The Real Reason Why Your GP Surgery Still Isn't Seeing Patients Face To Face

A new league table 'names and shames' surgeries, but doctors say it's not that simple.
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When the pandemic hit, GP surgeries across the country moved to telephone appointments where possible. But why, with everything else reopened, are some still operating remotely?

A new online league table “names and shames” GP practices over the number of appointments they offer and how many are face-to-face.

The league table, available via the NHS Digital website from Thursday, sets out how many appointments each practice in England is delivering and the length of time it takes to be seen.

The data reveals that just 12% of appointments are face-to-face at the lowest ranking trusts.

The government claims the statistics will help patients make “more informed choices” about the practice they choose.

But doctors have told HuffPost UK the system doesn’t tell the whole story behind why some practices are still semi-remote.

Dr Hannah Barham-Brown, a trainee GP based in Selby, points out that some patients actually prefer phone appointments – something that the new league tables do not factor in.

“For many of our patients who may have challenging shift patterns, caring responsibilities or disabilities, phone appointments are preferable as they save an often unnecessary trip into the surgery. Some of my patients with mental health conditions prefer not to come in, knowing they may have to sit in the waiting room for a while if we’re dealing with an emergency, or find it easier to talk on the phone than face to face,” she tells HuffPost UK.

“We have a lot of patients who when given the option, actively choose a phone consultation rather than taking on both the time and financial costs of travelling to an appointment, and it doesn’t need to be an either/or arrangement – if I speak to someone on the phone and feel that I do need to physically examine them, we generally still have the option to bring them in to do so. Overall many people find it more convenient.”

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There may be readers who have struggled to get an appointment at all – telephone or in-person. And we get it, it’s incredibly frustrating and in some cases, frightening when you have a serious health concern.

But an article published by the British Medical Association (BMA) last year highlighted how GPs are increasingly shouldering the blame for an “understaffed and under-invested-in NHS” with claims that GPs are “refusing to see patients” commonplace in the media.

In reality, there’s currently a shortage of around 4,200 full-time equivalent (FTE) GPs across England alone, with concerns this will only increase without intervention.

The are fewer GPs providing care for more patients compared to five years ago, and those in the industry say this is the primary reason why appointments are scarce – it’s not for want of trying.

Yet GPs are facing the brunt of abuse. A BMA survey of more than 2,400 doctors in England, Wales and Northern Ireland carried out in July 2021 found that 46% of GPs had experienced one to five incidents of verbal abuse, while roughly one-in-five (19%) had received threats, in the previous month.

Within the same survey, 67% of GPs said that they had witnessed violence or abuse directed at other staff in their workplace in the past year, while 37% said that the instances of threatening behaviour, violence or verbal abuse they experienced had increased significantly on the same period 12 months ago.

The Royal College of GPs has now raised “serious concerns” about how the latest data will be used to compare practices and how this may demoralise the dwindling GP workforce further.

“What works in one practice may not in another, so they will tailor their services to their patient population,” Professor Kamila Hawthorne, chair of the RCGPs said.

“We worry that this data will be used to create arbitrary ‘league tables’ that don’t account for different patient demographics and ways of working and those that appear at the bottom will face undue criticism at a time when the profession is already demoralised and working under intense pressures,” she added.

“We also understand that the data published on Thursday will be experimental, so it’s unclear how comprehensive or useful it will be.”

Commenting on the launch of the new system, Health and Social Care Secretary Steve Barclay said: “We promised to prioritise patients and improve access and that is exactly what we have done – and this is just the start.

“I am determined to make it easier for people to get an appointment with their GP practice when they need one and this will allow patients to make a more informed choice about the care they receive.”

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