GPs urge caution over health secretary's push for 'all' consultations to be remote

GPs have accused the health secretary of failing to understand ‘the importance of human contact’ after he used a major speech to say that all future GP consultations should be carried out remotely unless there is ‘a compelling clinical reason' not to.

Remote consultations (Photo: andresr/Getty Images)
Remote consultations (Photo: andresr/Getty Images)

Delivering a speech on the ‘future of healthcare’, Matt Hancock said the government wanted to ‘double down’ on the huge advances the NHS had made with technology during the COVID-19 pandemic.

He revealed that 71% of routine GP consultations in the four weeks leading up to 12 April were delivered remotely - representing a huge swing from just 25% for the same period a year ago.

However, GPs called for caution over a blanket approach to appointments, with some arguing remote consultations increased stress levels for both patients and doctors.

Remote consultations

Mr Hancock said: ‘Before coronavirus there was a view advanced by some people which held that anyone over the age of 25 simply could not cope with anything other than a face-to face-appointment.

‘This process has shown that patients and clinicians alike, not just the young who want to use technology. [People] don't want to sit around in a waiting room, if that service can come to them at home.

‘So from now on, all consultations should be teleconsultations, unless there's a compelling clinical reason not to.

He continued: 'Of course, if there's an emergency the NHS will be ready and waiting to see you in person. But if they are able to patients should get in contact first by the web, or by calling in advance.

Mr Hancock added that a remote first approach would make care ‘easier to manage’ and meant the NHS could deliver ‘a much better service’. He also said the move would ‘free up clinicians to concentrate on what really matters’, in addition to making life quicker and easier for patients.

Remote consulting had benefited doctors practising in rural areas of the country, who were saving on ‘long travel times’, Mr Hancock added.

Human touch

However, GPs have warned that scrapping face-to-face appointments could take the human touch out of general practice.

Surrey Hills GP Dr Dave Triska, said: ‘That is a message from a human being who truly doesn’t understand the power or importance of human contact.

‘There is more to medicine than diagnosis, and there is more to empathy and compassion than a telephone or computer screen. Often they are enough but he has clearly not grasped the breadth of our practice.’

Oxfordshire GP Dr Helen Miles also questioned the health secretary’s suggestion, she said on Twitter: ‘[We] rapidly need more research into the impact of this on health outcomes, staff wellbeing and retention.

‘I think we are already seeing stress levels rise in both patients and GPs with current massively increased levels of remote consulting.’

Face-to-face vital part of general practice

BMA GP committee chair Dr Richard Vautrey said GPs had to continue to use remote consultations where appropriate, but expressed caution over a remote first approach.

He said: ‘If doctors are given access to the right technology, they will embrace it. However, his suggestion that all appointments going forward will be remote by default must be approached with caution.

‘Physical appointments will always be a vital part of general practice, and they continue to be necessary for many patients and the management of specific conditions, and we must not lose sight of that.’

RCGP chair Professor Martin Marshall, said: 'While there is a compelling case to retain some aspects of the different ways we’ve been working, we certainly do not want to see general practice become a totally remote service.

'A totally, or even predominantly, remote general practice service wouldn’t be in anybody’s best interests long-term, and throughout the pandemic face to face appointments have been facilitated when they’ve been necessary.'

GPonline reported earlier this month that face-to-face GP consultations had risen 70% compared with the early stages of lockdown. GPs delivered 144.2 consultations face-to-face per 10,000 patients in the week beginning 29 June, RCGP surveillance data show.

A GPonline poll also revealed that most GPs think more than half of consultations should continue to be delivered remotely after the pandemic subsides. But the research showed there were still concerns about the limits of remote consulting, the potential harm to relationships with patients and the danger of missing serious conditions.

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