Case Study: Centralised Digital Access Hub for Online Consultations
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The Challenge
From 2019, it became a contractual requirement for all GP practices in England to offer online consultations. While some practices within a large GP Federation quickly embraced this digital model developing robust internal systems and pathways, others continued to operate through more traditional access routes. This variation in readiness led to inconsistent patient experiences, with some patients reporting delays in response or difficulty submitting requests at all.
For the federation, this inconsistency not only risked patient satisfaction but also limited their ability to deliver equitable, safe and responsive access across their entire population. The challenge was to support all practices to meet the contractual requirement in a way that enhanced quality and efficiency, while recognising their different starting points.
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Our Work
Hill Health led a structured programme of engagement across the federation to understand how practices were managing online consultation requests and to explore what support would be needed to create a safe, consistent model at scale.
We co-designed a clinically-led model of centralised triage, built around agreed pathways and governance. Working in partnership with the online consultation supplier, we adapted the tool to enable central handling of requests while maintaining visibility and accountability for individual practices.
We supported the development of the existing workforce to operate the new model and successfully secured external funding to resource the service. Practices retained clinical oversight and decision-making, while benefiting from centralised triage, standardised routing, and reduced administrative pressure.
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The Outcome
A high-quality, clinically led Digital Access Hub now processes online consultation requests on behalf of all federation member practices. The hub operates as a single point of access, improving consistency and ensuring that all patients across the network experience timely, safe and equitable access to care.
Practices are now able to plan their internal clinical capacity around a predictable, structured workflow, while benefiting from more reliable data on demand and response times. This solution aligns with national ambitions to increase digital access, reduce variation in care, and unlock capacity through smarter ways of working.
This model was recognised nationally as an example of best practice and was formally blueprinted by the NHS Blueprinting Team to support wider learning and adoption across the system.
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By taking an at-scale approach, the federation was able to embed digital first access without compromising clinical quality and created a model that could scale further to support broader system access challenges.
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If you're exploring digital access, struggling with inconsistent patient experience, or want to scale up your use of online consultation tools, we’d be happy to help.