As a GP in her final year of specialism training, Dr Herregods has a refreshingly optimistic perspective on the state of primary care and the NHS’s digital transformation. She shared her thoughts on teledermatology, advice and guidance, integration (and more) with us in this exclusive interview.  

Please introduce yourself, and tell us why you chose a career in general practice
My name is Dr Kirsten Herregods, and I’m a GP based in Bath who’s about to fully complete my training (ST3). There is so much that I love about General Practice, but the main two things are the wide variety of cases I get to see, meaning not one day is the same, and the relationship that I get to build with my patients.

As someone who’s fairly new on the primary care scene, what would you say are the most pressing challenges facing you and your colleagues at the present moment?
In my opinion, the most pressing challenge we currently face in primary care is the waiting lists for specialist appointments. Having been away for a year on maternity leave during the pandemic, this change has been very noticeable. Waiting lists now often reach a year or more. This means that patients come back so see us multiple times, increasingly upset by their symptoms, and often leaves both them and us frustrated by our inability to help them further

What do you consider the role of advice and guidance technology to be in primary care? Can it help address the challenge you outlined above?
Yes absolutely - the role of technology in primary care is vital. It helps us to work more efficiently and accurately, which in turn has a huge impact on accelerating and enhancing the care we deliver to patients.

In turn, advice and guidance can play a big role in reducing waiting lists. It provides GPs with the opportunity to discuss individual cases with specialists, sometimes subsequently avoiding referral to them all together. If a referral is required, we can work together with the specialist to ensure that all primary care investigations and management options have been ticked off, thereby benefiting everyone involved.

We agree! Can you give an example of how technology has helped you deliver excellent care to a patient?
We regularly deliver excellent care to patients through the use of teledermatology technology. My practice uses the Cinapsis platform, which allows us to take photographs of skin lesions in using a smartphone-compatible dermatoscope, send it to the dermatologists, and receive their opinion and recommendation within days (or sometimes within hours). Not only does this allow for rapid detection of possible malignant lesions, but it also prevents an unnecessary referral for the patient.

How else do you use Cinapsis in your practice?
I would say that I use Cinapsis on a weekly basis. I tend to use the service when I am unsure what my patient’s diagnosis is, or when I am uncertain about the next step in management despite CKS guidelines. Although I have used the urgent telephone discussion function, I find that I more commonly utilise the messaging system, usually receiving an answer within a day or two

What has the impact of your use of Cinapsis been (so far)? Both in terms of your work and on patient outcomes
My use of Cinapsis has resulted in my patients being able to get started on specialist medications more rapidly than before. 
For example, I recently had a patient with a recurrence of hyperthyroidism. I used Cinapsis to contact the endocrinology consultant, who was able to see the patient’s blood tests and previous letters via his end of the platform. He recommended starting Carbimazole, and referral, but explained that the waiting lists were very long, and hence suggested we do repeat bloods in 6 weeks and re-contact them to help appropriately adjust the dose of carbimazole.

This meant that I was able to start the patient on Carbimazole on the same day of seeing her blood results, in addition to being able to adjust the dose appropriately, with specialist advice, in the future, despite the long waiting lists for review.

What would you say to a colleague who is considering adopting Cinapsis for referrals and A&G?
I would highly recommend using Cinapsis for advice and guidance! It has helped me on numerous occasions to get specialist advice without having to endure a painfully long wait on the hospital switchboard telephone line.

As a relatively new doctor, what are your hopes for the future of primary care?
I would really love to see fully integrated electronic notes across primary and secondary care. If both teams, plus the entire multidisciplinary team, could work off the same electronic system it could allow everyone to see the full patient record.

This would mean efficiency, accuracy, reduce admin related errors, and would massively enhance patient care. The GP could admit the patient to hospital without printing off the notes, the hospital doctors could see the full history of the patient, and the GP would be able to see what is happening with the patient whilst they are in hospital. It would mean that the hospital doctors could make changes to the patient’s medications, adding and removing items from their regular medication list, thereby preventing any unnecessary delays and duplication of work.

The improvements this would create for both patients and the healthcare professionals would be dramatic.
We think that lots of your colleagues in the NHS are also hoping for the same thing! …And finally, tell us a fun fact about yourself.

I became a first-time mum during the Covid pandemic lockdown, which inspired me to write a rhyming children’s book: Our Bubble, based on my personal experiences.

Thanks so much Kirsten, it was a pleasure to interview you for this blog series. If you’re a Cinapsis user and would like to take part in Conversations with Clinicians, drop our team an email on: hello@cinapsis.com