Patients are being told they can no longer visit or even call their GP to make an appointment, in a move that has sparked fears over access to vital healthcare and appears to breach NHS rules.
Doctors’ offices are abandoning traditional ways of communicating with doctors and telling patients they must do so via the Internet.
Even anyone with an urgent problem (or a parent concerned about a sick child) must submit a detailed request form and wait up to 24 hours for a response. Doctors backing the change say they are dealing with more patients than ever before and insist that digital systems make it easier to identify and prioritise the most important cases.
But NHS England has warned that GPs are contractually obliged to allow patients to make bookings on the walk-in or phone call, and could face action if they fail to do so.
Campaigners are concerned that patients, especially older ones, may be missing out on crucial appointments because they find it difficult to use high-tech booking systems.
Several Daily Mail readers shared messages from their GP practices stating that walk-ins and phone calls were no longer acceptable ways of making appointments.
NHS England has warned that GPs are contractually obliged to allow patients to make bookings on the phone and without prior appointment.
Last month, our resident GP, Dr Ellie Cannon, said she had heard “worrying” stories from friends about practices no longer taking calls and forcing people to email if they wanted an appointment. She said her practice would never do this and that it was almost unbelievable that any good GP practice would ban patients from booking over the phone.
However, in response, we received a flood of letters from readers saying that their surgeries were making it difficult for them to get an appointment.
Carole Nicholls, 67, from Hertfordshire, said booking a visit to her GP is now so complicated she has resorted to calling the NHS 111 hotline to speak to an adviser, who can then book a slot with her own doctor.
Several readers shared messages from their GP practices stating that walk-ins and calls were no longer acceptable ways to make appointments.
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Graham Moore, 71, from Shropshire, who suffers from diabetes, arthritis and a heart condition, was told to “submit an online form to contact the practice rather than phoning or popping into reception to book”. He worries that when he is unwell he may struggle to accurately complete an online form and may even miss crucial details.
“As an older person with health problems, it is vital to have reasonable access to GP services,” she said. “I can’t believe how difficult it is for me to get an appointment.”
And in one particularly shocking case, a reader reported seeing an elderly man, in tears, leave his surgery after the receptionist refused to let him book an appointment in person, despite him saying he was having difficulty using the internet. Last night, Rachel Power, chief executive of the Patients’ Association, said: “We have raised concerns with NHS England about some GP practices insisting that appointments can only be booked online. This should not be happening – the GP contract makes it clear that patients should be able to book appointments by phone, online or by coming into the surgery in person.”
For more than a decade, GPs have used online booking (in addition to walk-ins and phone calls) to make appointments. However, experts believe the rise of online-only booking systems began during the pandemic and has become more common as GPs struggle with an increasing workload.
In 2020, to reduce the spread of Covid, the NHS encouraged doctors to reduce walk-in requests by adopting a system called Total Triage, which means each patient provides information to the practice about their problem before booking an appointment.
While this can theoretically be done over the phone with a receptionist, many practices set up online systems so patients can write down their problems in detail.
This system reduced the workload on receptionists and has largely been maintained because many doctors believe it ensures that patients who most need an appointment are seen first and discourages others from booking unnecessary visits. For example, receiving test results and sickness certificates is now normally done online, rather than by visiting a GP.
Patients who would be better cared for by another member of staff, for example a physiotherapist, may also be referred directly without needing to see a doctor.
The need to free up GP time is clear. According to the British Medical Association, there are around 27,000 full-time GPs in England, almost 2,000 fewer than a decade ago. Meanwhile, NHS patient numbers have increased by around six million over the same time period, with 1.4 million GP consultations taking place every working day.
Last month, GPs announced they would be taking industrial action (including limiting their working hours) over a contract dispute that is partly linked to their increasing workload. Unsurprisingly, public satisfaction with GPs is at an all-time low, with many saying they have stopped trying to see their doctor altogether, according to the GP Patient Survey.
Professor Clare Gerada, a London-based GP and former president of the Royal College of GPs, says greater use of digital technology is crucial for patients and doctors. “GPs who go digital are not lazy, they are just trying to prioritise their work,” she says. “Most patients appreciate having digital means of accessing their GP.”
She adds that there should always be an option for people who can’t use digital technology. “If someone comes in with an emergency, such as a sick child, they should be allowed to book an appointment at the counter. Turning them away and asking them to use the website would be unacceptable. Similarly, there should be options for people who don’t have access to a computer or smartphone or who are simply not tech-savvy. Patients should be able to walk in without an appointment or call for appointments.”
An NHS spokesperson said: “Practice centres are contractually obliged to allow patients to come in person, phone or go online to make appointments and if this is not possible, local commissioners should support practices to address this access issue.”