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Infectious patients only acceptable reason for refusing face to face, NHSE clarifies


GP appointment face-to-face


Exclusive GP practices must give face-to-face appointments to patients who request them unless they are deemed to be an infection risk, Pulse has learned.

Last night, new NHS England guidance issued to GPs said practices must offer patients face-to-face appointments if that is their preference.

A letter to practices said they must ‘respect preferences for face-to-face care unless there are good clinical reasons to the contrary, for example the presence of Covid symptoms.’

However, it added that practices – which must also open their reception areas to walk-in patients – should continue to triage such patients ‘as they would be via phone or via an online consultation system’.

The official letter was unclear whether patients should be given in-person appointments if they request one, even if the practice does not believe an appointment is clinically necessary following triage.

But an NHS England spokesperson confirmed to Pulse that if a patient is not deemed to be a clinical infection risk, they should be given a face-to-face appointment if they request it. 

GP leaders said the letter had ‘no contractual force’ and should be regarded as guidance only by practices.

In a letter to local practices, seen by Pulse, Surrey and Sussex LMCs chief executive Dr Julius Parker said: ‘I confirm this letter was not discussed with the BMA GP Committee and has no contractual force, it is guidance, and in the LMC’s view poorly-thought-through guidance at that.’

‘You are not obliged to offer patients a face-to-face appointment on request’, he added.

Pulse has asked for clarification on the reasons behind the change in policy, which has been in place since the start of the pandemic.

It comes amid ongoing pressure from the media around claims that GP practices are closed – most recently a Mail on Sunday campaign to get practices to see patients face-to-face ‘again’.

Recent claims from the Telegraph that non-Covid appointments have not been available to patients also prompted NHS England medical director Dr Nikki Kanani to pen an open letter refuting the claims.

But NHS England this month signalled it was working on plans to help manage growing GP workload in a way that will also ‘make sense to patients’.

GPs responding to NHS England’s new guidance branded it ‘tone deaf’ and ‘badly judged’.

READERS' COMMENTS [10]

Patrufini Duffy 14 May, 2021 4:35 pm

You only need to clarify things that don’t make sense. Seems to be an innate habit.

Simon Ruffle 14 May, 2021 5:06 pm

Everyone is an infection risk.
Carry on, nothing to see here.
‘Aven’t you got homes to go to?

Robert James Andrew Mackenzie Koefman 14 May, 2021 5:24 pm

We will open when we feel it is safe for our staff like we closed the doors before the government eventually did! We offer F to F for those that need it and will continue to do so. Why does NHSE not understand the reason we have seen fewer colds and flu is because we have done what we have and not had waiting rooms full of viral illnesses to spread around. i can feel another year of discontent coming . Roll on retirement.

Stephen Kell 14 May, 2021 5:37 pm

In one non-contractual but very public letter General Practice is put back 10 years. The only way to deliver this is to introduce waits, which will quickly be 6-8 weeks.
Perhaps letters from GPs to consultants should now include a patient preference for face to face appointments.
If I had been asked to sign this letter I’d have resigned.
Completely demoralising. Clinically wrong. Politically naive.

terry sullivan 14 May, 2021 5:54 pm

nhse should be abolished–save billions and no downside

Robert Caudwell 14 May, 2021 6:02 pm

“Tone deaf” lets them off the hook too easily, and suggests it’s some sort of ill-thought through blunder. They know precisely what they are doing. What we need is a robust response from our union (no, me neither)

David Stokoe 14 May, 2021 6:05 pm

The headline is incorrect and does not help. NHSE is pointing out that there have to be “clinical grounds” for not offering f2f and cites Covid as an example not as the only permissible scenario.

Mark Howson 14 May, 2021 6:21 pm

When and where and how a GP consults with a patient is the decision of the GP. This is written clearly into the GMS contract. The decision the GP makes has to be clinically justifiable but it is the GPS decision not the patient’s or NHSE’s.

David Stokoe 14 May, 2021 6:29 pm

I agree I was looking for that bit in our contract

David Church 15 May, 2021 2:24 pm

Apparently on 3% of men know how to wash their hands: I am tempted to lost GPs, Surgeons,….. everybody else is an infection risk! especially those small people with the big eyes who won’t eat their greens – they are the worst!