Eight million fewer GP appointments registered amid Covid -19 shutdown

Almost eight million fewer GP appointments were registered in England in April as the coronavirus pandemic took hold, new figures have revealed.

Data released by NHS Digital on Thursday showed there had been a 33 per cent month-on month fall in appointments made at practices across the country, despite a pivot to accommodate remote working.

The number of appointments made in England fell from 23.8m in March to just 15.8m in April.

The proportion of patients attending face-to-face appointments fell from 67 per cent to  47 per cent month on month, and was down from a long-term average of 80 per cent.

In April telephone appointments made up almost half (48 per cent) of all appointments attended in England, up from 28 per cent in March and a long-term average of 13.5 per cent.

While the total number of patients booking appointments fell sharply, with fewer having to come to the practice in person a larger proportion were seen the same day.

In April almost two thirds (63 per cent) of patients were given an appointment the same day, up from 45.5 per cent in March and a long-term average of 42 per cent.

But the number of patients being seen the same day has remained broadly static at around 10m in April.

The proportion kept waiting more than a week has halved under lockdown, at 14.5 per cent in April compared to 29.2 per cent in March.

NHS Digital has said the decline does not necessarily imply GPs are offering or booking fewer appointments.

They said practices are likely to be operating very differently in response to the pandemic and consequently may be recording appointments in different ways.

They include an increase in "list appointments" in which several patients are contacted but only one appointment is entered into the appointment book.

Chief Executive of the Patient's Association Rachel Power said: “It may be the case that some patients cannot attend remote appointments; responsibility rests with GPs for making provision for those patients, and ensuring they do not miss out on the care they need.

“It seems likely that some people who have avoided seeking medical help,  because they do not want to bother the NHS, or because they are concerned about coronavirus infection in a healthcare setting, will develop more serious problems that could have been treated more effectively if detected earlier.”

Professor Martin Marshall, Chair of the Royal College of GPs, said general practice had "rapidly transformed" the way it works in response to Covid-19.

"GPs and our teams continue to offer routine general practice appointments – remotely where possible - alongside supporting COVID hubs and providing clinical support to NHS 111," he said.

"We have noticed a reduction in the number of patients making routine appointments since the lockdown started in mid-March.

"This could be due to a number of reasons including the fact that patients may feel concerned about over-burdening NHS services or contracting COVID-19.

"However, if anyone is seriously ill or concerned about their health, we’d strongly urge them to contact their GP practice or 111 – and in an emergency situation, call 999. The reality is unmanaged or untreated conditions may not go away and may get worse and this could cause serious consequences."

Prof Marshall added their own research suggested around 70 per cent of consultations are being done remotely via phone or video.

“In line with government advice GPs and our teams continue to deliver the vast majority of care remotely," he said. "However, in cases where a patient needs to be seen face to face, such as for a medical examination or vaccination, we will continue to facilitate this in as safe a way as possible.

“As we move into the next steps of the pandemic it’s imperative that the NHS is given the attention and resources it has been at the height of COVID-19.

"General practice must be adequately resourced to deal with the predicted increase in demand as GPs care for patients who may have put off symptoms during the peak of COVID-19, outpatients managing COVID-19 at home, and those suffering from indirect side-effects of the pandemic, such as associated mental health conditions.”

Raj Patel, deputy medical director of primary care at NHS England, said: “Our GPs are quickly adapting to new technology – including phone and video consultations – to continue providing care in a different way.

“Not only do remote appointments allow patients to consult their GP from the comfort of their own home, it helps protect staff and patients by limiting exposure to infection.

“If you are unwell, the NHS is here for you and practice staff are working hard to ensure that everyone gets the care they need, whether that is face to face or virtually.”