GP practices accused of ‘excluding’ older patients by introducing online access changes

Exclusive GPs have called for better national guidance around new online access requirements, after practices were accused of discriminating against elderly patients by implementing the mandatory changes.

Patient groups have raised concerns about the changes, with Healthwatch and the Patients Association telling Pulse that older patients ‘feel excluded by the shift to online booking’ and that as digital access ‘becomes the norm’, there must always be a non-digital option ‘for those who need it’.

Since the 1 October changes came into effect, ‘ageism’ claims against GP practices have been reported by several local newspapers around the country.

GP practices in Swindon were accused of ‘phasing out elderly patients’, while on the Isle of Wight there were concerns that vulnerable groups would not be able to access GP appointments because of the new requirements.

In response to these claims, GP leaders said that the changes have been imposed by the Government and told Pulse that national guidance is needed on how to support vulnerable groups to access digital options.  

It comes as the BMA GP committee is currently in dispute with the Government over the changes, arguing that the requirements are currently not safe to implement and that they risk overwhelming GP practices.

Healthwatch England chief executive Louise Ansari said: ‘Healthwatch often hears from people concerned about GPs becoming overly reliant on new technology. They feel excluded by the shift to online booking systems, a change that has particularly impacted older people and those without internet access.

‘Under the GP contract, patients have the right to choose how they book their appointments, whether by phone, online (including via the NHS App), or in person.

‘Additionally, to ensure the NHS delivers care that meets people’s needs, patient preferences, including their preferred method of booking appointments, should be recorded at the point of GP registration.’

The Patients Association chief executive Rachel Power said: ‘Many patients have asked for better use of technology to make GP services easier to access, and there’s real potential for digital tools to improve care.

‘But across all demographics, people have different levels of digital confidence, and the system has a responsibility to make sure everyone who wants to use new technology can do so with the right support.

‘Technology should be designed and implemented in partnership with patients, so it meets their needs, reduces barriers to access, and strengthens the human contact that patients value.

‘And as digital access becomes the norm, there must always be a non-digital option for those who need it.’

Lancashire and Cumbria LMCs chief executive Dr Adam Janjua told Pulse the requirements have made the system more ‘rigid’ than it previously was, leading to the complaints.

He said: ‘It’s a big issue and digital literacy isn’t as high in the elderly, especially in certain deprived areas.

‘This is a problem that is squarely belonging at the feet of NHS England and the Department of Health and Social Care who have mandated such a rigid system.’

Professor Azeem Majeed, a GP and head of the Department of Primary Care and Public Health at Imperial College London, said that similar stories of ‘frustration and exclusion’ from online health services are being reported by patients across the country.

He said: ‘The shift to online triage forms can create unnecessary barriers, potentially leading to delayed care and increased stress for those who need healthcare the most.

‘We need better national guidance on supporting people from vulnerable groups such as the elderly, those with disabilities, people with limited digital literacy, or those who lack access to the internet or digital devices.

‘It’s essential that the introduction of online appointment booking systems by NHS GP practices does not inadvertently exclude these patients.

‘In my own practice, we offer in-person help at reception with our receptionists completing the online forms for patients unable to do so themselves. NHS primary care should remain equitable and accessible to all groups in society.’

In response to the ‘ageism’ claims directed at GP practices, an NHS England spokesperson told Pulse: ‘Online consultation tools provide an additional way for patients to access care, not a replacement for traditional methods – and more GPs are telling us that offering this choice has made their lives easier and improved patients’ experience.

‘The NHS has upgraded thousands of GP telephone systems, and by expanding the hours people can submit an initial request online, we’re helping to free up phone lines for those who prefer to make an appointment by phone or by visiting their local practice in person.’

Pulse has contacted the Department of Health and Social Care for comment.

Pulse recently reported that GPs were warning the new requirements risk compromising patient safety, with patients reporting breathing difficulties, severe vomiting, acute abdominal and chest pain, and rectal bleeding through online forms.