NHS tells GPs to replace face-to-face with remote consultations

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Millions of patients in the UK will have face-to-face appointments with their general practitioner (GP) replaced by telephone or video consultations under National Health Service (NHS) plans to respond to the threat posed by the coronavirus.

The Guardian reports that in a significant policy change, NHS bosses want England’s 7,000 GP surgeries to start conducting as many remote consultations as soon as possible, replacing patient visits with phone, video, online or text contact.

They want to reduce the risk of someone infected with COVID-19 turning up at a surgery and free GPs to deal with the extra workload created by the virus. In a pre-emptive move some surgeries, especially in London, have already begun texting patients to tell them not to come in for pre-booked appointments from Monday and that appointments will be conducted by phone instead.

The report says the approach could affect many of the 340m appointments a year with GPs and other practice staff, only 1% of which are currently carried out by video, such as Skype. The change could last for several months as experts believe the virus may not peak until April or May, and could last until June or July.

The move is likely to prove controversial because it will mean that many patients are unable to have a physical examination as part of their consultation, risking some symptoms going undetected. According to the report, the Royal College of GPs made clear that patients who still want to see a GP should be able to do so.

NHS England has started asking health technology firms such as PushDoctor, Babylon, Docly and Visiba to help surgeries put in place the equipment needed for a massive expansion in remote consultations.

Also in the UK, final year medical students could be drafted in to work in hospitals and first year doctors have their responsibilities extended if the NHS comes under severe pressure from increasing coronavirus cases, the chief medical officer has said. Professor Chris Whitty told MPs these measures would be considered in addition to the emergency re-registration of recently retried doctors if NHS hospitals are overwhelmed with new coronavirus cases.

Whitty told the Health and Social Care Committee: “One of the things which is clear, if you model out the epidemic, is (that) we will get 50% of all the cases over a three-week period and 95% of the cases over a nine-week period if it follows a trajectory we think it’s likely to.”

Active coronavirus cases are decreasing rapidly in China, but there is a “slim to zero” chance that the global spread of the virus will be slowed and the number of community-transmitted coronavirus cases in the UK is likely to go up, Whitty said.

Coronavirus has been declared as a national incident by NHS England.

The UK’s emphasis should be on delaying the spread of the virus he said, as there will be no available vaccine for the coronavirus for at least a year, Whitty told MPs. He said he was confident that a large number of recent retired doctors would be willing to go back to work to help with coronavirus cases if needed, but added the NHS would only be contacting those who had retired in the last two to three years.

“Doctors go into medicine for a reason, if there was a crisis and they thought they could help, I’m confident we’d get a lot of volunteers”, he said. Whitty added that there would be a “long period between knowing we have an epidemic and its peak,” and that the government would not intervene by taking such measures as closing schools until it absolutely has to.

Meanwhile, figures published today by NHS England laid bare the pressure being placed on the NHS 111 service, which has not been able to keep up with the unprecedented demand. The number of times people dialled 111 in the week ending 1 March was 442,675, an increase of 79,000 on the previous seven-day period. However, it had only managed to answer 340,702 calls, a rise of 22,000.

Full report in The Guardian

HSJ material

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