The number of GP appointments carried out over the phone has tripled during the coronavirus pandemic – with some patients asked to perform pulse and blood pressure checks at home, it can be revealed.
And that revolution is here to stay, health experts said today.
But some doctors cautioned against the rise in phone consultations.
Figures from NHS Digital reveal 80% of appointments in Suffolk and north Essex were carried out face-to-face in February 2020 but by July that had fallen to just over 50%.
In that time, telephone consultations soared, tripling from 14% in February to 41%. Online and video appointments stayed relatively low, accounting for less than 1% of consultations during the pandemic.
NHS bosses in Suffolk say many patients have welcomed the move towards virtual appointments – and the region’s British Medical Association chief said using phone conversations to triage patients has helped to deal with “huge levels of demand”.
But while experts agree there must always be face-to-face consultations available for those who need them, others are concerned a sustained lack of physical examination could lead to symptoms of serious illnesses being missed.
Central Suffolk and North Ipswich MP Dan Poulter, who is also a doctor, fears the “abrupt, almost overnight switch” from face-to-face to remote consultations could have “unintended consequences” on sicker patients.
“While the increase in technology has been welcome for a lot of patients, it’s also potentially creating difficulties for people with long-term illnesses such as heart failure, who can deteriorate very quickly,” he said.
“Although technology is around for people to monitor their conditions at home, such as blood pressure and pulse monitors, that’s not widely available yet.
“We need to make sure where people need face-to-face appointments, they are still readily available, as some people will continue to need physical examination.
MORE: ‘Likely’ that parts of Suffolk will be hit by second coronavirus spike this winterHe added: “In some cases, technology has slowed down the process of getting people to the right care.
“If you have a breast lump requiring examination, the phone call or virtual appointment is often a gate-keeping service which can slow the next step down and delay it by days or even weeks.”
Kate Melton, a patient at Long Melford Practice, claims she was not offered a face-to-face appointment for her medication check-up – and was told she could buy a blood pressure machine for £20 to use at home.
“They expected me to have a set of scales to weigh myself and a blood pressure machine to give them the readings,” she claims.
The surgery has been approached for further comment.
Amy Dawson, from Ipswich, recently had a better experience and rang Pinewood Surgery to ask for antibiotics for a minor ear infection. Her prescription was ready within 20 minutes.
“I phoned them up and said I don’t need to see a doctor; I know I just need to have the antibiotic spray,” she added. “The receptionist said if I was happy, the GP would text me with a simple ‘yes/no’ message. It was fantastic, there was no waiting around.”
Suffolk mum Sam Sayer-Everett said: “Virtual surgeries have really helped me access my GP better than I would normally with two children at home. Since lockdown I was able to increase my medication instantly, had a suspicious lump referred to the appropriate hospital department very promptly, had a helpful mental health chat with both the GP and mental health practitioner.”
Another patient, from north Essex, had a telephone appointment with a district nurse for an infection and given antibiotics. But the next day she developed strange bumps in her throat and phoned the surgery who explained she may have been given the wrong prescription.
“I felt that by just speaking over the phone, the nurse was unable to diagnose my infection properly. It’s worrying that I was given the wrong medication, because it could have had serious consequences,” she said.
MORE: How Suffolk’s new test-and-trace system will workThe switch from face-to-face to remote appointments has been more pronounced in Suffolk and north Essex than in Norfolk and Waveney, where six in 10 consultations were carried out face-to-face in July.
Dr Ruth Bushaway, medical director at Suffolk GP Federation, said it will be difficult to predict where the balance will lie in the future - but doubts the NHS will scrap face-to-face altogether.
“Before Covid, the anticipated evolution to do more consultations remotely, either by telephone, email or video call, has clearly dramatically escalated in the context of this crisis,” she said.
“But we understand not everyone is able to use these methods largely due to IT technical ability or availability.”
In a letter sent out at the end of July, Sir Simon Stevens, chief executive of NHS England, said: “All GP practices must offer face-to-face appointments at surgeries as well as continuing to use remote triage and video, online and telephone consultation where appropriate, while considering those who are unable to access or engage with digital services.”
MORE: Rise in young people infected with coronavirus in SuffolkBosses at Suffolk’s two clinical commissioning groups acknowledged a “big increase” in video and online consultations.
A spokesman said now, around 70% of the time, issues can be “best resolved” by text, email, phone or online.
“The big increase in the use of video and online consultations is here to stay, but there will still be times when face-to-face appointments are needed, and they will always be available as indicated so every patient receives the most appropriate care,” the spokesman added.
“Many patients have told us how much more convenient a digital consultation is for them, and the CCGs are supportive of practices using more digital services in the future.”
Andy Yacoub, chief executive of patient watchdog Healthwatch Suffolk, said responses to the organisation’s Covid-19 survey have shown people enjoyed faster access to online prescriptions and feel GPs have more time for them.
But he added: “As lockdown guidelines continue to change, so will the public’s expectations. It is important to listen to their needs and how services can be improved in order to adapt for the future.”
A YouGov survey in The Times last week showed just over half of people had found it harder to book a GP appointment since coronavirus hit.
The organisation’s Covid-19 experience survey is continuing to collect data from patients about their experiences of new technology during the pandemic.
Phone appointments are here to stay
Coronavirus has only accelerated an online revolution which the NHS has been flirting with for years. Health secretary Matt Hancock has made no secret of his desire for the NHS to embrace the leap from face-to-face to virtual.
In 2018, the newly-appointed secretary of state outlined his vision for a more tech-focused NHS, championing virtual GP services and calling for them to be made “available for all”.
For years, NHS bosses have been quietly revolutionising booking systems, enabling patients to secure appointments and view medical records online.
Coronavirus has jolted surgeries into action – forcing thousands to make the swap from face-to-face to phone appointments during lockdown. And that is now here to stay.
Four months after Mr Hancock said the NHS was open again after the pandemic, the percentage of face-to-face appointments remains at pandemic levels.
Mr Hancock told the Royal College of Physicians in July he now wants consultations to take place “remotely by default”.
However the number of appointments via video remains very low at less than 1%. For the next stage in the tech revolution, that needs to increase.
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