Barriers

Barriers

Below are the barriers shared by participants in the chat box during the webinar.

Buildings
- "We don't own our building, it belongs to the board, and it is in poor condition".
- "Electric convector heaters are very inefficient."
- "We rent the building from Health Board, 40years old, falling apart and any building changes/grounds installations take months-years to put in place. Very frustrating- ideas on how to put the pressure on our health board are welcome."
- "Health Board had declined to sign up for any recycling programs, we have discussed this with them on several occasions, especially since COVID-19."
Considerations of other unintended consequences
- "Consider environmental and social impact not just cost."
- "Fascinated to learn that CO2 emissions from e-bikes can be less than human powered bikes. The analysis assumes that the cyclist will eat more after regular cycling and this leads to increased emissions. But beware of "rebound effects" e.g. I used the e-bike for my home visits so I deserve an extra biscuit."
Limited funding for electronic prescribing
- "Some initiative i.e. electronic prescribing and remote consultation have seen limited prioritisation in funding and adequate support as often locally reminded to return to face-to-face consultations."
Technology
- "As a British Sign Language user, the access to primary health care services via near me, while great for reducing the carbon footprint (less travel) is not successful. I think this is due to the need for all participants (health professional, patient and interpreter) to have video access which requires a much better broadband signal strength. More often than not, the screens freeze and visual / sign language communication is impossible.
  Often a near me appointment results in then needing a face-to-face meeting which increases wait time for patients for treatment and advice. Very frustrating.
  Can this be looked in to?"
Travel
- "Patient travel - how many wasted patient miles travelling to treatment/investigation care hubs in primary care, rather than their local practice. An unintended consequence of new GP contract. Often unnecessary tests as well. Can we do better and reverse this change and make the local practice the hub of activity?"
Virtual consulting
- "Near Me at most time is the automatic go to by the health professional. Type of consult needs to be a shared decision but varies considerably in Primary Care. We've learned that 97% patients who use it would like to again."
- "Near Me should be a shared decision but often the patient is not consulted in advance of the appointment. Triple bottom line assessment behind every decision."

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