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GPs should do 'all' consultations remotely going forward, says health secretary

Unless there is a 'compelling clinical reason' to see a patient face to face, all GP consultations should be carried out remotely going forward, health secretary Matt Hancock has said.

GP leaders warned that a predominantly remote GP service ‘wouldn’t be in anybody’s best interests long-term’ and should be 'approached with caution'.

In a speech on the ‘future of healthcare’ today, Mr Hancock said the Covid-19 pandemic has digitally transformed the NHS for the better.

In the four weeks leading up to 12 April, 71% of ‘routine’ GP consultations were delivered remotely, compared with about 26% face-to-face, Mr Hancock said.

This has ‘reversed’ compared with the same period last year, when 71% were face-to-face and 25% of patients were seen remotely, he added.

Mr Hancock said: ‘The feedback from this transformation has been hugely positive and especially valued by doctors in rural areas who say how it could save long travel times both for doctors and patients.

‘So from now on, all consultations should be teleconsultations unless there’s a compelling clinical reason not to.’

This will ‘free up clinicians to concentrate on what really matters’, he added.

He added that while there ‘always’ has to be an alternative system for people who can’t log on, we ‘shouldn’t patronise older people by saying they don’t do tech’.

He added: ‘Of course, if there’s an emergency, the NHS will be ready and waiting to see you in person just as it always has been.

‘But if they are able to, patients should get in contact first via the web or by calling in advance. That way, care is easier to manage and the NHS can deliver a much better service.’

Mr Hancock, who was speaknig at the Royal College of Physicians, added that making ‘Zoom medicine’ available is ‘key’ to moving forward after the pandemic.

He said: When the culture change came, things moved very fast and the key is that we don’t go back.

‘We do provide face-to-face where needed - whether that’s because you need a physical interaction to give the healthcare obviously or because someone doesn’t want to - but we also make available "Zoom" medicine.’

And moving to remote consultations long-term will lead to a ‘better service’ for those who need face-to-face treatment because it will ‘free up time’, Mr Hancock added.

It comes as data published today by NHS Digital showed that the numbers of GP appointments are continuing to rise to pre-lockdown levels.

In June, 21.3 million appointments are estimated to have been delivered in general practice - of which 53% took place with a GP.

And 61% of GP appointments were carried out by telephone, compared with 32% for other practice staff, the data show.

Dr Richard Vautrey, BMA GP committee chair, said the new statistics show the need to continue ‘triage arrangements’ and using remote consultations ‘where appropriate’ to keep both staff and patients 'as safe as possible'.

He said: ‘Practices are working incredibly hard not only to deal with the continued impact of Covid-19, but also to provide other routine services as well as they are able to.'

However, Dr Vautrey added that Mr Hancock’s vision for remote appointments by default ‘must be approached with caution’.

He said: ‘Physical appointments will always be a vital part of general practice and they continue to be necessary for many patients and the management of specific conditions, and we must not lose sight of that.’

And Professor Martin Marshall, chair of the Royal College of GPs, said the RCGP supports the greater use of technology post-pandemic ‘to an extent and as long as it is safe’. 

He added: ‘We should remember that the changes were made out of necessity - to keep our patients and our teams safe and to help stop the spread of Covid-19. While there is a compelling case to retain some aspects of the different ways we’ve been working, we certainly do not want to see general practice become a totally remote service.’

A ‘predominantly’ remote GP service ‘wouldn’t be in anybody’s best interests long-term’, Professor Marshall added.

He said: ‘Many patients ‘prefer seeing their GP in person and many GPs prefer this too, particularly for patients with complex health needs who really value the relationship-based care that GPs excel at delivering. 

‘We agree with Mr Hancock that it’s important we learn from how we have been working during the pandemic - and what we want to be able to do in general practice is offer patients a choice of how they access our services to best suit their health needs and preferences.’

A BMA survey last month found that nine in 10 GPs want to carry on delivering consultations remotely after the coronavirus pandemic has ended.

The chair of the RCGP has said that as many as half of GP consultations may be carried out remotely after the Covid-19 pandemic has passed.

During the pandemic, outpatient appointments have also taken place remotely, and this week, NHS England confirmed plans for patients to call ahead before attending A&E from this winter.

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Readers' comments (80)

  • Patients are already demanding to be seen, even for trivial things because the hairdressers are open and why can't we see patients. It is more stressful over the phone or Accurx than seeing patients F2F. wondering whether it's worth the stress and working on alternatives currently because this is not sustainable for some

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  • The compelling language - despite ignoring what range of access patients actually need, and ignoring the fact that we've been doing telephone consultations for decades- suggests to me that Hancock has a deal lined up with Livi. Like GP At Hand, competing for profitable patients. Nothing about patients, much about disaster capitalism.

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  • Oh, and our IT has already become unstable with about ten api platforms. Bolt-on model is doomed, IMHO.

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  • ‘So from now on, all consultations should be teleconsultations unless there’s a compelling clinical reason not to.’

    This will ‘free up clinicians to concentrate on what really matters’, he added.

    How and why does a video or phone consultation will free up time? The man is beyond contempt.

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  • no explanation that in have seen so far is how you gain experience, how you pick up those whilst I am here essentials.
    Plainly many things can be managed non f2f and should be but for multi morbidity small children abdo pain breathlessness general tiredness etc I fear it is dangerous and often think at the end of an on line surgery that i am in danger of winging it.

    the agenda is being driven by those who like it and links with the behind the scene roll out of the new 111 with returner gps managing the triage and booking into your surgeries

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  • Those GPs who believe they have been consulting adequately in the past few months via non-F2F need to be less hasty in their judgement. There is a time-lag before the things of import which have been missed/mis-evaluated become incontrovertibly exposed to the light of day and I would suggest re-judging matters in another 6 months time.

    Many GPs find themselves unable to read the notes as they should due to time pressures but this can be off-set a little by a quality F2F evaluation. If this too is absented then the quality of care provided is going to drop further. Meniscus medicine is what will result ie just the top layer of the most superficial evaluation will be provided. I reckon the medical defence bods will be watching matters closely.

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  • It’s a good excuse not to provide or fund PPE.

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  • Took Early Retirement

    71% of ‘routine’ GP consultations were delivered remotely, compared with about 26%. So where's the missing 3%. the numbers don't even add up for this clown.

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  • Free up GP time, to basically take over social care. And get nailed for it.

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  • He's even more of a clueless prat than I gave him credit for being.

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