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The new normal for GPs: Just half of appointments will be face-to-face post-pandemic

Face-to-face appointments with family doctors will never return to their pre-pandemic levels, Britain’s top GP Professor Martin Marshall has warned

Face-to-face appointments with family doctors will never return to their pre-pandemic levels, Britain’s top GP has warned.

Only around half of GP appointments are now in person – with the remainder via telephone or video services such as Skype.

Prior to Covid, most appointments were face-to-face. Many patients, particularly the elderly, are thought to be uncomfortable with phone and video arrangements.

Experts, meanwhile, have warned that symptoms can be missed if patients are not seen in person.

But Professor Martin Marshall, the chairman of the Royal College of GPs, told the Mail that ‘remote’ consultations with GPs were ‘here to stay’.

He said that despite the concerns of many, a 50-50 split between face-to-face and remote appointments was ‘about right’ and that the pre-pandemic approach would never return. 

He suggested patients would ‘get used to it’ in the same way they have got used to online banking.

Professor Marshall also predicted that waiting times for any type of consultations would grow even longer thanks to a post-lockdown surge in demand.

Before the first lockdown in March last year, as many as 80 per cent of GP appointments were face-to-face.

In April last year, that fell to just 10 per cent. It has since risen to 55 per cent – and Professor Marshall said this was unlikely to increase. 

‘Although I know some patients are very uncomfortable about the loss of face-to-face, we need to remember that remote care is here to stay because it is more convenient and it does have a number of advantages,’ he said.

Face-to-face appointments with family doctors will never return to their pre-pandemic levels, Britain’s top GP has warned. Only around half of GP appointments are now in person – with the remainder via telephone or video services such as Skype (stock image)

Face-to-face appointments with family doctors will never return to their pre-pandemic levels, Britain’s top GP has warned. Only around half of GP appointments are now in person – with the remainder via telephone or video services such as Skype (stock image)

Asked what the ratio would be, he replied: ‘I have said in the past 50-50 is about right. But that’s a finger in the air.’ 

He continued: ‘Practices want to embrace technology. There’s some really exciting things we can do with technology and I don’t think it will go back.’

Professor Marshall said he accepted, however, that remote or virtual consultations should ‘certainly not’ be the default and that face-to-face appointments were still crucial.

‘Our view is that face-to-face care is a fundamental part of our ability to provide good care for our patients,’ he said.

‘It isn’t just about being able to examine somebody, it’s about being in the same room and being able to pick up the soft signs, maybe being dishevelled, maybe smelling of alcohol.

‘Those soft signs allow you to make a good diagnosis and be able to help the patient as much as possible. A lot of GPs are… saying they don’t want to be part of a speciality which is largely remote.’

In May, NHS England sent a letter to GP practices stating patients must be offered face-to-face appointments if they demand them. 

But the move triggered a row with family doctors who were concerned this would increase Covid transmission in surgeries, at a time when infections were already on the rise.

Last night, Rachel Power, head of the Patients Association, said most people preferred a face-to-face approach. 

She said: ‘Phone consultations, and to a lesser extent online appointments, have become more common, and some patients like and will prefer them in future.

‘But patients have made clear to us that most commonly they prefer to see their GP in person.’

Professor Marshall said waiting lists are expected to grow as rising numbers of patients are seeking help for issues they have ‘sat on’ for a year – such as chronic pain or deafness – or for conditions that have worsened while they waited for hospital treatment. 

Doctors are also seeing more long Covid patients and those with mental health conditions triggered or exacerbated by the pandemic.

‘In terms of waiting to see a GP – particularly a GP of your choosing, and most patients would like to see someone that they know and trust – that is going to get worse,’ Professor Marshall said.

‘GPs try really hard to ensure patients receive as good care as possible, but it might well be less accessible and that’s a worry and a real concern.’ 

In May, NHS England sent a letter to GP practices stating patients must be offered face-to-face appointments if they demand them (pictured, a woman waits for an appointment)

In May, NHS England sent a letter to GP practices stating patients must be offered face-to-face appointments if they demand them (pictured, a woman waits for an appointment)

His college is also concerned that plans to offer booster jabs to all over-50s this autumn, as outlined by government scientists this week, could further increase GP workload and reduce their availability for appointments.

Professor Marshall, who practises at a surgery in Newham, east London, also predicted that up to a third of family doctors would leave the profession within the next five years, further intensifying the pressures.

A recent survey by the college involving 1,250 of its GP members found that 34 per cent expected to leave or retire within the next five years, including 15 per cent who planned to do so within the next two years.

‘That’s a real worry,’ he said. ‘We’re seeing a significant and worsening crisis in general practice and it’s going to get worse if people are leaving, if they’re off sick or they’re retiring. There’s a real risk of thing will spiral.’ 

Imelda Redmond CBE, national director at Healthwatch England, the patient champion organisation, said: ‘We acknowledge there are significant long-term workload and workforce pressures… however, we are still hearing from thousands of people who are struggling to access the care they need.

‘Among those affected are often the most vulnerable in our society: older people, disabled people, people on low incomes and those whose first language isn’t English.’

An NHS spokesman said: ‘Face-to-face appointments are available for those that need them, as are virtual consultations, which can offer a more convenient way for patients to see their GP team, so as has been the case throughout the pandemic. Please come forward for care when you need it.’ 


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