Patient Centred Primary Care in England: Implementation, Risks, Regulation and Potential of Digital Innovation

Patient centred care (PCC) is holistic, focussed on the individuality of the person and their values. PCC in primary care encompasses shared decision making, effective communication systems and patient involvement in the development of services. Innovations in digital technology can contribute to PCC but may have negative impacts on safety and quality of care. AI, increasingly prevalent in primary care, brings with it risks as well as potential benefits. The COVID pandemic saw a change in methods of primary care delivery including the establishment of digital communication systems, resulting in less direct patient-clinician contact. Increased health anxiety has been linked to these rapid developments AI in primary care has been greeted with cautious optimism by policy makers and clinicians. Current usage of practice approved AI systems is estimated at 25% of GPs. Benefit has been seen in terms of time saving, freeing clinicians to focus on patient care. Concerns include security, safety, litigation, inequity and impact on doctor- patient relationships. Ambient voice technology (AVT) has become widely used to record consultations, create reports and letters and provide receptionist services. Nonetheless, many products have been found inaccurate, with some not recognising different accents, risking errors and threatening patient safety. AI enabled total triage appointment systems save telephone queues but may disadvantage patients unable or unwilling to use them. The design and deployment of safe, secure AI systems that ease clinician burden and enhance patient centredness, require patient involvement, research into varying patient experience and needs, piloting, and continuous evaluation.