NHS reminder about face-to-face appointments angers GPs

NHS bosses have sent a letter to GPs to remind them to offer face-to-face appointments where necessary, sparking an angry response from professional bodies who say such comments risk insulting hard-working doctors.

Nicola Davis www.theguardian.com

In March, GPs were urged to move to remote consultations where possible in a bid to reduce the spread of Covid-19. The result was a surge in the number of appointments conducted at a distance: in May alone, 48% of GP appointments were carried out over the phone.

Now NHS England has written to GP practices reminding them they must make sure patients are aware face-to-face appointments are available, where clinically appropriate, and warning practices they face investigation by local commissioners if they fail to offer such appointments where needed.

“We know that the vast majority of practices have made significant efforts to remain accessible to patients through the pandemic, and to keep staff and patients safe,” the letter states.

But, it adds: “It is important that no practice suggests in their communication that the practice is closed or that the practice is not offering the option of face-to-face appointments.”

Nikki Kanani, the medical director of primary care for NHS England, said general practice had adapted quickly during the coronavirus outbreak to offer remote services, while providing face-to-face appointments where necessary.

“While many people, particularly those most vulnerable to Covid-19, want the convenience of a consultation over the phone or video, the NHS has been and will continue to offer face-to-face appointments and I would urge anyone who feels they need medical support to come forward so they can get the care, support and advice they need – the NHS is here for you,” she said.

Prof Martin Marshall, the chair of the Royal College of GPs, said the proportion of appointments carried out face-to-face is increasing, with more than 300,000 delivered each day last week.

“General practice is open and has been throughout the pandemic. GPs have been delivering a predominantly remote service in order to comply with official guidance and help stop the spread of Covid-19,” he said.

“Where face-to-face appointments are necessary, they are being facilitated, and we have called on CCGs to work with practices where this is not possible – for example, if all GPs at a practice are at high risk of Covid-19 – to ensure that they can be.

“Any implication that they have not been doing their job properly is an insult to GPs and their teams who have worked throughout the pandemic, continued delivering the vast majority of patient care in the NHS, and face an incredibly difficult winter ahead.”

Dr Richard Vautrey, the GP committee chair at the British Medical Association, agreed, adding that doctors have experienced a significant increase in workload.

“GPs have been working incredibly hard to keep their services as accessible as possible during the Covid-19 pandemic, with most offering virtual triage as the first point of contact in order to help keep their workforce and communities safe. This is exactly what the government has been encouraging them to do,” he said.

“This does not mean practices have stopped face-to-face appointments, and they continue to be offered where safe and necessary. Any inference that in-person consultations were put on hold does a great disservice to the committed GPs who have continued to go to work throughout the pandemic.”