December 11, 2023

Kelvin Medical Centre said that as of June 1 all consultations would be done face-to-face but urged patients to honour bookings and turn up on time.

In the two years prior to Covid, around 83-86% of appointments were done face-to-face, but this was dramatically scaled back during the first lockdown.

In April 2020 at least half of the 1.2m consultations carried out by GPs were done remotely, via telephone, email or online video-call.

Around two-thirds of GP appointments in Scotland were being carried out face-to-face by the end of last year despite some health experts saying virtual consultations were “here to stay”.

READ MORE: New figures on face-to-face consults ‘should end claim doctors not working hard enough’

However, a recent investigation by The Ferrett raised concern that access to in-person appointments was not uniform.

It found that urban GPs with large patient lists were most likely to give patients phone consultations.

Doctors with the largest lists – over 4,000 – held 66% of consultations by phone last May, compared with 39% of those with less than 500 per GP.

Research commissioned by the Scottish Government last year found that 94% of patients said they were more comfortable with a face-to-face appointment than telephone (71%) or video (67%).

Cancer Research warned that remote appointments “don’t allow for the same level of examination and testing, which could impact diagnosis”.

Calls were also made to “urgently invest in training for safe remote consulting” following the tragic case in England of David Nash, a 26-year-old law student who died following four telephone consultations for a painful ear infection which led to a fatal brain abscess.

READ MORE: Warning of ‘disaster ahead’ as NHS forced to take over a quarter of GP surgeries 

A coroner ruled in January that he was “likely to have lived if he had been given a face-to-face appointment”.

Dr Chris Williams, joint chair for the Royal College of GPs Scotland, said it had advocated for an “appropriate mix of appointment types” but said the ability to provide this was dictated by capacity within each general practice, “which is stretched”,

He said: “Where GPs have been dealing with patients remotely, this has reduced the number of people in waiting rooms.

“That these areas have become less crowded can give the false impression that GPs are more available when in fact they are now dealing with more clinical contacts than ever.”

It comes as senior doctors warned of a “full-blown crisis” in general practice, with new figures showing Scotland has lost nearly 90 surgeries in the last decade – with almost one in 10 having closed their lists to new patients.

The British Medical Association (BMA) Scotland highlighted what it described as “extremely worrying trends”, with the number of GP surgeries in Scotland down from 994 in 2013 to 905 in 2023 – a decrease of 89.

Demanding action from the Scottish Government, Dr Andrew Buist, chair of the BMA’s Scottish GP committee, said: “I cannot be any clearer when I say that intervention is needed now.”

Dr Patricia Moultrie, Medical Director of the Glasgow Local Medical Committee said the criticism that was levelled against GPs for limiting face-to-face consultations during and in the aftermath of the pandemic “had a major impact on morale and caused a lot of hostility from patients.”

She said: “Practices have got to determine what is possible for them.

“Patient demand is significantly outstripping GP capacity.

READ MORE: The SNP promised 800 extra GPs: Five years on we have 61

“We think it is quite likely that there will be patient need that is not met because Scottish Government has not funded general practice adequately.”

Adam Stachura, head of policy and communications at Age Scotland, said the charity welcomed the shift back to in-person appointments.

He said: “During the Covid pandemic the widespread use of telephone consultations with GPs was a completely understandable move to keep patients and staff safe.

“However we know that for many older patients the continued lack of face-to-face appointments, long after lockdown restrictions have been lifted, is having a detrimental effect on their health and wellbeing.

“Telephone consultations feel impersonal to many older people and can make it difficult for them to share deeply personal symptoms and concerns.

“Others are hard of hearing and struggle to use the telephone.

“It is well known that many patients turn up to see a doctor with one issue and it is only through a face-to-face conversation that what is really troubling them comes to light.

“GPs gain a lot of insight into a patient’s condition from seeing them in the consultation room and that is entirely lost in a telephone call.”

A Scottish Government spokesman said: “Patients should always be seen face to face where there is a clinical need.

“The Scottish Government has encouraged GP practices to ensure there is an appropriate mix of pre-booked, same day, face-to-face and remote appointments that suits individual practice populations.

“We have a record number of GPs working in Scotland – and more GPs per head than in other parts of the UK – and are making good progress on our commitment to deliver an additional 800 GPs by the end of 2027.”


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