Just 1 in 10 GP appointments are face to face as patients fear cyber visits are here to stay

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Only one in ten GP appointments is face to face – three months after ministers vowed to get the NHS back to normal. 

A major survey found 61 per cent of consultations are via phone call, 6 per cent through text or email and 4 per cent by online video. 

Telephone triage assessments and home visits account for another 18 per cent, meaning that only 11 per cent of consultations led to direct contact at a surgery. 

Over the two weeks to last Wednesday 61 per cent of consultations were via phone call, six per cent through text or email and four per cent by online video, according to the Royal College of GPs

This figure stood at 75 per cent before the pandemic. Some patients now fear their surgery will not reopen fully while health experts point out that virtual appointments can miss symptoms and complex conditions. 

Yet in late April – as coronavirus cases tailed off – Matt Hancock promised to restore regular NHS care. 

And today the Health Secretary will announce major plans for future working, including proposals for doctors to contact patients on WhatsApp. 

Mr Hancock will also promise to slash bureaucracy and let staff work more flexibly so they stay in their jobs for longer. 

The survey by the Royal College of GPs involved 859 family doctors and  was carried out over the two weeks to last Wednesday. 

If the results are a true picture of the UK as a whole it means patients are three times more likely to receive a text or email from their GP than a home visit. 

As many as 88 per cent of doctors said their surgery was offering video or online consultations compared with 5 per cent before the pandemic. 

Seven in ten said telephone appointments increased their efficiency, rising to 76 per cent when asked about telephone triage. 

Dr Max Pemberton: ‘This will have devastating consequences for patients AND doctors’ 

Proposals to encourage – or ‘coerce’ – the majority of patients into GP telephone or virtual consultations rather than face-to-face appointments will have devastating consequences. 

They betray a fundamental misunderstanding of the doctor-patient relationship – built upon trust and familiarity – and I am appalled that ministers look set to endorse them. 

True, some young people with minor ailments will welcome the convenience of doing what comes so naturally to them – staring into their phones and talking. But it is a terrible idea for almost anyone else. 

As usual, it is the elderly and those struggling with their mental health who will be hardest hit. 

Medical students today are sent on courses to learn how to read subtle clues from a patient’s body language. 

Exactly how doctors are supposed to do this via a telephone or computer screen is a mystery to me. 

Telephone triage, in which patients are assessed over the phone, places a terrible burden on frail or inarticulate patients who will feel they have to prove they merit a appointment. 

And let’s not forget the ‘door knob revelation’ – the moment at the end of the consultation when a patient is about to walk out and suddenly reveals the real reason for the appointment – serious symptoms too alarming or embarrassing to be explained to the receptionist, or deemed too trivial. 

The problem is a shortage of GPs, and we should find ways to recruit more – and retain those already working. 

This initiative is no more than a stick – ing plaster – simple budget-trimming dressed up as innovation. 

In a few years, it will end up costing many more lives than coronavirus ever did.

Professor Martin Marshall, who leads the royal college, said: ‘These changes were made out of necessity – to keep our patients and our teams safe and to help stop the spread of Covid-19 – but there is a compelling case to retain some aspects of the different ways we’ve been working. 

‘The pandemic has shown care can be delivered effectively and safely remotely, where appropriate.’ 

Rebecca Fisher, of the Health Foundation think-tank and a family doctor in Oxford, said: ‘GPs are trying to find the safest ways to meet the needs of their patients, but we have to be alert to the possibility that switching to predominantly phone consultations may have unintended consequences. 

‘We might be missing things, or making it harder for certain patients to access general practice, for example, for people without access to the internet, or for whom using phones is challenging.’ 

Rachel Power, chief executive of the Patients Association, said: ‘The predominance of telephone consultation suggests the NHS is still compromising heavily on this in the interests of minimising coronavirus infection rates. 

‘We support the emergency measures taken earlier in the year by the NHS, but some patients are now telling us they are concerned that their GP’s practice might never reopen fully. 

‘We would like to hear more from the NHS about how it will be assessing the impact of recent changes on patients, and how it will work with patients to ensure it meets their needs in general practice, including restoring higher numbers of face-to-face appointments.’ 

Beccy Baird, senior policy fellow at the Kings Fund think-tank, said: ‘While digital tools can be useful, we should be wary of expecting technology to suddenly solve complex access issues in general practice.’ 

Currently anyone seeking a face-to-face GP appointment must call their surgery and undergo a telephone triage to deter – mine whether they need a slot. 

The royal college is awaiting guidance from NHS England on whether GPs can offer more face-to-face appointments. 

Nikki Kanani, a GP and NHS medical director for primary care, said: ‘Face-to-face appointments have and always will be in place for those who need them, with more than 30million taking place over the peak pandemic months, alongside more than 500,000 online consultations every week. 

‘While this snapshot survey covers just over 10 per cent of England’s practices, GPs have clearly had to adjust the way they work to protect their patients.’