Health

GP consultations held over the phone are being falsely recorded as ‘face to face’

Even fewer face-to-face GP appointments are being held than feared because some phone consultations are wrongly being recorded as having taken place in-person, it emerged today. 

Officials have admitted the error, blaming it on the way appointments are booked. 

But the true extent of the issue is unknown, with a cloud of doubt now cast over the official statistics. 

Face-to-face appointments have still not returned to pre-Covid levels, despite family doctors being ordered to offer them to those who still want them. 

Statistics for England from NHS Digital show only 58 per cent of GP appointments in in August were held face-to-face. This is well below levels seen before the pandemic struck, when 80 per cent of consultations were carried out in-person.

But campaigners fear the actual figure has been ‘fiddled’, following the revelation that some appointments have been incorrectly classified in official data.  

The number of GP appointments taking place face-to-face dropped dramatically at the beginning of the pandemic, as virtual appointments were encouraged in an attempt to keep social mixing low and hospitals virus-free. In-person appointments began to increase last summer, before dropping again during the second wave. Despite being on the rise, the figures are still much lower than pre-pandemic levels

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP’s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP’s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

GP consultations held over the phone are being falsely recorded as 'face to face'

‘My wife would’ve been saved if the GP had come to our home’ 

A grieving husband today claimed his cancer-stricken wife would still be alive if a GP hadn’t refused to make a home visit.

Anton, a father-of-three from Bromley, begged a doctor to visit his 44-year-old wife who was in ‘severe pain’. But a nurse was sent instead, who only checked her pulse and temperature.

By the time his wife eventually made it to hospital, it was ‘too late’, he told LBC in a heartbreaking interview this morning. She died three months ago after her disease had spread to her brain.

Anton, who only gave his first name, said: ‘My wife would have been saved or treated much earlier if that doctor would have paid a home visit, which I was entitled to.’

Face-to-face and home visit appointments have still not returned to pre-Covid levels, despite doctors being ordered to offer them to those who still want them.

Just 0.6 per cent of appointments in August were home visits, down from one per cent before the Covid crisis. 

Senior doctors have long called for the visits — a cornerstone of general practice for decades — to be scrapped because they are time-consuming, even in the face of warnings from campaigners that it would be disastrous for the housebound, elderly and dying.

Anton said: ‘I lost my wife three months ago. 

‘She had cancer. Once she developed severe pain, I called my GP and I explained to the GP and, in fact, I begged them to pay a home visit and to advise me [whether] to take her to the cancer unit straight away or not.’

But Anton revealed the GP instead sent a rapid service nurse, and claimed they only took his wife’s pulse and temperature.

When his wife later collapsed, he took her to A&E.  

Tests revealed the cancer had spread to her brain. 

Details of the timeline were vague, and it is unclear how long it was between the visit from the nurse and her collapse. It is also unclear what type of cancer she had.

Anton added: ‘My wife would have been saved, or treated much earlier, if that doctor would have paid a home visit, which I was entitled to.

‘I checked on NHS England and it clearly said at that time doctors are supposed to make a home visit for the people who can’t come to the surgery.

‘But it’s not happening and even today, surgeries are only trialling by phone.’

 

In a caveat in its official data, NHS Digital explained that since the start of the Covid pandemic some GP appointments have classified some remote interactions as face-to-face.

It says: ‘From March 2020, face-to-face appointment mode data may not be entirely reflective of what happens in the practices.’

The body adds: ‘Appointment types have been assigned to appointment modes prior to the pandemic.

‘Thus, even if the appointment was carried out through a different mode, the appointment registers as a face to face appointment on the system.’

An NHS Digital spokesperson added: ‘We do acknowledge that there may be data quality issues with the data and instances where the data may not be a true representation of what may be happening in all practices.’

While starting in March 2020, some patients have also reporting this as happening recently. 

Anne Bedish, 68, told The Telegraph that after checking her patient record online she was surprised to learn all 12 of her telephone consultations had been classified as face-to-face. 

This included those held just one month ago, she told the newspaper.  

Silver Voices, a campaign group representing elderly Britons, called for the issue to investigated.

Its director Dennis Reed suggested the figures may have been massaged by GP practices under pressure. 

‘This needs to be investigated. How many of the figures have been fiddled in this way? It is really worrying,’ he said. 

‘I know that practices are under a lot of pressure to increase the number of patients getting a face-to-face appointment, and it worries me that we could see more and more of this.’

Questions over official data represents the latest blow to the trust between patients and GPs, following a string of reports of missed diagnoses due to a lack of face-to-face appointments.

Yesterday, a grieving husband claimed his cancer-stricken wife would still be alive if a GP hadn’t refused to make a home visit.

Anton, a father-of-three from Bromley, begged a doctor to visit his 44-year-old wife who was in ‘severe pain’. But a nurse was sent instead, who only checked her pulse and temperature.

By the time his wife eventually made it to hospital, it was ‘too late’, he told LBC in a heartbreaking interview yesterday. She died three months ago after her disease had spread to her brain. 

The widower’s comments came as fury erupted yesterday over other government-backed data showing that the average GP who earns around £100,000 a year — was working just 6.6 sessions each week before Covid.

The news prompted outrage and calls from campaigners for family doctors to work a minimum number of hours a week in return for their taxpayer-funded training. 

It can cost up to £230,000 to train up a doctor over the course of several years, but the Government makes some money back through student loan repayments. 

Reacting to the news Mr Reed told MailOnline: ‘If people are put through very expensive health training all that is partly provided for free, there should be an expectation that they will work a certain amount of hours.’

He blamed the drop in sessions for being one of the main reasons why patients are struggling to see their GP in the flesh. Other critics said it was ‘disgraceful’ doctors were earning six-figure salaries for working three-day weeks. 

Mr Reed was reacting to a report which showed the number of sessions the average GP works has dropped from 7.5 to 6.6 sessions per week in the last decade. 

And the number of hours doctors work for each week has dropped from 46.4 in 1998 to 40 in 2019, according to the National GP Worklife Survey of 1,332 GPs, carried out by the University of Manchester.

A doctor consults with a patient in April 2020, during the first Covid lockdown (stock image)

A doctor consults with a patient in April 2020, during the first Covid lockdown (stock image)

Just 0.6 per cent of appointments in August were home visits, down from one per cent before the Covid crisis. Doctors have long called for them to be scrapped because they are too time-consuming

Just 0.6 per cent of appointments in August were home visits, down from one per cent before the Covid crisis. Doctors have long called for them to be scrapped because they are too time-consuming

Meanwhile, practitioners’ salaries have increased dramatically, with the proportion of doctors earning less than £100,000 falling.

In 2010, just 2.6 per cent of GPs were making £170,000 or more — a larger sum than the Prime Minister — but 7.1 per cent were making that much by 2019.

And 5.9 per cent were making between £150,000 and £170,000 in 2019, compared to 3.3 per cent making the sum in 2010.   

The British Medical Association, the trade union for doctors, argued the notion of a ‘part-time GP is often anything but’. 

It said the average doctor still works 40 hours per work — just split into fewer sessions, and the current levels of workload were made worse by ‘piles of admin and bureaucracy’. 

It called for family doctors to be relieved of red tape, in a move it claims would allow them to devote more time to patients.

The BMA’s calls come after it was revealed GPs could be stripped of responsibilities to free up their time. Under plans being considered by ministers, pharmacists could also be given the power to dish out prescriptions.  

THE MAIL’S FIVE-POINT MANIFESTO FOR GPs

  1. A guarantee that face-to-face GP appointments are the default – and anyone who wants to see their family doctor in person should be able to do so
  2. The Government should act to ensure a greater proportion of GP appointments are ‘in person’ – providing incentives or penalties for local surgeries if necessary
  3. End of the postcode lottery so everyone has the same chance of seeing their doctor face to face
  4. Urgent action to ensure the Government delivers on its election promise to recruit 6,000 more GPs and provide 50million more appointments a year
  5. If necessary, pharmacists or nurses based at GP practices should receive extra training so they can ease burden on doctors and help with face-to-face cases

The Royal College of GPs has blamed rising a workload and falling numbers for the ‘tremendous pressure’ doctors are under. This has led to many burning out, working less than full-time or leaving the profession, it said.  

There is now just one practitioner for every 2,000 patients, with the rate having risen 5 per cent since 2015. In the worst-affected parts of England, the rate is nearly one in 3,000.   

Matthew Lesh, head of research at the Adam Smith Institute (ASI) thinktank, told MailOnline: ‘The NHS is systematically broken. 

‘Millions of people are on waiting lists, it can take weeks to see a GP and many are still unable to get a face-to-face appointment. 

‘Now we discover that GPs, who earn six figure salaries, were working just three days a week on average before the pandemic. This is simply disgraceful. 

‘We urgently need to reassess the structure of the NHS and GPs to ensure it delivers for patients.

‘The top-down, bureaucratic nature is letting far too many people down. 

‘It may be time to move from a bulk payment per patient to a per appointment funding structure, to encourage doctors to actually see patients as quickly as possible. 

‘It may be time to allow for co-payments, so patients can pay small amounts to see a doctor faster.’ 

GP practices are currently paid by NHS England on the basis of how many patients they have registered.

John O’Connell, head of campaign group TaxPayers’ Alliance said: ‘Taxpayers expect a certain standard of care, given the huge amount they pay for the NHS.

‘Health professionals should ensure that all patients get the level of service they need.’ 

And Tory MP Peter Bone told MailOnline there were a ‘small number’ of GPs that were ‘to some extent using Covid as an excuse’ not to provide face-to-face appointments.   

Boris Johnson and his ministers promised in May to ensure face-to-face appointments were offered to all. 

But the Royal College of General Practitioners warned MPs this would be an empty promise if there was still too little capacity. 

The Daily Mail has been campaigning for in-person GP appointments to be the default option

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