachel – a technology researcher and health innovation advisor – said she found the system “baffling” and “extraordinary.”

“Who knows what you’re doing then?” It doesn’t make sense, ”she told openDemocracy. “I’m a relatively educated person, but the thing I would worry about, especially people who are sick and under pressure, is that they would end up inadvertently paying for things they probably don’t need because that they are not able to figure out how to talk to the GP.

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