Backlash to UK call for GP's to have virtual consultations only

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UK Health Secretary Matt Hancock is facing a backlash from patient and medical groups after declaring that all consultations should be conducted virtually unless there was a “compelling clinical reason not to”, reports The Daily Telegraph. The Health Secretary hailed a new era of “Zoom medicine” in which face-to-face meetings with doctors will be replaced by video link or phone.

Pointing to the operational changes introduced during the coronavirus pandemic, Hancock said there was a need for “bureaucracy-busting” in the National Health Service (NHS), with virtual consultations freeing up doctors’ time for those most in need. He added that while there would always be a system for people who could not “log on”, it would be wrong to “patronise older people by saying they don’t do tech.”

However, Rachel Power, the CEO of the Patients Association, claimed that moving consultations online “by default appears to be based on no evidence whatsoever of what works for patients. Patients have put up with a great deal over recent months to help the NHS cope with an unprecedented emergency – often at considerable cost to their own health and wellbeing. This cannot be allowed to become the new normal,” she continued.

There are also concerns that a shift to online will disproportionately impact elderly patients with limited access to technology, as well as reducing the chances of spotting the early signs of disease or illness compared with physical consultations.

Dr Richard Vautrey, chair of the British Medical Association’s GP committee, said that while the union had long argued for greater use of technology, the “suggestion that all appointments going forward will be remote by default must be approached with caution.” He added: “Physical appointments will always be a vital part of general practice, and they continue to be necessary for many patients and the management of specific conditions, and we must not lose sight of that.”

“While there is much in this vision that chimes with what the BMA has been calling for on behalf of doctors, there are still areas that need serious consideration. So although we want all doctors to have access to up-to-date IT that allows them to offer online and tele-video appointments where appropriate, the suggestion that ‘all consultations should be teleconsultations’, with every patient interaction essentially being screened first, is too rigid and likely to create barriers for many, with a detrimental impact on their care.”

BMA's Dr Chaand Nagpaul, the BMA council chair, said in a statement:

The report says echoing their concerns, Edel Harris, CEO of the charity Mencap, said the shift could “seriously exacerbate the health inequalities that already exist for people with a learning disability. The UK's 1.5m people with a learning disability should be offered face-to-face consultations automatically – without needing to ask for them.”

However, in his address to the Royal College of Physicians, Hancock said there had been dramatic changes to how the NHS works as a result of the COVID-19 pandemic and it could not be allowed to “fall back into bad old habits.” “The crisis has shown that patients and clinicians alike, not just the young, want to use technology,” he added. “The feedback from this transformation has been hugely positive. So, from now on, all consultations should be tele-consultations unless there's a compelling clinical reason not to,” he added.

"Of course, if there is an emergency, the NHS will be waiting and ready to see you in person just as it always has been. But if they are able to, patients should get in contact first via the web or by calling in advance. That way care is easier to manage and the NHS can deliver a much better service. Not only will it make life quicker and easier for patients but free up clinicians to concentrate on what really matters."

The RCP said in a statement: “The RCP has been at the forefront of arguing for using technology to transform the way in which services are provided, for the benefit of patients and the environment, but the government and the NHS must make sure that they bring everyone with them on this journey. In a recent survey, 50% of our members told us that they didn’t have access to a webcam.

 

Full The Daily Telegraph report (Subscription or registration)

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