To see the GP or not to see the GP — at the moment that’s not really a question.
While doctors are offering telephone and video consultations, as the Mail’s campaign, Let’s See GPs Face To Face, has highlighted, the number of face-to-face consultations has plummeted over the past year.
The latest figures suggest that, on average, little over half of appointments in England are in person now, compared to eight in ten before the pandemic.
Previously there were about six million appointments at GP surgeries every week — that number fell to three million in the first lockdown and is now back to six million. But many of these are not in person.
Currently, patients don’t have a legal right to ‘timely’ face-to-face GP appointments, which some campaigners now say is needed.
While doctors are offering telephone and video consultations, as the Mail’s campaign, Let’s See GPs Face To Face, has highlighted, the number of face-to-face consultations has plummeted over the past year
The Mail is calling for a guarantee that face-to-face appointments are the default (this contrasts with what the then Health Secretary Matt Hancock proposed in July last year, when he suggested that all GP appointments should be done remotely by default — which was quickly shot down by the doctors’ groups).
The Royal College of GPs (RCGP) says that face-to-face consulting ‘is an essential element’ of general practice and remote consulting should be an option but not the ‘automatic default’ for GP services.
In a statement released earlier this year it said: ‘Once we get out of the pandemic and things return to a more normal way of living and working, we don’t want to see general practice become a totally, or even mostly, remote service.’
There is a much publicised shortage of GPs, and clearly with fewer in-person appointments available, it is best to leave those slots that are there for those who really need them.
But if you feel your health concern or personal situation warrants it, how do you go about maximising your chance of getting an appointment?
How to get a face-to-face slot
This is what the NHS says currently about getting a GP appointment. You can contact your GP surgery by:
- Visiting its website.
- Using the NHS App.
- Calling them.
If you do call, the general view is that Monday mornings are the busiest part of the week for GPs so are not the best time to call.
But if you have serious concerns about your health, don’t delay calling the surgery just because you think it might be busy.
Statistics suggest that Tuesdays, Wednesdays and Thursdays are traditionally the quietest days (while Mondays tend to be busy because patients put off problems until after the weekend, Fridays are also busy because people worry they won’t get through the weekend). If your call is not urgent, then make it mid-morning when call volumes are reduced.
Previously there were about six million appointments at GP surgeries every week — that number fell to three million in the first lockdown and is now back to six million. But many of these are not in person
Talking to the GP receptionist
Receptionists are the GP gatekeepers, and whatever you might think of the process, they are there to triage patients. The sheer volume of numbers wanting to see a doctor can sometimes make the relationship with patients fraught at the best of times, only exacerbated by the demands of the pandemic.
Be prepared for the fact that you might have to wait some time before your call is answered.
‘When people aren’t well, it’s not the best time for them obviously, but aggression really doesn’t help — we are all working under immense pressure,’ says Myra Upton, president of the Association of Medical Secretaries, Practice Managers, Administrators and Receptionists.
One GP trainer we spoke to recently said a practice he’d been at had received 800 calls in one day, with 50 people in the queue at one point, some waiting up to two hours to get through.
‘That was for an appointment that has already gone, or for a service which they could probably have accessed via an app or the pharmacy,’ he said.
That’s why you need to ask: do you really need to see the GP face-to-face?
When to push to see the GP
There are certain instances when a patient should, ideally, see a GP in person, Dr Clare Gerada, a GP in south London and former chair of the RCGP recently told Good Health. If the any of the following scenarios apply to you, then you may want to spell it out when you call the surgery.
- If you have sought help more than three times for a condition that has not improved, such as severe skin rashes and a temperature in children under one.
- If you have a urinary tract infection that is not responding to treatment.
- If you have something for which a physical examination is needed, such as a suspicious breast lump or testicular lump, then a face-to-face appointment is also advised, according to Kefah Mokbel, a consultant breast surgeon at the Princess Grace Hospital in London.
One GP trainer we spoke to recently said a practice he’d been at had received 800 calls in one day, with 50 people in the queue at one point, some waiting up to two hours to get through
…And when you don’t need to, can anyone else assist?
There are certain circumstances when you can seek help from healthcare practitioners other than a GP. For example:
- Repeat prescriptions — medication reviews can be done by your pharmacist.
- Long-term blood pressure checks — this can be done by the practice nurse or at a pharmacy.
- To discuss follow-up test results.
Getting help for another person
What if you are concerned about an elderly neighbour who can’t manage a remote consultation? Can you offer to help?
You can collect a paper prescription from a GP for a friend or relative if that person has told the GP practice that this is OK. Some surgeries may ask for proof of your identity.
If an elderly or vulnerable person has given their consent, according to the NHS you can also speak about their health with their GP — be that on the phone or face-to‑face.
If you don’t have their consent, you can still raise concerns about a friend or relative’s health to flag these up. But the GP won’t be able to discuss any details.
Who can you complain to?
You don’t have the right to face-to-face GP consultations.
In the Handbook to the NHS Constitution for England (the latter sets out the principles of the NHS), it states you have the ‘right to receive care and treatment that is appropriate to you, meets your needs and reflects your preferences . . . This right reflects the fundamental standard about person-centred care.
‘The purpose of the ‘person-centred care’ fundamental standard is to ensure that providers of health and adult social care services plan and provide patient care and treatment that is appropriate, meets their needs and reflecting their preferences.’
If you are unhappy about the service provided by the practice, you can talk to the practice manager at your surgery. Each surgery will have an established complaints procedure to follow.
If you are really unhappy, you do have the right to change GP at any time you wish without having to give a reason. This involves telling your local Clinical Commissioning Group (CCG) that you want to change your GP.
They must give you details of how to do so and provide you with a list of alternative GPs, according to Citizen’s Advice.
But then you would have to find a GP practice that offers more face-to-face consultations.
For patients having difficulty getting a face-to-face appointment, the Patients Association recommends the following:
- Contacting your Clinical commissioning group (CCGs are responsible for deciding what health services are needed in your area) via NHS.uk.
- Ringing 111 for medical advice.Contacting the Care Quality Commission, which regulates all health services in England.