The NHS on Thursday night performed a climb down over plans to use online and telephone "screening" for GP appointments and announced that every patient would now have the right to see their doctor face-to-face.
The Telegraph revealed on Wednesday that family doctors had been told to introduce a system of "total triage", meaning those seeking to see their GP were being discouraged and told to have an online or phone discussion first.
But NHS England has now ordered that the system be abolished amid a mounting backlash from patients' groups and doctors. New guidance to all GPs will instead say that every practice in England must make "a clear offer of appointments in person" and respect the preferences of patients.
Dr Nikki Kanani, the NHS medical director for primary care, and Ed Waller, the director of primary care, wrote to all GPs on Thursday night to inform them that the new operating procedures supersede all previous guidance.
"GP practices must all ensure they are offering face-to-face appointments," the letter says. "While the expanded use of video, online and telephone consultations can be maintained where patients find benefit from them, this should be done alongside a clear offer of appointments in person.
"Practices should respect preferences for face-to-face care unless there are good clinical reasons to the contrary, for example the presence of Covid symptoms."
It came after the Patients' Association, the Royal College of GPs, the British Medical Association and Jacob Rees-Mogg , the Commons leader, all raised concerns about the NHS proposal for "total triage".
The Telegraph has been inundated with letters from readers describing problems accessing GP care – with one likening their local surgery to Fort Knox – after it highlighted the problems.
On Thursday night, Prof Martin Marshall, the chairman of the Royal College of GPs, said: "This is good news and is what patients and GPs want to see.
"It removes all ambiguity, and we're particularly pleased that our calls for shared decision-making between GP and patient on the most appropriate method of consultation have been heard. We now have a flexible approach decided upon by clinicians and their patients."
The system of "total triage" was first introduced at the start of the pandemic in an attempt to keep patients away from GP surgeries and reduce the spread of infection. The advice became formalised in annual NHS planning guidance which came into force last month.
NHS England had always said anyone deemed by a doctor to require a face-to-face consultation should still be able to get one after undergoing remote assessment. But the national system has now been scrapped amid increasing concern that patients were being denied care they needed.
One pensioner told how she had made more than 100 calls a day to her local surgery in Kent on behalf of a neighbour in her 90s in an attempt to get an appointment. When she finally got through, she was told the only way to be assessed was via an online consultation.
The Patients Association had called for face-to-face consultations to be restored as the "default" option, with the Royal College of GPs (RCGP) saying the policies were too risky.
Its chief executive, Rachel Power, said some patients had been left with terminal illnesses from conditions that might have been treated if they had been allowed a face-to-face appointment.
The instructions to the NHS also warn GP practices that they must stop deterring patients from visiting amid widespread use of signs discouraging patients from visits.
The new guidance says: "All practice receptions should be open to patients, adhering to social distancing … this is important for ensuring that patients who do not have easy access to phones or other devices are not disadvantaged in their ability to access care".
It adds that all patients should be given the same treatment, in contrast to previous advice which said those who tried to book an appointment over the phone should not be given one in case it discouraged people from using online systems, and says: "Patients should be treated consistently regardless of mode of access."
In addition, every GP website must now provide advice about how to contact the doctor, including how to get face-to-face or walk-in services.
@nabob @Pinkaholic79 💖🦄🌺 @margaret.s @roz @Janet 💋🍰🍝🍹 @renatew5😺🐶 @Flossy 🧁🧁🧁 @harryflatters @Bill Obermeyer @andym.aat @Paul - MenCanCleanToo @Tanith
If we are lucky enough to get through to our surgery before 8. 30 AM we can get a phone appointment the same day. At times it has taken me 10-15 minutes doing redial to get through and managed to the last available phone call for that day. @Happygirl @roz @Pinkaholic79 💖🦄🌺
Me too @Happygirl @Janet 💋🍰🍝🍹 @Pinkaholic79 💖🦄🌺
You can't get through on the phone to lots of doctors surgery to make an appointment and when you do you have to make do with a telephone appointment in a couple of weeks time. Not good enough, especially for people who are not great with technology. At least you should be able to walk into a surgery and make an appointment of request a prescription.
I know @Happygirl, but even using technology is not good enough for a visit. You need a face to face chat, and if the NHS can deal directly with C19 patients, then why can't a GP deal wit a NN C19 patient, just take temperature before going in, and done. Wonder how many ppl suffered in silence.
Doctors hit back at NHS bosses over orders to see patients face-to-face
Doctors have mounted a backlash against orders to see patients face-to-face, with their union passing a vote of no confidence in NHS leaders.
On Thursday, the British Medical Association’s (BMA) GP committee said medics had been let down by NHS England’s senior officials after patients were told they had the right to see GPs in person.
The U-turn last week came after the Patients’ Association and the Royal College of GPs raised concerns about the NHS proposal for “total triage”.
The Telegraph had been inundated with letters from readers describing problems accessing GP care – with one likening their local surgery to Fort Knox – after it highlighted the situation.
But doctors’ unions on Thursday turned on health officials for the change of stance, passing a motion of no confidence in the leadership of NHS England.
The BMA said the change by health officials was “tone deaf”, suggesting it had been issued in reaction to media coverage “rather than based on the needs of the profession”.
Pressure group GP Survival had already called for the resignation of Dr Nikki Kanani, the NHS England medical director for primary care, saying the letter she signed along with director of primary care Ed Waller was “insulting” to doctors.
In the letter, health officials had said: “GP practices must all ensure they are offering face-to-face appointments.
“While the expanded use of video, online and telephone consultations can be maintained where patients find benefit from them, this should be done alongside a clear offer of appointments in person.
“Practices should respect preferences for face-to-face care unless there are good clinical reasons to the contrary, for example the presence of Covid symptoms.”
On Thursday, the BMA GP committee’s online meeting passed a motion saying the decision to publish the letter last week was “unacceptable” and calling for a public explanation.
Medics said they were “outraged” by NHS England’s lack of understanding of the pressures facing general practice.
It came as Office for National Statistics figures for April showed deaths in England are the lowest since mortality rates started being recorded in 2001.
Dr Richard Vautrey, the BMA GP committee England chairman, said tens of thousands of GPs felt “anger, frustration and disappointment” about the way they had been treated by health officials, accusing them of failing to “recognise and celebrate” the contribution GPs had made to the response to the pandemic.
Dr Vautrey said the letter last week was “the final straw for many hard-working GPs, who have gone above and beyond over the last year”.
@nabob @Pinkaholic79 💖🦄🌺 @margaret.s @roz @harryflatters @Janet 💋🍰🍝🍹 @Flossy 🧁🧁🧁 and any one interested
I am pleased that surgeries will be going back to previous system, but personally as I do use the internet I like the triage system. I am able to write down exactly what I want to say to the doctor before speaking to him or her. This gives them time to review my notes before talking to me on the phone or making me a face to face appointment or to organize bloods.
There isn't just one system to suit everyone.
Glad he managed to get an appointment @nabob. So true tho, my dad hasn't got Internet either, and normally I'll do the calls for him too.
This is good news, especially for older people who do not have the internet, for example, my parents. My Dad HAS been able to get an appointment to SEE the doc but has terrible trouble getting through on the phone. If he wanted an appointment previously he used to call in at the surgery to get an appointment.
I also think that sometimes you don't actually need to attend the surgery, ie, results or a request for meds that you have not had in while.
Hopefully, they can offer all types of appointments. @Happygirl @Janet 💋🍰🍝🍹 @Pinkaholic79 💖🦄🌺
About time too @Happygirl @Pinkaholic79 💖🦄🌺
The dentists are all back as usual now over our way.
I am so pleased to hear that up there.
Our local surgery has been closed and only opens for blood tests, but if you are early then they tell you to sit in the car, but if you do not have one then you have to stand in the rain as they have no shelter at all.
It is high time things started getting back to normal with the GP surgeries.