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NHS England orders GPs to offer face-to-face appointments to all patients

by Costanza Pearce
14 May 2021

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NHS England has issued new guidance to practices which says GP patients must now be offered face-to-face appointments if that is their preference.

In a letter to practices published last night, NHS England said practices should ‘respect preferences’ for face-to-face care ‘unless there are good clinical reasons to the contrary’, such as the patient displaying Covid symptoms.

Practices must also open their reception areas to walk-in patients, although these should continue to be triaged ‘as they would be via phone or via an online consultation system’.

It comes as the RCGP this week warned against retaining the ‘total triage’ model of general practice beyond the Covid-19 pandemic, arguing that it may ‘exacerbate health inequalities’.

The new letter said that ‘GP practices must all ensure they are offering face-to-face appointments’ and that both patients and clinicians should ‘have a choice of consultation mode’.

It added: ‘While the expanded use of video, online and telephone consultations can be maintained where patients find benefit from them, this should be done alongside a clear offer of appointments in person.

‘Patients’ input into this choice should be sought and practices should respect preferences for face to face care unless there are good clinical reasons to the contrary, for example the presence of Covid symptoms.’

If conducting a remote consultation, GPs must be ‘confident that it will not have a negative impact on their ability to carry out the consultation effectively’, the letter said.

Meanwhile, NHS England said ‘all practice receptions should be open to patients’ to ensure no one is disadvantaged by a lack of digital access.

However, the letter said GP receptions ‘will not yet feel like they did pre-pandemic – for example where space is very constrained patients may be asked to queue outside’ and that social distancing and infection prevention and control guidance should still be followed.

It added: ‘Patients should be treated consistently regardless of mode of access. Ideally, a patient attending the practice reception should be triaged on the same basis as they would be via phone or via an online consultation system.’

Practices should also ‘engage’ with patients around access models and ‘actively adapt their processes as appropriate in response to feedback’, NHS England said.

It added that it is ‘asking CCGs to prioritise support to practices who are reporting very low levels of face to face appointments’.

An updated standard operating procedure will be published ‘shortly’ to replace previous guidance, as social distancing rules change from 17 May and services are ‘following and adapting accordingly’, the letter added.

But GP leaders have condemned the content and timing of the letter and urged NHS England to consider ‘retraction and apology to the profession’.

In an open letter to NHS England, chair of GP Survival Dr John Hughes said the grassroots organisation is concerned the announcement ‘appears to have been made as a result of a press campaign suggesting that surgeries are closed’.

He said: ‘We note that this guidance implies a kernel of truth to the allegations of closed surgeries and presume any implied support for these by Dr Kanani’s signature on this guidance to be an honest error. 

‘This guidance will not improve patient care, and indeed risks harm through increasing Covid transmission risk in surgeries (at a time when clusters of a new variant of concern appear to be on the rise this seems particularly risky) and reducing the GP workforce as a consequence of increasing an already extreme workload further.’

Dr Hughes added: ‘We further note that the new guidance was released without any consultation with the BMA, and that no such demands for hospitals to open up to patients on the basis of patient choice alone have been made.’

NHS England last month said that GPs should continue to triage patients remotely amid no plans for when the approach would end.

GP access previously caused controversy in the autumn amid suggestions that practices were not ‘open’ and ‘GP-bashing’ in the media.

In September, NHS England landed itself in hot water with a previous ‘reminder’ to practices to offer face-to-face consultations despite the ongoing pandemic and its own ‘total triage’ advice.

The health secretary has previously indicated that GPs should continue current levels of remote consulting after the pandemic.

This story first appeared on our sister title, Pulse.