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Patients seen face to face by GPs upon request, finds NHS England

Patients seen face to face by GPs upon request, finds NHS England

GP consultations tend to ‘be delivered in line with patient preference’, meaning that those requesting face-to-face appointments are ‘more likely to have one’, NHS England has found.

A new study, led by NHS England and the Health Foundation, examined more than 10 million patient-initiated requests for general practices services at 154 practices between March 2019 and February 2022 using a modern general practice access model, including both digital and non-digital access pathways.

It analysed trends in requests for services and the association between patient characteristics including demographics, preferences for care and clinical needs and modes of patient contact (online vs telephone), and care delivery (face-to-face vs remote) at practices using a modern access model.

The report, published in the BMJ, said: ‘Before Covid, patients with a preference for continuity of care were less likely to be seen face-to-face than those that did not, but after 2020/2021, the trend reversed.

‘Consultations tended to be delivered in line with patient preference—those requesting a face-to-face consultation were significantly more likely to have one compared with those who requested an online or telephone consultation.’  

The study pointed out that ‘only a minority’ of requests at these practices indicated a preference for a face-to-face consultation.

It added: ‘Importantly, mode of contact did not determine how care was delivered.

‘Face-to-face consultations were more likely to be used by clinicians for the youngest and oldest patients, those asking about new medical problems, non-frequent attenders (likely to be less familiar to the practice), a preference for continuity of care (during the pandemic) and a preference for face-to-face consultation.

‘These findings are consistent with other evidence suggesting that face-to-face consultations are more likely to be used for the most vulnerable or complex patients.’

The authors concluded that from a patient perspective, ‘modern general practice access may enable greater flexibility better matched to individual circumstances and support patient-centred care’.

Professor Azeem Majeed, head of the Department of Primary Care & Public Health at Imperial College London, said that the study showed a flexible patient behaviour, which could inform policy.

He told Pulse: ‘The study suggests that a blended model of digital and non-digital access does not disenfranchise non-digital users, an essential point for NHS staff concerned about health inequalities.

‘The study also showed patient behaviour is flexible; they will choose the medium (digital or in-person) based on the urgency and type of the problem.

‘This flexibility could inform policy, encouraging a more adaptable primary care system. The study underlines the importance of a modern, multimodal, and flexible general practice model that can adapt to the evolving needs and preferences of the UK population.’

Dr Steve Taylor, a GP in Manchester and GP spokesperson for the Doctors’ Association UK (DAUK), told Pulse: ‘All GPs would probably prefer to offer appointments in line with patient request and preference.

‘The harsh reality of lower numbers of GPs, with numbers of patients per GP rising from 1,800 to 2,300 on average, is it is increasingly difficult to meet patient requests and preferences.

‘It is interesting to note that many patients prefer online/text and telephone consultations. GPs will call many of these people in for a face to face appointments knowing that this will actually be better for patient care.

‘Sometimes a telephone call from a doctors that knows you and your condition well is better than a face to face appointment with someone new to you.

‘We are in a tricky time of balancing the needs and desires of patients, with what realistically can be provided by the reducing number of GPs.’

Last month, a Pulse survey revealed that around 60% of GPs say they are able to offer face-to-face appointments to patients with similar waiting times to remote consultations.

At the time, NHS Digital figures showed there were more than 29 million appointments in June 2023, 20 million of which were face to face.

Meanwhile, a Pulse analysis earlier this year showed that practices that offered a higher proportion of appointments face to face had longer waiting times and a greater percentage of appointments with non GPs.



Please note, only GPs are permitted to add comments to articles

John Graham Munro 7 September, 2023 5:02 pm

Do articles like this leave anyone else ‘brain dead?’

Rogue 1 7 September, 2023 5:19 pm

Shock story – GPs know how to consult with their patients !

David Jarvis 7 September, 2023 5:46 pm

So all the guff about remote or face to face GP bashing and when they do some proper investigation it is not true. Any chance of an apology from NHS England do we think. Perhaps as policy makers appreciating how good a service you get and be more careful with it might be sensible.

David Church 7 September, 2023 6:20 pm

A number of patients are still requesting very inappropriate F2F appointments, increasing risk, but when I as the GP request to see the patient F2F to be more confident of reaching a diagnosis, a small number of them fail to attend – even if I am telling them over phone the appointment time for today, tomorrow, or next week.
Some may have fallen to unexpected occurrences, perhaps, but are some having second thoughts about the risk of coming into the surgery?
Some nearby GP staff had to take leave last week due to having Covid – reducing appointment availability;
but very few patients are wearing any PPE in the waiting room (not even on cool days!)
I think GPs are achieving far too high on the non-clinical government and media demands. This is NOT good ‘Clinical Governance’ – we are being ‘governed’ by soundbites and vote-winners, not by Clinical needs.

paul cundy 7 September, 2023 7:21 pm

Dear All,
OMG, revelation, revelation.
if you let those who know how best to bake bread,
to bake the bread,
and thence,
those who partake of that bread,
report that it is indeed good bread.

Thus acknowledged the soothsayers. But lo, did those soothsayers atop their ivory towers not conclude; why do we not let the bakers simply get on with it, for they appear to know how to deal with the demand for bread?
Lowly as I may be, a mere dough kneader, I ask do we not need the soothsayers?
Answers on a scroll, tablet, parchment, letter, telegram, letter or e-mail.
Paul C

David Jarvis 8 September, 2023 8:37 am

Soothsayers talk themselves out of a job in a puff of logic. Who’d have thought. We all know the opposite is true and bureaucrats are like a cancer that whenever there is a problem then doubling themselves is their solution whilst killing the host.

Truth Finder 8 September, 2023 10:11 am

Thank you NHSE. At least for once you are scientific in this and realize GPs actually know how to consult instead of listening to the dailywail scaremongering and causing GP surgeries to be attacked. I am glad corporate manslaughter charges are being brought in now so doctors are not put in dangerous unworkable environments.