Just one in 10 patients preferred face-to-face GP appointments during the Covid pandemic, with most requesting telephone consultations instead, according to research carried out on behalf of NHS England.
The Improvement Analytics Unit (IAU) – a partnership between NHS England and think-tank the Health Foundation – looked at data from 146 England GP practices using the askmyGP online consultation system between March 2019 and September 2021, examining over 7.5 million patient-initiated consultation requests.
GP leaders suggested that NHS England needed to take the research into account and allow practices to decide their own way of working.
However, NHS England declined to comment beyond a press release sent out by the IAU on the research findings.
The research found that:
- Before the pandemic, 30% of patients requests specified a face-to-face consultation, dropping to less than 4% at the beginning of the pandemic.
- But by the end of the study period in September 2021, only 10% of patients requests were for face-to-face GP appointments.
- Telephone consultations were the most popular option, making up over half (55%) of patient requests in 2020/21.
- However, less than 1% of patients preferred a video consultation, according to the data.
IAU head at the Health Foundation Arne Wolters said: ‘Our analysis shows that patients often choose remote over face-to-face consultations and that GP practices can mitigate the risk of digital exclusion via a blended approach.’
He said that ‘traditional routes to accessing and delivering care’ had been ‘offered alongside an online option and, in planning care, practices were able to take account of factors such as patients’ age, frequency of use, clinical needs and preferences’, at the studied practices.
And he added: ‘With patient demand at an all-time high due to the care backlog that has built up during the pandemic, digital tools can help practices manage this pressure, enabling them to triage patients to the right person or service and prioritise face to face consultations for those that need them most.’
BMA England GP committee executive officer Dr Richard Van Mellaerts said: ‘This evolution in how we provide care for our patients has attracted significant criticism and in some instances, abuse, which is deeply unfair, and has had a profound effect on many GPs and colleagues.
‘Despite this, this latest analysis suggests that while not suitable for everyone or all conditions, in many cases patients themselves will often prefer and indeed request a remote consultation.’
He added that ‘going forward’, it is ‘crucial that patient choice, clinical need, and staff and practice capacity are at the centre of decisions around how people can interact with their surgery, rather than pressure from politicians or the press’.
Doctors’ Association UK lead and GP Dr Lizzie Toberty told Pulse: ‘GPs have been berated by both the media and NHSE during the pandemic for not conducting enough face-to-face appointments.
‘This data must be treated with some caution as askmyGP practices may be self-selecting for “tech savy” populations. However, it does seem to suggest GPs have been right to juggle their limited resources by managing many conditions remotely, where appropriate.’
She added: ‘Once again Doctors’ Association UK would point out that local primary care services are best placed to identify the exact needs of their population. There should not be the “one size fits all” approach we are seeing pushed by NHSE and the Government.
‘We would welcome further research into both patient needs and desires when it comes to the modality of appointments.’
It comes as MPs urged NHS England to produce ‘clear guidance’ regarding face-to-face versus remote GP appointments.
They come as the Government had urged GPs to increase face-to-face consultations as part of the GP Access Fund measures launched in the autumn.
But, at the same time, GPs were also given contractual targets for promoting remote consultations to patients.
And GPs and practice staff will be surveyed as part of an NHS England-commissioned independent evaluation of remote GP consultations.
Other findings within the report
- Telephone consultations were most preferred pre-pandemic and in 2020 and 2021, accounting for 44% of consultations on average pre-pandemic, and over half (55%) of requests across 2020 and 2021.
- Requests for GP advice via text or online messaging made up on average 26% of requests before the pandemic, increasing to a third in 2020/21.
- Less than 1% of patients asked for a video consultation.
- At practices with a digital-first approach, most patient requests were initiated online.
- During 2021, 72% of all patient requests were made online instead of over the phone or in person.
- In June 2019, 60% of patients requests were initiated digitally, rising to 70% in March 2020.
- Once patients accessed their GP online, they were 25% more likely to do it again, compared to those who had never used online GP access.