Patterns of online consultation use in Great Britain, 2019-2023: an observational analysis

To examine online consultation (OC) uptake and usage patterns over time in Great Britain by patient characteristics, practice location and condition/symptom-specific OC template type, for a major provider of OC services (eConsult).

An observational study was conducted using records of OCs completed between January 2019 and December 2023. Main outcome measures were OC volume and rates by country, region, deprivation level, template type and user demographics (age group and sex).

Over 43 million OCs were submitted on the eConsult platform within the time frame. The number of OCs per month greatly increased in early 2020 after the introduction of COVID-19 pandemic restrictions on in-person contacts. Sign-ups to the platform were highest between February and May of 2020. At their respective peaks, 43.7% of English practices, 11.6% of Scottish practices and 50.5% of Welsh practices were active in eConsult. Rates of OCs declined throughout 2022 and most of 2023 and were highest in more affluent areas. For England, Scotland and Wales, respectively, OC rates peaked in October 2021 at 17.6, 10.5 and 20.4 OCs per 1000 general practitioner-registered patients. Nearly two-thirds (64.4%) of OCs were completed by female patients. The proportion of OCs for children aged ≤10 has risen over time. 89% of OCs were submitted to the patient's practice, whereas 7.7% were redirected out towards urgent or emergency care services. Over time, there have been decreases in the number of OCs submitted at the weekend and in usage of generic 'general advice' templates.

These findings reveal the substantial and evolving utilisation of eConsult over time across Great Britain. These findings may reflect evolving product functionality and engagement with OC services by patients and clinical staff, or local differences in service coordination.