Petition Create a legal right for patients to receive timely face-to-face GP appointments
There are reports of some GP practices refusing requests for face-to-face appointments from patients, despite guidance stating patient preference should be respected unless they are considered a covid-19 infection risk. Government should legislate if necessary to put this fundamental right in law.
The pressures of the pandemic should not be used to introduce a major permanent change to GP services. Without the physical proximity to a doctor, some conditions may not be diagnosed through remote consultations alone. Older patients, in particular, may be uncomfortable with, or ill-equipped for, video or telephone consultations and be unable to describe their symptoms correctly. In a survey of Silver Voices members, over 70% reported difficulty this year in seeing a doctor.
This response was given on 30 July 2021
Practices are expected to offer both remote and face to face appointments taking into account clinical appropriateness and patient preference for appointment type.
General practice teams have remained open and offering face to face appointments throughout the pandemic and we are incredibly grateful for their tireless and continuing efforts and all they have done to support their patients, including their vital role in delivering the national vaccination programme since December 2020.
General practice teams are busy, working hard to meet high and rising demand for services as restrictions ease. In June 2021 there were an estimated 31.1 million appointments in general practice, including Covid-19 vaccinations delivered by general practice. This is 30.1% more than June 2019 (23.8 million). There has been a strong recovery in appointment numbers from a low point in April 2020 at the start of the Covid-19 pandemic, where appointments per working day were 0.83 million rising to 1.22 million in June 2021 (excluding GP delivered Covid-19 vaccination appointments), over half of which were face to face (56.3%).
In response to the pandemic, general practice teams rapidly changed how they provide support and deliver services to their populations, with a focus on triage and remote (telephone, video and online) consultations. This enabled practices to see as many patients as possible, while minimising risk of infection from Covid-19. Remote consultations provided alongside face to face appointments, provides extra flexibility and convenience for patients to access general practice services.
NHSEI estimate that 95% of practices now have online consultation capability and 99% have video consultation capability, prior to the pandemic data from the General Practice Forward View (GPFV) Monitoring Survey estimated that 42% of practices had online consultation capabilities and 3% had video consultation capability.
We understand that some patients have concerns about accessing general practice services, including getting through on the telephone and with the availability of face to face appointments. NHSEI has throughout the pandemic provided guidance to general practice and on 19 July, following the Government’s announcement of a move to Step 4 of its Covid-19 response, NHSEI wrote to general practices, to outline the expectations across primary care in relation to access, infection prevention and control and continuing contractual/regulatory requirements. The letter reiterated that general practice contractors should continue to offer a blended approach of face-to-face and remote appointments, with digital triage where possible. We know that remote consultation, telemedicine and online access can provide flexibility for patients accessing services and that many people find online consultations more convenient and accessible.
To help expand general practice capacity and to ensure general practice can continue to provide the necessary care for all patients during this busy time, we have made available an additional £270 million funding from November 2020 until September 2021.
We are training more GPs than ever before, with the highest ever number of doctors accepting a place on GP training in England in 2020 – 3,793, against a target of 3,500, and a commitment to increase the number of training places to 4,000 in 2021. However, there is a finite number of GPs in the general practice workforce and that is why we increasing the number of other direct patient care staff in general practice by 26,000 to ensure that patients can access the right service, with the right member of the primary care team, which may or may not be a GP, at the right time.
NHSEI leads a programme of work to support practices use of digital and online tools to widen access to general practice services. The Department, NHSEI and NHSX maintain an open dialogue with GP representative professional bodies, Voluntary, Community and Social Enterprise organisations, and patient organisations to understand access issues and how to better support the safe and effective use for staff and patients of remote consultations in general practice. NHSEI have an independent evaluation underway to understand the impact for staff, patients and the wider health and care system of using digital tools in primary care, including the effectiveness of online consultation systems and triage in general practice. The NHSEI Access Improvement Programme is supporting practices whose patients are experiencing the greatest access challenges, such as drops in appointment provision, long waiting times, poor patient experience or difficulties in embedding new ways of working relating to Covid-19, such as remote consultations as part of total triage.
Department of Health and Social Care
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Petitions Committee requests a revised response from the Government
The Petitions Committee (the group of MPs who oversee the petitions system) have considered the Government’s response to this petition. They felt that the response did not directly address the request of petition and have therefore written back to the Government to ask them to provide a revised response.
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