RCGP survey provides snapshot of how GP care is accessed in latest stages of pandemic
Publication date: 30 July 2020
Remote consultations can provide both benefits and challenges for patients and GPs and while convenient and efficient for many, ‘won’t be suitable or preferable for everyone’ the Royal College of GPs has said today as it releases the results of a survey of its members.
The College says that general practice has undergone a ‘technological revolution’ during the COVID-19 pandemic and that there are lessons to be learnt from the new ways GPs and their teams have been working – but that post-pandemic it is vital patients are able to access GP services in ways that meet their health needs and preferences.
Its survey of 829 GPs across the UK, which looked at access to general practice services, found that between 9 and 22 July on average, 61% of GP appointments were conducted by telephone, with a further 16% spent doing telephone triage. 11% were conducted face to face, 6% by SMS or email, 4% online via video and 3% were home and care home visits.
While just 4% of consultations were reported being done by video, the survey found that 88% of respondents said their surgery was equipped to deliver video or e-consultations – up from 5% before the pandemic - and that 74% said they had done at least some consultations in this way.
Since the start of the COVID-19 lockdown, GP practices have been following official guidance to conduct their work remotely, where possible, in order to stop the spread of the virus, and to protect the safety of practice staff and patients who have needed a face to face consultation.
Asked about the efficiency of delivering consultations remotely, 70% of respondents said telephone consultations increase efficiency, while 67% said video or e-consultations do so. Furthermore, 76% of respondents said that GP-led telephone triage increases efficiency, 66% said non-GP triage and 65% said online triage increased efficiency respectively.
Data from the RCGP’s Research and Surveillance Centre, which collects practice data from more than 500 GP practices in England, shows that at the peak of the pandemic, around 71% of GP consultations were conducted remotely by telephone or video and 25% were conducted face to face. This is compared to the same period last year, which showed the opposite: around 70% were conducted face to face and 25% remotely.
However, the most recent figures from the RSC show that face to face consultations have increased by 40% over the last eight weeks, while demand for telephone consultations has increased 4%. Its data for the week ending 19 July shows that 67% of appointments were telephone and 29% face to face.
Professor Martin Marshall, Chair of the Royal College of GPs, said: “The increase in telephone triage and consultations we have seen during the COVID-19 pandemic has been out of necessity – and in line with official guidelines. That isn’t to say there aren’t lessons to be learnt from the new ways we have been working in general practice. The pandemic has shown care can be delivered effectively and safely remotely, where appropriate.
“Telephone consultations are, of course, not new, but before the pandemic they accounted for around a quarter of consultations – during the pandemic, it’s been more like 70%, with face to face appointments reserved for those patients who really needed them. We’ve also seen an increase in video consulting, with almost 90% of GPs telling us their practices are now video-enabled, even though these account for a small proportion of consultations overall.
“Telephone consulting can be convenient for many patients – and as our survey results show, many GPs who have been doing telephone triage or consultations more frequently than usual during the COVID-19 pandemic have found them an efficient way of delivering care. They can also improve access to some of our harder to reach patients – those for whom the actual act of visiting a GP surgery can be a barrier to accessing care, which can include patients with mental health conditions.
“Telephone consulting does pose a challenge for GPs, not least the lack of visual cues that we often use to help us make a diagnosis – we can’t do physical exams over the phone, we can’t give vaccinations or take blood tests. It’s a different skill to face to face consulting, but it can be effective, especially for patients with simple conditions. The biggest challenge is when patients have complex health needs as being in the same room as a patient, often who you have built up a relationship with over time, is incredibly useful and difficult to replicate remotely.
“Remote consultations, whether by telephone or video, won’t be suitable or preferable for everyone, and that certainly isn’t what the College is suggesting. We’ve already seen face to face appointments increasing, with a 40% increase over the last eight weeks according to figures from our Research Surveillance Centre, while demand for telephone consultations has only risen 4%. Once more normal service resumes in general practice – and we await official guidance on this – patients who want face to face appointments will be able to have them. We want patients to be able to access GP services in the way that is best for them and best meets their health needs.”
The survey of 829 GPs was conducted online between 9 and 22 July 2020.
RCGP Press office: 020 3188 7494/7633/7574/7575
Out of hours: 020 3188 7659
Notes to editor
The Royal College of General Practitioners is a network of more than 53,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.