Our latest special report revolves around primary care telephony. Earlier this month, we covered the updates to the GP contract, including a new requirement to mandate the use of cloud-based telephony.
“All practices need to be aware, that from the end of 2025, all analogue ISDN and PSTN lines will be removed for use in all home and business settings,” the document states, adding that “only cloud-based platforms will be supported”.
What does that mean in practice, and what does it mean for primary care in general? In this special report, we explore the implications for this change and hear from telephony suppliers babblevoice and Think Healthcare on the drive towards cloud telephony along with the opportunities in this area.
To set the scene, the new Advanced Telephony Better Purchasing framework, described by the NHS as “a new way of supporting the commissioning of advanced, cloud-hosted GP telephony system.” A vital part of the now-mandatory move towards cloud-based telephony, the framework provides support for commissioners with regard to procurement, requirements identification, exit and migration, and supplier management.
Alongside this, the Digital Care Services Cloud Telephony framework is planned to launch this spring and will “set a strategic, technical and commercial direction for future services”. It aims to support care settings from practices to primary care networks to integrated care boards in commissioning advanced GP telephony systems, built around cloud-hosted Voiceover IP (VoIP) systems. Functionalities are to include clinical system integration, remote access, and peak demand management capabilities, and the framework is built around a number of key functions such as call reporting and forecasting, auto-attendant and interactive voice response, and rule-based call routing.
So that’s the future of telephony, and the direction in which the NHS is heading. But where have we come from?
The NHS has been building capacity in this area for a while; the NHS England board papers we covered last month highlight how additional VoIP capacity has been provided since December 2021 to support primary care in freeing up practice phone lines for inbound calls.
The value in improving telephony has long since been recognised too. Last year, we asked our health tech audience for their thoughts on the biggest benefits an integrated care system can derive from deploying technology. From the Health Innovation Network South London, we heard from director of digital transformation Amanda Begley and head of digital transformation and technology Darragh Twomey. Amanda and Darragh noted that the opportunities for technology to bring significant benefit are split by timeframe, but added that there are some “relatively quick wins out there to support more efficient administrative processes through the use of automation and improvements in primary care telephony”.
Let’s see what our suppliers have to say.
Think Healthcare on the NHS drive towards cloud telephony
Pressure on general practice has never been higher, and it’s not easy to find time to focus on designing out problems at their source as opposed to handling the fallout.
The recent GMS contract announcements, along with recommendations in the Fuller Stocktake have brought cloud telephony into the spotlight as both an impending problem, and also a solution to a number of COVID recovery and patient access issues within primary care.
In 2025 the old analogue PSTN & ISDN circuits are all being switched off. Put simply, if a GP practice was on this legacy technology and didn’t upgrade to the cloud then they would simply stop receiving patient calls. Latest figures from NHSE show there could be over 50 percent of practices still using these older systems.
When you combine the technical need to upgrade with the commercial benefits and improved terms provided by the new NHSE Better Purchasing Framework, we’re entering a sweet spot for practices to upgrade before the last minute switch off rush.
How to address multiple problems with a single solution
There are a small number of NHS specific cloud telephony solutions such as Think Healthcare who focus solely on addressing the full range of challenges faced by GP surgeries. It’s for this reason only a limited number of suppliers are assured under the new NHSE cloud telephony framework as being the best of breed for primary care services.
Improving patient access
It feels like every other article on the subject of primary care recently is centred around improving patient access. Thankfully cloud telephony solutions such as ours can improve patient access and minimise patient complaints via clever technology involving minimal user intervention.
There’s auto-call back, for example. When the queues are long, patients have the option to press a button and Think Healthcare holds their position in the queue while they hang up and carry on with their day. The system automatically calls them back when they reach the front of the queue.
This supports happier patients, and streamlines demand to make it easier for staff to handle.
Reducing access inequalities
With many new contracts requiring focus on improving access inequalities, it’s often hard to pinpoint tangible big impact changes that can be made. Thankfully advanced cloud telephony solutions can help with this.
Take VIP call routing – you can configure Think Healthcare to react differently to the needs of different patient groups. Run searches within your clinical system to define who needs a bespoke experience. For example, palliative patients can be routed to the front of the queue automatically; those who struggle with phone system menus can be routed directly to a human; or key practice or PCN staff can be straight through to a receptionist.
Maximising practice efficiency to help improve patient care
Integration with practice clinical systems helps identify patients & their requirements automatically assisting call handlers to work more efficiently.
Supporting NHS contracts current and future
With the recent QOF requirements for optimising access to general practice, and the upcoming 2023 general practice access recovery plan there’s never been a better time to look at how cloud telephony can improve the performance & service given by your practice and PCN.
For more information please visit their website.
Babblevoice on the mandate for primary care cloud-based telephony
Patient demand for general practice has reached record highs putting surgeries under considerable pressures. According to the BMA, the number of standard (non-COVID vaccination) appointments booked in January 2023 totalled 26.8 million.
Most of these appointments will have been made over the telephone. While some patients will use online and apps, the vast majority still reach for their phone to contact their surgery.
Surgery telephony systems are therefore a critical function of primary care service delivery. Yet, until now, their provision has been largely unregulated.
A new purchasing framework
The step change from analogue lines to cloud-based telephony introduces surgeries to a world of unlimited lines, potential cost savings, greater flexibility for ways of working, and the provision of new services for patients and staff.
The new GP contract mandates this move and introduces a new purchasing framework to support surgeries and primary care networks with buying decisions.
One of the most positive aspects of this framework is that it heralds new provision standards. This will ensure surgeries can no longer be trapped by onerous contracts or lack of support. Instead, suppliers must provide telephony services that are purpose-built for healthcare.
New telephony functionality
Switching to a cloud-based telephony system like babblevoice brings functionality benefits that are three-fold.
- Patients gain functionality such as automated queueing, call back, and self-booking via their handsets.
- Staff can utilise functionality such as automated diverts, seamless integration with patient records, and continued system access when home working.
- The practice can benefit from functionality such as data reporting, assisting practice management decision making.
Opportunities for primary care
This range of new functionality supports surgeries handling high call volumes. Automated call features relieve pressure on reception and enable clinicians to manage patient appointments more efficiently. Call data reporting can help primary care teams improve responsiveness.
Digital telephony also supports the NHS direction of travel towards greater integration of services. Increased signposting to appropriate services, including social prescribing can be enabled by systems like babblevoice. They can divert calls where appropriate away from surgeries to other relevant teams such as citizens’ advice.
Top tips for surgeries
The move to cloud-based telephony is simpler thanks to the new framework. Surgeries can benefit from economies of scale, access purchasing advice from experts, and be reassured that the suppliers on the framework meet key requirements.
Our top tip for practice managers and GP partners is to identify your surgery’s requirements and find a system that is flexible and customised. Your telephony should be tailored to your needs, not the other way around.
In addition, look for cost transparency to help with budgeting – ensure you only pay for what your surgery needs and uses.
As a specialist provider of primary care telephony, we welcome the framework, the setting of standards for quality and commercial practice, and the commitment to continual revision into the future. We very much look forward to the improvements this will bring throughout healthcare.
What is happening elsewhere?
Finally, we’ll move on to look at some examples of telephony work in progress from across health and care.
Telephony features in up and coming plans, with the move to cloud-based telephony highlighted as a key part of Norfolk and Waveney ICS’s efforts to improve infrastructure, network and connectivity in their roadmap for the next three years.
Earlier this week, the Royal Marsden NHS Foundation Trust officially launched their new electronic health record. As part of that, chief information officer David Newey commented on the importance of the trust’s new unified communications (UC) platform. He shared how testing has commenced in the trust for devices to “provide access for clinicians to [the EPR] and also Team’s telephony”, which he called “an essential step in our UC rollout”.
Towards the end of last year, we interviewed Jeffrey Wood, deputy director of ICT at The Princess Alexandra Hospital NHS Trust, for our podcast Let’s Talk. On the growing issues around waiting lists, Jeffrey shared that the trust has taken on board cloud telephony to provide “a customer-focused management system”, which they can use as a contact centre for booking waiting list people in.
