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No f___ing appointments, but we can offer you an e-consultation



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It’s the receptionists I feel sorry for. But at least they have a new answer for those bug-eyed balls of fury swearily demanding, for their many and varied symptoms, ‘A f—- appointment’. Because they may not be able to offer a ‘f—- appointment’, but they can offer an ‘e-consultation’, which is close.

We know this because of the remarkable coincidence of two news stories, one of which seems to solve the other.

Thus, we discover that, in the last year, one in six GPs were so drowning in demand that they had to resort to stopping patients booking any more routine appointments. Plan B is presumably to take the phone off the hook, board up the door and pray.

But never fear. Because the second story points out that e-consulting will ride to the rescue, given that ‘online consultation systems’ resolve ‘Forty to sixty per cent’ of GP consultations without needing the patient to attend. So all of us – GPs, patients, receptionists – can sleep easier in our beds.

If NHS England can’t get their heads round this I suggest they phone their own 111 helpline

Or can we? Closer scrutiny of story 2, aka a glance at the comments section, reveals some possible flaws in the e-consultation approach, including;

1 This is NHS England saying this. Yes, the same NHS England that has a mandate to spend shedloads of GP Forward View cash on e-consulting, despite the lack of evidence of benefit.

2 If half of consultations are avoided, then half aren’t, meaning the patient has an e-consultation and then the real thing, too, which doesn’t sound like a system likely to reduce anyone’s workload anytime soon.

3 NHS England doesn’t seem to have grasped the simple fact that increasing heath access stimulates, rather than reduces, demand because it lowers the threshold at which people decide to seek help. If they can’t get their heads round this I suggest they phone their own 111 helpline, which will explain.

So it would be wonderful if NHS England could admit, just for once, that it is fiddling while Rome burns, and that the £45 million e-consultation slush-fund could be put to much better use – such as paying for a locum for each practice for a month to clear the appointment backlog. I worked that out on the back of an envelope which I could show them. But I’ll email it if they insist.

Dr Tony Copperfield is a jobbing GP in Essex