The number of GP appointments over the phone or via video call have surged during lockdown, figures reveal, with the practice likely to continue after restrictions are fully lifted.
NHS figures reveal that 48% of GP appointments in May were carried out over the telephone, compared with 14% in February. Despite appointment numbers dropping during lockdown, from 25m in February to 17m in May, the figures suggest many GPs have turned to “telemedicine” to interact with patients.
Dr Richard Vautrey, the GP committee chair at the British Medical Association, said: “There has been a massive change from the vast majority of consultations in general practice taking place face to face, to now the vast majority taking place by telephone or increasingly by video consultation.”
Prof Martin Marshall, the chair of the Royal College of GPs, said data from the college showed that before lockdown about 25% of GP appointments were carried out remotely, with about 70% face-to-face. Since lockdown began the figures have been reversed.
“Coronavirus has been the watershed for video conferencing and video messaging each other,” said Dr James Gill, an honorary clinical lecturer at the University of Warwick and a locum GP. .
Vautrey said that while many practices had arrangements for telephone consultations before the coronavirus outbreak, video consultations were a different matter, noting bandwidth was often limited and the available systems were difficult to use.
He said: “Many practices had only just received systems literally months or two before the pandemic started that enabled them to actually utilise it in an integrated way with their record, and in a way that patients then found easy to use as well.” He said patients could now simply click on a text message and activate a video consultation on their smartphone.
A survey from the BMA suggests remote consultations could be here to stay. The questionnaire, from 1 June, found 95% of GP respondents were providing remote consultations, with 88% wanting greater use of remote consultations to continue in future.
Vautrey said the approach was more environmentally friendly and was often more convenient for patients, allowing them to access appointments at home or at work. He said, however, that physical examinations remained an important option both for clinicians and patients, while remote consultations could take longer than those in person.
Marshall said face-to-face appointments were sometimes necessary, including for physical examinations and interventions such as childhood vaccinations, while some patients preferred to see a doctor in person. Moving forward, he said, he envisaged a 50/50 split between remote and face-to-face appointments.
He said: “It is in no one’s interest for general practice to become a largely remote service as that will run the risk of isolating some patients, for example those with complex needs as well as our less tech-savvy patients and those who don’t have access to the appropriate tech – this in turn risks exacerbating health inequalities.”
But it is not only GPs who have welcomed the growth of remote services. The BMA survey by hospital doctors revealed 74% were in favour of a greater use of remote consultations continuing.
Prof Cliff Shearman, vice-president of the the Royal College of Surgeons of England, said that before Covid-19 remote consultations had been used, but not widely. They now play a significant role, which is likely to continue in the post-coronavirus era.
He said: “Nine out of 10 surgeons we recently surveyed had used telephone or video conferencing facilities to undertake patient consultations and outpatient clinics during the pandemic, helping to ensure that patients have only had to attend hospital when absolutely necessary.”.
Aneel Bhangu, a senior lecturer in surgery at the University of Birmingham and a consultant colorectal surgeon at University Hospitals Birmingham, said he had fully adapted to telephone and video, including 30-day post-operative follow-up and wound assessment. “The only face-to-face I do now is to tell people they have cancer,” he said. “This is 100% the future.”