Hundreds of thousands of patients living in the poorest areas of the UK may miss personal GP appointments because of Covid’s precautions, a report has warned.
NHS guidelines urge all GPs who are at high risk of the coronavirus themselves to switch to online or telephone consultations for the safety of their own health and that of their patients.
GPs considered to be of high risk are normally over 50 years of age, have a black, Asian or ethnic minority (BAME) background or suffer from comorbidities themselves.
Research by the Health Foundation’s charity estimates that one in three GPs who perform their own surgery falls into this category, meaning the entire practice may need to be closed.
Doctors who perform their own surgery alone are also three times more likely to operate in highly disadvantaged areas, according to the charity.
In total, the Health Foundation estimates that 710,043 patients will miss the personal appointments due to the number of GPs considered at risk for Covid. At least 8 percent (3,632) of general practitioners fell under this category.
Experts say personal appointments are critical because doctors can notice subtle symptoms and patients often feel comfortable revealing more specific information about their health problems.
It is feared that some of this nuance will be lost to cyber-visits, which may include a phone call or a video chat.
Last Friday, health secretary Matt Hancock threw his weight behind a much wider use of remote appointments, dismissing those involved as just ‘naysayers.’
Hundreds of thousands of patients living in the poorest areas of the UK may miss personal GP appointments due to Covid precautions, a report has warned (file)
NHS England has instructed all its front-line personnel to assess Covid-19 for risk, taking into account factors such as age, gender, ethnicity and BMI.
Nurses and paramedics placed in this category are either moved to areas of low infection rate, while general practitioners are asked to switch to online consultations.
Across England, at least 8 percent (3,632) of GPs are considered ‘high risk’ of Covid-19 death.
Analysis by the Health Foundation estimates that one in three (32.7 percent) general practitioners who control their own general practice fall into the category.
Only 1 in 10 GP appointments are now face to face, as patients fear that cyber visits will stay here
Only one in ten GP appointments come face to face – three months after ministers promised to return the NHS to normal.
A large study found that 61 percent of consultations take place by telephone, 6 percent via text or email and 4 percent via online video.
Telephone evaluations and home visits account for an additional 18 percent, meaning only 11 percent of consultations led to direct contact with surgery.
But in late April, as coronavirus cases declined, Matt Hancock promised to restore mainstream NHS care.
And today, the health secretary announces important plans for future work, including proposals for doctors to contact patients via WhatsApp.
Mr Hancock will also promise to cut red tape and increase staff flexibility to keep them on the job longer.
The Royal College of GPs survey involved 859 GPs, who were conducted for two weeks to Wednesday.
If the results are a true picture of the UK as a whole, it means that patients are three times more likely to receive a text or email from their primary care doctor than a home visit.
As many as 88 percent of the doctors said their surgery offered video or online consultations, compared to 5 percent before the pandemic.
Seven in 10 said phone calls increased their efficiency, up to 76 percent when asked about phone triage.
These GPs work more than three times more often in the most disadvantaged regions, threatening to exacerbate health inequalities that have been exacerbated by Covid-19, the charity said.
The analysis also found that London may be particularly affected if GPs at high risk of the disease limit their patient-centered activities.
The capital has the highest percentage of very high risk general practitioners from Covid and from one-man practices by a very high risk general practitioner.
The Health Foundation calls on CCGs to ensure that all patients have access to personal appointments when they need them.
Dr. Rebecca Fisher, a senior policy officer at the Health Foundation and a practicing family doctor, said, “Covid-19’s continued risk to the safety of both patients and GPs means that hundreds of thousands of people may find it much more difficult to get a face appointment with the doctor.
“It is especially worrying that GPs with a higher risk of Covid-19 are much more likely to work in areas that are highly disadvantaged.
‘Those are precisely the areas with the greatest health need, the greatest burden of Covid-19 and an existing under-supply of GPs compared to the need.
“Unless urgent action is taken, it could be another way of further disadvantaging poorer communities and risking further health inequalities.”
The report comes just days after a retired taxi driver was hospitalized with a serious infection after being denied a personal appointment with the family doctor under Covid-19 ‘safety’ rules.
Since March, most GP practices have drastically reduced personal consultation to reduce the spread of the coronavirus. Doctors instead call patients, often from their own homes.
Few operations have resumed normal service and some remain closed despite the virus dropping to a low level in many areas.
Lisa King, 54, from Brentwood in Essex, feared the arrangements could have been fatal for her husband Peter, 62.
She emailed their surgery three weeks ago to provide an “urgent personal appointment” for Peter.
He had been suffering from persistent pain for weeks, his stomach was “bloated and tender” and he had just been “severely ill.” She was afraid it was cancer.
Deal Tree Health Center emailed back the next day saying “on this occasion” that they would be giving Mr. King a GP consultation by phone that that day would take place.
After asking a series of questions, the family doctor said that Mr. King probably had acid reflux and had been prescribed a drug. The doctor told him to contact him again in a week if he hadn’t gotten well.
Lisa King (photo right), 54, from Brentwood in Essex, feared the arrangements could have been fatal to her husband Peter (photo left), 62
However, Mr. King did not improve and the following Sunday his condition deteriorated significantly. Ms. King called 999 and an ambulance arrived within 20 minutes. She recalled, “Peter was in so much pain that he cried. When the ambulance came here, he was asked where it hurt and suggested a physical examination. As she did, Peter flinched. Then she said, “Right, you should go to the hospital immediately.”
At Queen’s Hospital in Romford, doctors found a gallstone in his bile duct and his gallbladder seriously infected and inflamed.
Ms. King recalled, “We were told that if the gallbladder had been left much longer, his gallbladder would have ruptured and caused systemic sepsis, which can be fatal. If he’d seen a doctor six days earlier, the doctor would have known something was wrong – that it wasn’t just bad digestion. You cannot diagnose such a thing over the phone. ‘
She warned, “People will die if this lack of personal consultation continues. And I don’t know why operations are not reopened. Does anyone have? Because I can do my hair. You can go to the pub and also to the gym.
‘All those places have had to invest in PPE for their staff. Doctors are part of the NHS – they have personal protective equipment for them. So what are they afraid of? Mr. King has had surgery to remove a gallstone, but may need more surgery for the others in his gallbladder. He has also been diagnosed with an inflamed pancreas and has been told that the delay in surgery has probably made matters worse.
The telephone consultation was “not good enough,” he said.
The symptoms I showed required a physical exam by a primary care doctor to determine exactly what was wrong with me. ‘
The doctor had been “succinct” and “dismissive,” he said, “which I suppose because he thought it was only indigestion.”
Mr. King said: “It seems to me that general practitioners are beginning to display a ‘new normal’ behavior by telephone consultation. I think it has to be addressed before things get out of hand. ‘
Last night, Dr. Ken Wrixon of Deal Tree Health Center said, “We hope Mr. King recovers quickly and encourages him or his wife to contact us so we can investigate further.
‘Although personal appointments are available in practice, we initially offer telephone appointments with our GPs, but encourage patients to contact them again if they think their condition has gotten worse, to protect people. we can reassess whether their care needs have changed. ‘