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Setting up and running Virtual Clinics

Chaired by Dr Bibhas Roy Consultant Orthopaedic Surgeon & Virtual Orthopaedic Clinic Lead at Central Manchester University Hospitals NHS Foundation Trust, today’s conference aims to give you detailed knowledge to enable you to set up effective virtual clinics in your practice. 

Dr Murray Ellender GP Partner & CEO WebGP at The Hurley Group opened the conference with an update on the role of virtual clinics in managing demand and reducing unnecessary appointments.  He also discussed

  • developing virtualization by non face to face interaction
  • looking ahead to the health service of the future

In his presentation Dr Ellender covered:

Virtual Clinics for GP’s:

  • Aim is to reduce demand for unnecessary appointments
  • Patient selects or searches for issue, wide range of conditions.
  • Choose what they want to do – help self, advice from GP, pharmacist, 111
  • Is local in range identifies which area they live in so they can find local assistance
  • eConsult: for GP advice, they are asked questions which narrow issues down to enable proper advice.
  • Inbuilt red flags – will push them off the site towards appropriate advice e.g. alert GP (safety features) e.g. worrying symptom
  • Responses are aggregated into a GP report.
  • Improved Access – popular with patients, patients overwhelmingly positive.
  • 6 months, 133k patients, 20 practices, 10 CCG’s.

Better Health Outcomes – patients happier to talk about certain issues online than in person e.g. rectal bleeding, anxiety and depression (these cases may have been missed before this system).

Increased Practice Efficiency - Better use of practice resources – better self management

Behavioural change still needs to happen, so that more patients use system and clinicians trust it and use it more.

Pricing/Features – it is now being sold to other practices.  Now got 230 practices using, 2 million users.

Future Developments – better content/feedback.  Inter-operability with clinical software systems.  Long term conditions app, to capture biometrics, piloting with hypertension in a London clinic.  Possibility of using within outpatients services, would work well.

Abstract of Dr Ellender's presentation:

eConsult from webGP – shift patient care online and cut GP workload

eConsult is an on-line consulting tool developed by The Hurley Group, an NHS GP partnership. It encourages self care - diverting patients away from the need to see their GP at all - and also allows patients to be treated remotely by their own GP. This is a system designed by GPs, for GPs.

The General Practice Forward View allocated  £45 million for the procurement of online consultation systems. This presents general practice with a significant opportunity to reduce the pressures and bring forward the digital revolution within healthcare.

To build the eConsult system we worked with General Practitioners, IT specialists and patient groups, designing a platform which:

  1. removes patient demand before it hits the consulting room, diverting them into more appropriate channels
  2. and then makes interactions with a GP (be that telephone, face to face or virtual) more efficient and, where necessary, less time consuming

We have built a suite of self-help and sign-posting tools, and also created condition-specific questionnaires for patients to complete which they return to their own NHS GP.  During our pilot study of the service we received ‘excellent’ satisfaction rates of over 80%. We also demonstrated that patients had a significant appetite to use online access for their healthcare needs. Practices reduced costs through reductions in face-to-face appointments and feedback from GPs was that they were very comfortable using a remote consultation service.

Since we launched 2 years ago, over 240 practices across 33 CCGs and GP federations are live with the service - providing over 2.1 million patients with access. Another 50-100 practices are due to go live in the coming months.

Further information on the service can be found at

Dr Murray Ellender's Biography:

Murray qualified from the University of London in 1999 and trained as an A&E doctor before starting his career in general practice. In 2006, he joined the Hurley Clinic and now works as a GP across all of our sites. Murray leads on both digital and urgent care for the Group. He sits on various urgent care boards, including the Clinical Leadership Group for Urgent & Emergency Care, NHSE (London). 

Recently he has increased his involvement promoting and developing our online eConsult offer for both registered and urgent care patients. In October 2015 he took on the role of CEO of 

Murray stays fit by running marathons and helping look after his four children.

Download Dr Ellender's full presentation here


Setting up and running Virtual Clinics: Extended interactive session facilitated by Dr Bibhas Roy Consultant Orthopaedic Surgeon & Virtual Orthopaedic Clinic Lead Central Manchester University Hospitals NHS Foundation Trust.  This interactive session will focus:

  • clinical process mapping
  • developing the business case
  • the supporting technology
  • communicating the clinic and developing referral processes

In his presentation Bibhas stated:

Cybersecurity in Virtual Clinics:  Big problem in the US.  Medical identity theft – for insurance – in US.  They are struggling with this.


At some point this will come to the U.K. – you need to look at security v carefully before you set up a virtual clinic.


Regulatory Framework – new EU general data regulation coming into force 24/5.  2 years to comply.  What does it really mean?  It is law, not a guideline.  If you are the data controller, you are responsible e.g. cloud providers, can share responsibilities with them – gives some protection.


New patient-clinician relationship – define roles and responsibilities, security has to extend to patients.


Bibhas has a virtual clinic with follow up patients – outpatient numbers currently 107.2 mllion outpatient appointments, 70% are follow ups.  This will give you a business case for setting up a virtual clinic!


Waiting times – such a problem, with virtual clinics it would reduce waiting times as less appointments so less pressure on clinics.


Appointments not attended – cancel or no show, again unnecessary pressure on clinics, virtual clinics might reduce unnecessary follow up appointments.


Attributes of virtual care delivery:

  • What is it?
  • Hi tech?  No
  • Tele something (skype?) No – not secure and won’t save time
  • Asynchronous – yes
  • Outsourced – yes – shift activity to other resources e.g. online advice
  • Anonymous - yes

Its cost effective but it is not about cost cutting, its about quality.

Download Bibhas' full presentation here

Dr Bibhas Roy's biography

Bibhas Roy is a specialist shoulder and elbow surgeon In Manchester. He works in Trafford Hospital, Central Manchester Foundation Trust. He also takes part in the general orthopaedic on call and operates on general trauma conditions. His special clinical interest in Tennis Elbow (lateral elbow pain) and has experience in arthroscopic treatment of the condition. Complex rotator cuff surgery is another special interest.

Most of Bibhas’ work is also performed as day surgery. This means quicker return to work and usual activities for his patients.

He is on the HSJ's inaugural Healthcare Top Innovators list in 2013

Bibhas is a member of the Health Informatics Clinical Advisory Team (HICAT); working across the complete healthcare spectrum ensuring that the people of the North West enjoy better care, better health and a better life, through the innovative and efficient use of Information Technology.

Future conferences of interest:

Improving & Enhancing Perioperative Medicine
Thursday 13 October 2016
Hallam Conference Centre, London
Masterclass: Designing a Reliable Response to Sepsis
Thursday 20 October 2016
Hallam Conference Centre, London
National PROMs Summit 2016
Wednesday 7 December 2016
Cavendish Conference Centre, London

26 May 2016


    Partner Organisations

    The Tavistock and Portman NHS Foundation TrustInPracticeClinical Audit Support CentrePlayoutJust For Nurses
    GGI (Good Governance Institute) accredited conferences CPD Member BADS (British Association of Day Surgery) accredited conferences