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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 (77)

  • This will kill General Practice. Who wants to do ten years of training to spend 9hrs a day on the phone? I for one am already looking for a way out.

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  • But it doesnt free us up,there is just more relentless meaning less sjit rolling down to the GP.Time to get out if you can.

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  • So this moron is now a doctor???
    Worse than hunt, which I did not think was possible.....

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  • Vinci Ho

    ‘’ ‘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’. ‘’

    You see , unless my English is that poor to understand this , the Health Secretary has serious problem in expressing in simple words what he meant to say ?
    Otherwise, this is old habit hard to rid again , One Size Fits All.
    OMG , mo wonder we are in this predicament under such leadership .

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  • Vinci Ho

    Roboco*k , fo you know what the reality in general practice is ?

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  • Compelling reasons to see patients face to face:
    No internet access for patient because it is too costly.
    No internet access for patient because the links to video consults are in English.
    No ability to read body language over the phone.
    Information filtered down the phone to a telephone interpreter is too limited.
    I cannot examine you over the phone.
    You need some human contact.
    The "doctor as drug" does not come into play over the phone.
    Spending 20 minutes on the phone (using the interpreter) then 20 minutes seeing you face to face (still using interpreter) beacuse of all of the above doubles the GP workload.
    Remote consultations are "doctor centric" dealing with your specific presenting problem when we all know that the hidden agenda "whilst I am here doctor" is usually the more important and a patient centred approach increases patient empowerment and leads to better outcomes.
    And a million more reasons why this increases health inequalities. Could we go for indirect discrimination on this one too?

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  • I think that he is right. We do most of our consultations remotely and it is more efficient as many can be managed with a brief email/text conversation without phone or video without seeing the patient. That is where the savings are so that time to give to those that need it and that small number that need to be seen. It is not without problems and it is a shift in working practice but I think that we are good at learning new skills and adapting to change. I cannot see us returning to what was before.

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  • 1. The contract allows us to deliver care in the way we see fit. If he wants this he will have to negotiate it with GPC, or impose it.
    2. He hasn’t stopped to see if it is more or less efficient, he has just assumed it is more efficient. The only good quality evidence out there suggests it is 8-30% less efficient (some you see anyway, some you have to call three times, phone calls are less efficient delivery mechanisms for complex care etc). So, you will have to increase funding or resources to deliver this, or watch the service deteriorate quickly and significantly.
    3. Many patients will hate it. I hope the MPs have lots of time to answer these letters as well as all the ones complaining about delays in secondary care delivery.
    4. It will open up the possibility of private GP services, and GPC should now push hard for this so we can do what the dentists did. Matt clearly wants a two-level service, and for our own sanity and health we should stop fighting it and stay planning for it.

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  • I am practising remote pr exam; or is that what Hancock is doing to GP's?

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  • Absolutely NOT what he said on a radio interview on LBC this morning which he ended with ‘ of course if a patient prefers to be seen face to face they will be’
    So punters will remain disappointed with this current service which has been decided as they way forward with NO patient input

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