Warning over GP access as figures show only half of appointments are ‘in person’

Just over half of all GP appointments are now conducted in person, new figures show.

The data analysis comes as a stark new report warns that difficulties in accessing care because of the digitalisation of family doctor services during the pandemic has left many people “struggling”.

A new Healthwatch England report, seen by the PA news agency, warns that this puts people’s health and wellbeing “at risk”.

The organisation said that tens of thousands struggled to contact or see a doctor last year.

It comes as data shows only 54% of appointments at GP surgeries in England were conducted face to face between March and December 2020, according to PA analysis of NHS Digital data.

From March to December 2020, there were 223 million appointments, down from 252 million the previous year, a fall of 29 million.

Of the 2020 appointments, only 122 million were conducted face to face, or 54%, during the same period in 2019, face-to-face appointments accounted for 80% of consultations.

Two out of five (40%) appointments were conducted over the telephone between March and December last year, a rise from 13% during the same period the previous year.

The number of video consultations fell from 1.4 million in 2019 to 900,000 in 2020, according to the data, which includes experimental statistics for 2020.

In December, 56% of almost 24 million appointments at GP practices in England were face to face.

It comes as a new Healthwatch England report suggests that the digitalisation of family doctor services has left many feeling unable to access care.

The authors said that the way people access GP services fundamentally changed during the pandemic, with many services moving online for bookings and video and phone consultations.

While the digitalisation of services has benefited some, many people are now “struggling” to access care.

“It is clear many people are now struggling to access care from their GP, often simply because they do not know how,” Sir Robert Francis, chairman of Healthwatch England, wrote in the foreword of the report.

“This is leading to people feeling that GP practices are not ‘open for business’ or that they should not seek care for their health issue because of the pressures the pandemic has placed on the NHS.

“This puts people’s health and wellbeing at risk and increases demand on overstretched hospitals – both from those who cannot get a GP appointment so seek care at A&E, and from people who now need more advanced care and treatment because they were unable to get help sooner.”

He warned that the pandemic has “exacerbated” longer term problems in accessing GP care.

The organisation has called on the NHS in England to carry out a formal review into how people access general practice to “make sure the service works for everyone”.

The report draws on experiences of more than 200,000 people between April 2019 and December 2020.

Issues highlighted included:

– Difficulties booking appointments

– Remote appointments “not meeting people’s needs”

– People struggled to get regular health check-ups

– Communication problems left some unsure how they could access GP care.

The authors said that routinely offering remote appointments particularly disadvantage some people, including: some older people, some people with learning disabilities, people with dementia, people with sensory and communication impairments and people who cannot access technology.

Cynthia Norman, from Surrey, contacted Healthwatch concerned about her 97-year-old mother-in-law, Norma.

She told her local Healthwatch that a sudden shift to electronic prescriptions meant her mother-in-law felt “disempowered”.

“Pre-pandemic, and even in the early days of the pandemic, she would call the pharmacy next door to the surgery and ordered her medication,” she said.

“The pharmacy sent the request to the GP and then delivered the medication at a small charge. This worked well for her and allowed her a degree of control and privacy.

“The service was withdrawn about five months ago as the practice introduced online prescription requests.

“The pharmacy said it would be too time-consuming and expensive for them to be the point of prescription ordering.

“The GP practice could only suggest that someone else took responsibility for ordering the medication.

“I was told this was a problem for many of the older patients.

“My mother-in-law feels disempowered by the change and dislikes being dependent on others to manage her prescriptions.

“Expecting everyone to be able to access technology disadvantages the elderly and many others who don’t have easy access to the internet.”

Commenting on the Healthwatch England report, Dr Nikki Kanani, NHS England’s primary care medical director, said: “Healthwatch rightly recognises that many people’s experience of their GP practice remained positive, despite the challenges of the pandemic, because GP teams in England carried out over 200 million appointments during the last year, and remain committed to ensuring that patients receive high-quality care, with face-to-face appointments available during the pandemic.

“The growth of online channels has provided an additional safe and convenient way for people to ask for help, which GP teams then respond to, in the most appropriate way, either by making a face-to-face appointment, by telephoning or by using an online message or video call depending on a patient’s needs and circumstances.”

Responding to the report, Dr Richard Vautrey, General Practitioners Committee chair at the British Medical Association, said: “We’re acutely aware that remote appointments don’t work for everyone, as this report highlights, but it’s important to dispel the myth that patients without access to the internet have in some way been abandoned and simply cannot access their GP.”

Dr Vautrey said the “vast majority” of initial contact with patients was made through phone calls, and practices “will always” see patients face-to-face when clinically necessary.

He added: “We understand that the pandemic has been difficult for many of our patients – it has for us too – but it’s important to remember the context practices are currently operating in; a once-in-a-generation health crisis with minimal Government support.

“Government and NHS leadership must learn from this, to ensure services are better prepared for the future, and that GPs are never left again without the resources and funding they need.”