GP appointments: seeing a doctor face-to-face easier in some parts of England than others

Patients’ body Healthwatch said some people struggled with remote appointments, such as those who speak English as a second language, while the doctors’ union said GPs were working harder than ever amid a nationwide staffing shortage.

Access to face-to-face GP appointments varies widely across different parts of England, new figures show.

Access to face-to-face GP appointments varies widely depending on where you live, new figures show.

In-person consultations make up less than half of all appointments in some areas of England but nearly three-quarters in others.

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Patients’ body Healthwatch said some people struggled with remote appointments, such as those who speak English as a second language, and called for NHS England to carry out a full review of access to surgeries.

The British Medical Association, the doctors’ trade union, said GPs were “doing their best to give as many patients as possible the appointments they need safely” amid huge backlogs and staffing shortages.

Across England, rates of remote appointments remain at similar levels to those seen in the winter lockdown, analysis of NHS England data shows.

Telephone or online calls made up 39% of all appointments in August, the first full month since Coronavirus restrictions were lifted.

This compares with 41% in January, during the winter lockdown.

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How often patients see a GP face-to-face differs widely across England.

Nearly three-quarters of appointments in the North Tyneside Clinical Commissioning Group (CCG) area were in person in August, either at surgeries or through home visits - the highest rate in the country.

In comparison, face-to-face consultations made up less than half of all appointments in South East London, East Staffordshire, South Sefton in Merseyside and Bolton.

Appointments where the location was unknown accounted for up to 9% of the total in these areas.

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The ability to book face-to-face appointments remains a hotly debated topic, with the BMA warning that its members are facing increasing hostility from some patients over the issue.

Earlier this month, health secretary Sajid Javid called on GPs to provide more face-to-face appointments, telling MPs that “life is starting to return almost back to completely normal” after the pandemic.

NHS England issued guidance in May stating that “practices should respect preferences for face-to-face care unless there are good clinical reasons to the contrary”.

And a Department of Health and Social Care spokesperson said yesterday: “We are clear GP practices must provide face to face appointments to those who want them, alongside remote consultations.”

‘Jess felt that no-one listened’

A 27-year-old woman had to call her doctors’ surgery more than 20 times to get an in-person appointment which revealed her cancer diagnosis.

Jessica Brady, 27, passed away from liver cancer after her GP surgery refused her an in-person appointment (image: JustGiving)

Her mum, Andrea, told MPs at the Health and Social Care Committee on 14 September, that if doctors would have seen her daughter sooner, she might still be here.

Andrea said: “We feel, and Jess felt, that no one listened, no one took it seriously.”

Call for review

Jacob Land, head of policy at Healthwatch, said they wanted NHS England to carry out a full review of primary care access to “ensure services work for both patients and staff”.

He said primary care needed a flexible model which gives patients the choice of how and where they are seen.

He said: “Remote appointments have been hugely positive for some people, and they create opportunities to make care more flexible.

“However, they are not always the best approach for everyone or every circumstance, including people who don’t have access to the Internet, for whom English is not first language or those in a mental health crisis.”

Organisations representing doctors said GPs were working harder than ever amid a nationwide staffing shortage.

Dr Mark Sanford-Wood, of the BMA, said: “GPs are doing their best to give as many patients as possible the appointments they need safely, against a backdrop of a shortage of GPs, all the while still working within the national guidance of infection control and social distancing measures.

“We didn’t have enough GPs before the pandemic, and we don’t have enough now. Sadly, there are 1,904 fewer fully qualified full-time GPs than there were in 2015.

“Every part of the NHS is under an immense burden like never before.”

Professor Martin Marshall, Chair of the Royal College of GPs, said: "Ultimately we need more GPs and other members of the practice team to deliver the care our patients need.”

But he said telephone appointments did have their advantages.

He said: “The narrative that remote consultations are substandard compared with seeing a GP face to face is concerning.

“GPs, nurses, pharmacists and others working in general practice strive to deliver the same high-quality care whether a consultation is remote or in person.

“Some patients prefer remote consultations as they can be more convenient and fit around other commitments - and some people are more likely to access care when they need it remotely as opposed to going to a surgery or feel more comfortable discussing certain aspects of their health.”

An NHS spokesperson said: “Every GP practice must provide face-to-face as well as telephone and online appointments as part of making primary care as accessible as possible for patients - the latest figures show that around 24 million appointments were delivered in August alone, above pre-pandemic levels, with more than half delivered in person.

“Record numbers of people are now training to become GPs, with up to 4,000 new starters this year and the NHS invested £270 million to expand general practice capacity during the pandemic on top of rising investment over the last five years.”

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