GPs in Herts Valley delivering more face-to-face appointments

GPs in Herts Valley delivered a higher rate of face-to-face appointments last month, figures show, after they fell to below 55,000 in April.

NHS England has written to all GPs practices to make sure they are communicating the fact doctors can be seen in person, face-to-face if necessary, as well as virtually.

The JPI Data Team has combined the most recent monthly published data on the face-to-face appointments offered by GPs in 2020 so far to quantify what has happened to face-to-face care since lockdown began.

Their analysis shows in no CCG area in England, are GPs offering the same percentage of face-to-face appointments as pre-lockdown – the latest July 2020 figures all show the percentage of face-to-face appointments was down on the percentages recorded in January 2020 before lockdown began.

The NHS Herts Valley CCG - which serves residents in Dacorum, St Albans, Harpenden, Watford, Three Rivers and Hertsmere - there were 208,179 face-to-face appointments in January 2020 but that fell to 96,081 in July 2020.

NHS Digital data shows patients booked 187,696 appointments with practices in the NHS Herts Valley CCG area in August – 47 per cent of which involved a face-to-face meeting. This was up slightly from ​46 per cent in July.

Nationally, there were 21.7m face-to-face appointments in January 2020 but that fell to 11.2m in July 2020.

It is not the case that face-to-face appointments have kept dropping every month in every CCG area since the start of lockdown.

It has started to pick up again in July despite the number of all types of appointments having fallen since the height of lockdown.

Across the 115 CCGs in England for which we have the full seven months of data, the number of face-to-face appointments has fallen by an average of 50 per cent.

Face-to-face appointments at NHS Herts Valley CCG has fallen from 81.2 per cent in January to 45.9 per cent in July.

In April, face to face appointments fell to 54,612, they slowly began to rise in May to 58,824, and they have been increasing every month since. In July there were 96,081 face-to-face appointments.

A spokesperson for NHS Herts Valley CCG said: “GP surgeries have been open and working hard throughout the pandemic, but they have switched to phone and video consultations to keep patients and staff safe.

"Patients are provided with face to face appointments where needed – with the appropriate infection control measures in place.

“Over the summer the number of face-to-face appointments has increased by around 90 per cent compared to April and appointments overall have increased by around 15 per cent.

"Many patients have welcomed the convenience of the new phone and video consultations and we would want to continue to offer those as an alternative to face-to-face appointments where appropriate.

"It is particularly important for patients to contact their GP practice if they have cancer-like symptoms.”

Across England, the average proportion of face-to-face appointments being carried out in July was 50.1 per cent across those CCGs. Back in January the average was 81.4 per cent.

Professor Martin Marshall, chairman of the Royal College of GPs and whose own GP surgery is in Newham, east London, said: “That letter [from NHS England reminded GPs practices to offer face-to-face appointments] caused a mixture of bemusement and anger from GPs

“Anger because it was insinuating that GPs weren’t doing what they should be - that they were shirking their work somehow. And bemusement because the guidance was so contradictory.

“It has been very clear throughout that if someone needs to be seen face-to-face, for things such as a blood test, then they need to be seen. That is a clinical decision.

“But the advice was that consultation should be done remotely with remote triages at the front end. Now that guidance appears to be changing.

“To suggest that GPs should open up their doors on the basis that a small number of patients are unhappy that they can’t see their GP just seems frankly silly to me.

“The number of face-to-face contacts has gone up. At the peak of the pandemic our own figures show about one-in-ten appointments were face-to-face, now it is about one-in-three and I think that is about right.

“It’s all about infection control. Even then the patient is wearing a mask and the GP is wearing PPE - there is a risk patients will spread infection, certainly in the waiting room.

"No matter how much we try and socially distance people, if people are coughing and spluttering in the waiting room there is a risk in both directions as clinicians can give it to patients."

An NHS England spokesperson said: "It's entirely right that more GP appointments are now available by phone and online, and that is completely consistent with also saying that there still needs to be options of face to face appointments - which these figures confirm are available everywhere."