Letter: GPs respond to criticism about lack of face-to-face consultations

Dr Richard Vautrey, BMA GP committee chair, wrote in response to a letter from NHS England to GP practices telling them they must all offer face-to-face appointments.

We need to be very clear, GP practices have continued to see patients in person during the pandemic, but as with many other NHS services, the number of face-to-face appointments has understandably had to reduce to protect patients - particularly those at higher risk if exposed to such a potentially lethal virus – and to protect our staff.

In the face of social distancing and infection control restrictions, practices should be commended, not condemned, for providing more than half of their appointments face-to-face.

Even as restrictions ease, Covid is still circulating and new variants remain a concern, so to continue protecting patients, we have to limit how many can be in the surgery at any one time – something even NHS England note in its guidance.

Sometimes this means a surgery waiting room with space for 40 patients can now hold only six, affecting the number of patients that can be physically seen each day.

During the Covid pandemic, GPs have restricted patient consultations to the telephone or via video call (Image: PA Archive/PA Images)

So while the new guidance encourages face-to-face appointments to be offered if requested and where there is no clinical reason not to, NHS England must clarify exactly how practices will be expected to meet demand, and be clear with patients that this will mean waiting longer if they wish to see a doctor in person.

As Covid becomes less of a threat, phone and online consultations will continue to play an important role for many, but patients should also be reassured that face-to-face appointments will increase as it becomes safe to offer them and where local capacity allows.

The letter from NHS England is sadly completely tone deaf and rather than recognising the efforts GPs are making and the stress they are feeling as a result of the massive workload pressures they are currently experiencing, it has let them down and left them believing their efforts have gone unrecognised.

Most GPs chose family medicine because they recognise the benefit of longstanding relationships with patients and communities. They do not want to be call centre clinicians but do want to get back to seeing more of their patients face-to-face. But this cannot happen overnight and there must be honesty around the current state of play.

Practices in England are delivering more than a million appointments each day, as well as now beginning to manage the huge backlog of patients who did not receive the care they needed because of the pandemic.

This invisible waiting list is just as real as the record number of patients waiting for hospital treatment – many of whom will also return to their GP for ongoing care.

Add to this the Covid-19 vaccination programme, the fact we have nowhere near enough GPs and practice nurses, and that those we do have are exhausted. NHS England and the government owe practices a huge debt of gratitude, not a public rebuke for ultimately doing what they were instructed to do.

Crucially, practices require understanding, support and resourcing from government so that they can meet demand and are able to offer patients a choice in the ways they can get the care they need.