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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)

  • Let common sense prevail

    You are wrong Mr Hancock. We may be able to deal with some of the whingers, whiners and needy by phone. But the practice of medicine still requires the laying on of hands. Do you want us to provide a service to those who need it, or to those who demand it (and shout the loudest).
    Reappraise your priorities, or risk destroying Primary Care, which remains the jewel in the crown of the NHS.

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  • Well done Mr Hancock. A most sensible decision but most GPs are already doing it without the dictat. Screens out the dross. Prescription rates have dropped so much.

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  • Hawkeye

    Call centre based abroad .....
    Sent to local hub if needed ,seen by nurse.
    A&E appointment only via call centre.
    Is this what they plan?
    RIP General Practice .

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  • Speaking as retired GP who is now unfortunately a patient I find this awful. Over the last two months I have had five telephone appointments about three problems - none trivial - with five different doctors, none of whom had read why I had the appointment. All contacts were to be anytime in the day which meant I either had to sit by my landline or use my mobile and give personal medical details in the local supermarket. This is rubbish! Hancock should get back to what he's good at -playing Candy Crush. Donald Trump could do his job better. Any GP that thinks it is a good idea should clear out of medicine and work in a call centre frightening old ladies.

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  • In 44 yrs of medicine I haven’t seen such a stupid comment by a politician about medical practice.(and I have seen a few).He has no clue about assessing patients and the dangers of triage even with most up to date technology.2

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  • PS
    I wonder if the MDU and GMC would like to comment

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  • Extremely worrying that this man is in charge of health care in the UK. This will be the end of NHS general Practice. It will be replaced by triage algorithms which will either lead to excess morbidity and mortality or overwhelm secondary care with unnecessary referrals. Thankfully I am near retirement.

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  • As a patient I think it’s very good to consult remotely . You can tell the GP your life story and you don’t have to watch the GP body language , the subtle hints that time is ticking on , the nods and the ‘ ahh , I see’ that they teach medical students these days . You have freedom to direct the conversation and you don’t see the closing gambits - like picking up the prescription pad that tells you you’ve exceeded your notional 8 minutes ! 30 minutes pass very quickly .

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  • I remember a 3/52 old with feeding problems. Mum had spoken to HVs twice, midwife twice and one of my partners once. I just said get in and lets look, stripped her off and pulse was uncountable. Turned out to be SVT at over 200. Granddad still sends me a bottle of scotch every Christmas even though I packed in five years ago. Sometimes you just have to examine your patients I am afraid.

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  • Agree with Mr Hancock. Only now do I realise the amount of time I have wasted on pointless visits/appointments. This has allowed me to banish 10 minute F2F appointments for 15 mins. Agree there are dangers, but if managed well (by GPs not managers) then a more manageable job may result.

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