The Value of Electronic GP Reports: January Protection Forum Part 4

David Mead: I also fell into the category, having spent 21 years in this industry– I know you probably find that difficult to believe looking at me– I had very little awareness of electronic health reports or electronic GP reports until probably about a year ago. And I started asking myself, there are a couple of events that happened that sort of brought them to my attention. I suppose the reason I wasn’t aware of what they were and the extent to which they’re being used is at an adviser level when we submit an application to an insurer, they don’t come back to us and say, “Oh, we’re going to the doctor with an electronic request or we’re going with a paper request.” It’s just sort of happens in the background. So it’s not sort of language that I was particularly familiar with, but two events happened last year that that really started me thinking a lot harder about what are the value of electronic health reports and GP reports and how can we encourage them to be used more? So one thing was we had a client who we made an application for and nine months later, despite chasing every week to 10 days, as is our situation in our company, we got a phone call from the client’s wife to say that he’d had two strokes. So the GP report for nine months hadn’t been completed, and the client then became uninsurable because of the two strokes. Now it turns out that this client’s wife was a lawyer who specialised in medical situations, so that’s one still playing out. But it started us thinking well, and she requested just to emphasise the value that we put how important our role is, she made a subject access request for our notes off our database since the application and what we’ve been doing. So luckily, or not luckily, because it’s part of our process, we’ve been documenting that we’ve been chasing this surgery every week to 10 days and there were all the things that we’ve been told, whether they were truthful or not. And so she’ll be using that as part of her case if she feels there’s a case of potential negligence against the surgery. So that happened and obviously it’s extremely unfortunate for the client and their family. And then I started hearing in meetings I have with our advisers more and more advisers saying, “Oh, we submitted an application. They needed a GP report. And guess what? We had it back in a week or 10 days.” I’m thinking, “well, blimey, that hardly gives enough time for the post to get to the surgery be opened, let alone someone fill it in and return it”. So there must be more to this. So for those of us on to where basically some insurers are not by any stretch all insurers when they get an application at their end, if they realise the surgery is on a register, who will accept an electronic GP report request will ping it out that way, otherwise it will probably go out by paper. There are about three million paid for health reports going out a year. Three million. And about a million to a million and a half of those are for our part of the industry. So there’s a huge amount of activity going on around this area. Digital GP reports have been used by some insurers, with up to 45 percent of GP requests, which is really encouraging. Basically, what happens at adviser level we submit an application, they decide whether they’re going to request it electronically or by paper, and that’s based on are the surgeries signed up at their end to be able to provide it in this way? And then if they are, in simple language and I’m sure there’s better, more expert people than me on this call who can explain in more detail. But bottom line is the surgery gets a digital report. They accept it. It interrogates the client’s record. Redacts information isn’t necessary or doesn’t need to be shared and sends it straight back into the insurer, which is why we were seeing turnaround times in a week because it requires very little human intervention, and the GP themselves isn’t having to sit there as they do with the way I always understood it, sitting and filling in a GP report themselves by hand. Obviously this makes a huge time saving at the surgery and which at times like now, when they’re really hard pressed, as we all know, is obviously a huge advantage to the surgery to be able to not be filling in forms. No wonder paper GP reports are very low priority and you can see why they literally sit on the stack. And there will be many people on this call who’ve got GP reports outstanding, and they have been for months and months and months, and we’ve got several over six months old at the moment, and it’s quite hard… you can see why it happens, but it’s hard to justify how it can happen because obviously this could cause all sorts of consumer detriment. So the research I’ve done with insurers, and other people are saying that on average, electronic health reports are coming back at least three times faster than their paper alternatives. So this is obviously a massive advantage to insurers and to us in the adviser community because at Futureproof we employ 15-20 people in back office who spend a lot of their time phoning surgeries, chasing these through, updating clients, keeping partners and introducers on board and just keeping people informed. And of course, if these reports are being turned around in a week or two all of that has been saved. We won’t need to do any of that. And of course, this also applies at provider end as well. So the advantage is clearly a lot less pressure on GPs, a lot of time and effort and money saved. Therefore, at provider and distributor end as well. So as I say, there are some providers who are collecting 45 percent of their reports like this now, which is really encouraging and it shows what’s possible. But I don’t feel we’ve quite got to a critical mass and to create a win-win situation, we obviously need to get all providers using them. That would be a great start. And also a report I read some time ago said that at least 50 percent of the adviser intermediary community had no idea about electronic health reports at all and had no knowledge like I didn’t a year ago. So part of this was just to say, “Look, these are a thing. Here are the advantages, and how can we work together to make this the default for all providers on all medical reports? So we would all save time would also save a lot of money. And ultimately, the NHS and hard pressed surgeries would massively benefit from people like us, not phoning them up every 10 minutes, saying How are you getting on with that GP report?” So that’s from the adviser end, so what are we doing with the PDG? So we started, Alan at Cura and ourselves at Futureproof have been doing a little bit of a trial where we’ve been phoning the surgeries. And if they’re not familiar with what electronic health reports are explaining a little bit about it and in combination with the ABI, we’ve come up with a PDF which explains what these are, and we can email it to the surgery. So they can see what the benefits are and how they can maybe get involved in a trial, so we’re not promoting any particular provider, there are two or three providers out there who offer this service, we’re not promoting any particular provider service. What we want to do is just get them to do their first one or two like this and then they’ll soon see what the advantages are from their perspective. So we’ve been running a trial, but it’s very limited. So I think from an adviser community or intermediary community, that might be something that some of you want to help out on. There are obviously very few amount of providers, but there are thousands and thousands of intermediaries. So although it seems fairly granular in approaching it that way, that’s one way that we can start to approach. All of us are phoning surgeries on a regular basis. How can we introduce this idea to them and get them signed up as well? We’re also planning on working alongside the with AMI and FTRC so we can hopefully lobby MPs and, if possible, get the BMA involved to encourage greater take up as well. We’d obviously, I think all of us in the intermediaries space could probably work with providers to encourage them, those who aren’t using them, to maybe start using them more regularly. Although it’s fair to say those who aren’t now are probably all well down the road in terms of putting plans in place for the next couple of quarters of the year. We’re hoping that maybe we can talk to MPS about this and ministers and the BMA as I said. And then the other angle we’re thinking about is in the case of our client who had two strokes and therefore was uninsurable. And I know of another case I read about, where they lost a client, a client died during this process outside the free cover period. So the family, of course, will be left with nothing at all. Is there a potential risk there from the surgery to the GPs, PI insurers? Because if there is a case of negligence, if it’s seen that they have been negligent, then I’m sure their PI insurers would be interested in finding ways to incentivise surgeries, maybe along the electronic route to make this faster. And so we get less of these type of really unfortunate incidents. So that’s where we’re at. But it would be interesting to hear everyone’s thoughts and and open up the bit the debate.

David Mead: Some insurers absolutely are, and some of them are outsourcing it to the GPR provider or the eGPR provider to do that on their behalf. And obviously, if they’re not using eGPRs to encourage them to do so. And there was a good, I won’t name the provider, but there’s an interesting conversation I had since the beginning of the pandemic till now. And of course, this is the moment where you’re thinking, “look, your time is pressed. This is the time to really engage with this. This is obviously a great opportunity to cut some type wasted time and all these inbound calls from people like the likes of us coming in.” And one provider said that they’ve managed to double the amount of surgeries that are collecting digitally as opposed to by paper since the pandemic started, which was really encouraging.

David Mead:

Well, I’m sure we’d be more than happy to share the document that Cura and FutureProof have been using in our limited way to try and encourage surgeries to engage with this, we’d be happy to share that one. In terms of the cost, surgeries, if they return a report digitally or by paper received the same revenue. So this is clearly a way of saving loads of time and maximising their time and their revenue. It was to say there’s about a million to a million and a half life insurance related GP reports being collected here.

And there’s one thing worth noting, Rob, is that claims are handled in this way as well. We’ve currently got a claim that we’re working on at the moment, and the report has been sitting in the GP surgery for six months. Six months. Yes, I mean, for me, if there’s one thing that gets my blood boiling it’s that. It’s absolutely outrageous. The poor family has not received a bean except for maybe the £10,000 they get. But even then, because it hasn’t been agreed the claim, they probably haven’t received a single been.

And it’s because the surgery is just not prioritising it. The digital solution would overcome that pretty much straight away. It just wouldn’t be an issue.

Michelle Lawson: I’ve got a few things I wanted to raise off of the back of that actually is that we’ve had various issues, certainly over the last 12 months, with the eGPRs where the surgeries actually have them in place. And I don’t know how they actually work, but it’s almost like they have the lines open, and the insurers are sending the request for the eGPRs down the eGPR line. But the line may not be switched on, so it might be something that the GP’s have gone back to the insurance and said, “yes, we’re live with these, we take these” because what’s happened is we’ve chased the GP reports through with the doctors surgeries and they’re like, “No, we’ve not received it. We’ve not received it, not received it.” And then I’ve gone to them and said, “Are you sure you’ve not got this down your eGPR line?” And then I’ve double checked back with the insurer and they’re like, “Yes, we’ve sent it by eGPR.” And then the doctor’s surgeries are saying, we haven’t even got eGPR. The insurers are confirming, “Yeah, we’ve definitely got the eGPR, the surgery definitely has got the eGPR in place,” but it’s almost like they’ve signed up for it, but it’s not active. And what we found out last year is if they don’t deactivate it, the insurers are still sending these requests down the eGPR line. So again, the problem being is that actually the surgeries… And a lot of this is coming back to the surgeries with everybody’s comments, I fear, and I think it’s great from an adviser point of view. We do a lot of good work to try and sell these protection policies. And then what’s ending up happening is the surgeries. I mean, we’re trying to alleviate any potential problems for the surgeries here with people that can take income protection that have got sort of alternative support packages like physiotherapy packages and stuff like that where they don’t even need to go through the GP. But the problem being is it’s all being undone by the GPs, not actually sort of responding and doing what’s in place. So there needs to be almost like an industry standard set in place where A) there’s a set time limit within which GPs have to respond to a GP report. I feel 28 days is more than adequate because I can’t see that they’ve got that many that come through. But also the difficulty is a lot of the secretaries that do these are only working one day a week. It’s a staffing level. But again, it all comes back to the GP, but all our good work as advisers is being undone by the GPs, by having these facilities that they’re not using and also by not doing what they’ve been asked to do in the first place.

David Banks: At L&G, we’ve been looking for the best part of 10 years at electronic health reports. So it’s really encouraging to hear, there seems to be a groundswell of supporting them and everything we can do to get them in place. I mean, we’ve not been silent through those 8 to 10 years. I mean, we’ve tried most of the things that David said, already we’ve done incentives for GPs, speaking to government, the BMA, speaking to surgeries, speaking to the clinical commissioning groups, speaking to the PI insurers and none of it’s really moved the dial. I’d be happy to speak to the PDG and see if there’s any elements I can pass on. It really just comes down to individual GPs, they’ve got to find the time to adopt a new approach. And that’s the difficult bit. Unless the BMA suddenly mandates it, then it comes down to one GP at a time. Unfortunately, really, and they all have different reasons for not doing it. It tends to be they’ve got other things to do, and they don’t think they can afford the time. Someone mentioned sometimes it’s just a woman comes in and photocopies reports every Friday, and they don’t want to train that person on something new. So it’s a huge challenge to get us beyond the 40 percent. COVID has increased the usage, but we’re still a long way away from getting it to be the norm, unfortunately.