New Public Health England (PHE) guidance has said that GP practices should use virtual consultation ‘where possible’, contradicting recent NHS England orders.
GPs told Pulse that ongoing mixed messages from authorities were leading them to view guidance ‘with a pinch of salt’.
Last month, NHS England said GP patients must now be offered face-to-face appointments if that is their preference and receptions must be open for walk-ins.
But PHE infection prevention and control guidance updated this week recommended against unnecessary face-to-face contact in practices.
It said: ‘In outpatient, primary care and day care settings… where possible and appropriate, services should utilise virtual consultation.’
It added that all patients should be triaged before being admitted to practices’ waiting rooms.
The guidance said: ‘Prior to admission to the waiting area, all patients/individuals and accompanying persons should be triaged for Covid-19 symptoms and assessed for exposure to contacts.’
Surrey GP partner Dr Emma Watts told Pulse that ‘confusing’ and contradictory guidance has been the ‘narrative’ throughout the pandemic, driving GPs to view new instructions ‘with a pinch of salt’.
She said: ‘It’s confusing, but that’s not new. That seems to be the narrative that has gone through the pandemic.
‘I can’t speak for all GPs, but at this point it’s really not a surprise and I think people are viewing the guidance with a pinch of salt and doing what they think is right.’
Former NHS Clinical Commissioners co-chair Dr Steve Kell told Pulse he too is ‘not surprised’ by the contradiction but welcoms the ‘sensible’ PHE guidance.
He said: ‘[The PHE guidance] is obvious and common sense – and it’s what practices essentially are carrying on doing
‘It also gives more patients access if you don’t have unecessary face-to-face consultations because you can help more people more quickly – which is exactly what we’ve been doing.’
Dr Kell added: ‘NHS England’s guidance has been probably one of the most unwelcome emails I’ve had in my career.’
And Lancashire and Cumbria LMCs chief executive Peter Higgins told Pulse that the mixed messages practices are facing make him feel ‘sad’.
He said: ‘Some of it is clumsy communications and some of it is politically motivated.
‘There is a national problem of emphasis here – some national bodies are using logic and science but others are using politics too much.’
The LMC is advising local practices that it is the GP’s ‘ultimate decision’ around whether a patient should be given a face-to-face appointment, he added.
Both LMCs and the BMA have advised practices that NHS England’s guidance has ‘no contractual force’, but Pulse revealed that NHS England is monitoring how many face-to-face appointments practices are offering and asking them to justify ‘low’ levels.
GPs previously warned that many Covid-symptomatic patients are now attending face-to-face appointments having only had a negative rapid lateral flow test (LFT), putting GPs and staff at risk.
The updated PHE guidance made no changes to PPE recommendations, although it did suggest that GP practices could ‘consider’ the use of FFP3 masks if an ‘unacceptable risk of transmission’ remains following a risk assessment.
Formal meetings between NHS England and the BMA’s GP Committee remain suspended following a vote of ‘no confidence’ in NHS England’s executive directors.