Just a quarter of GP appointments in England are face-to-face and with an actual doctor, MailOnline can reveal.
Critics have warned general practice is heading down a ‘slippery slope’ where nurses and other staff are picking up the burden amid crippling staffing shortages.
An NHS source told MailOnline that of the 27.5million GP appointments carried out across England in May, just 27 per cent were both in-person and with a qualified doctor.
That figure is not routinely published but publicly-available data shows 64 per cent of total GP appointments were face-to-face and roughly half were with a real GP. The rest were a mixture of virtual or telephone consultations and appointments led by practice nurses, physiotherapists and even acupuncturists.
Health Secretary Sajid Javid has demanded GPs do more in-person consultations after the share done physically plummeted during the pandemic. Campaigners argue remote consultations increase the risk of doctors missing signs of serious illnesses.
Despite the Government’s push to go back to normal, the country’s top family doctor yesterday said the current level of face-to-face appointments was ‘probably about right’. Professor Martin Marshall, chair of the Royal College of GPs, told a conference in London that going back to pre-pandemic levels of more than 80 per cent ‘just doesn’t make sense for patients’.
NHS England data shows 64 per cent of total GP appointments were face-to-face in May. The figure is the second-highest since the height of the first Covid wave forced the majority of appointments to be held virtually. But it is still well below pre-pandemic levels, when eight in 10 appointments took place in-person.
The latest monthly GP appointment data, published by NHS Digital, shows 27.5million appointments took place last month.
This included nearly 1.2million that were listed as ‘did not attend’.
Half of appointments — 13.8million — were with GPs and 12.8million (46.6 per cent) were with nurses or other members of staff, which could include acupuncturists, chiropodists or even counsellors in some cases.
The type of healthcare staff was not logged for 878,374 appointments.
Practice nurses have many of the same powers as GPs as they can examine and diagnose patients, as well as provide treatment, prescriptions and referrals.
Meanwhile, 17.6million of the total consultations took place face-to-face (64.1 per cent).
The figure is the second highest since the pandemic took off in spring 2020.
But it is still well below pre-pandemic levels, when eight in 10 appointments took place in-person.
A third of appointments in May were phone calls, while 0.5 per cent took place via video or online.
Dennis Reed, director of Silver Voices, a campaign group for elderly people, told MailOnline the figure highlighted the double-whammy hurting patients.
While the lack of face-to-face appointments has dominated headlines, he said the lack of appointments with qualified GPs was also a big problem.
Mr Reed warned GPs are now the last point of contact rather than the first and warned the NHS is heading down a ‘slippery slope’.
The trend ‘seems to be due to the shortage of GPs’ and has become ‘necessary in so many practices’ to manage demand, Mr Reed said.
He added that the Government has ‘gone completely quiet’ on the issue because they know that the number of GPs are the ‘root of the problem’.
But Professor Marshall, chair of the Royal College of GPs, told MailOnline: ‘GPs continue to make more consultations every month than they did pre-pandemic.’
Patients should be able to access GP care ‘in a variety of ways depending on their health needs and preferences’, with many preferring in-person appointments but also finding remote consultations ‘convenient and effective’, he said. ‘We know that good, safe and appropriate care can be delivered remotely,’ Professor Marshall added.
He said general practice ‘is a team service’ and GPs are not always the most appropriate staff member to meet a patient’s needs.
‘Working in multi-disciplinary teams also frees up GPs’ time to see those patients who need our medical expertise, such as those with multiple and complex health conditions,’ Professor Marshall added.
Ministers had promised to hire 6,000 new GPs by 2024 but have since admitted they will likely fail, breaking a key manifesto pledge.
Surveys suggest that one in six GP roles are vacant and as many as half of family doctors plan to quit in the next five years.
Professor Marshall yesterday told the Royal College of General Practitioners (RCGP) annual conference in London that just two-thirds of appointments being in-person would probably be the new normal.
The RCGP chair said: ‘The argument about face to face against remote have been really frustrating, it has to be said. What we’ve seen in a transition.
‘Pre-pandemic, around about 80 per cent of consultations were conducted face-to-face. At the height of the first wave that dropped down to 10 per cent and now it’s back to pretty much stable at 64 per cent.
‘A higher proportion of face-to-face consultations are carried out by members of the primary care team other than doctors, nurses obviously doing examinations, procedures, whatever.
‘But generally it feels to me if you look across the country, 64 per cent is probably about right.
‘We’ve learnt from the pandemic that we can do more in general practice for the convenience of patients remotely than we ever thought was possible.
‘So the idea that we should go back to 80 per cent of consultations face to face just doesn’t make sense for patients.’
Professor Marshall said GPs have got better at making decisions about when in-person appointments are necessary and when they are not over the last two-and-a-half years and patients have ‘got used to it’.
‘So we’ve just been through a learning exercise and it feels to me like we’re stable now,’ he added.
It comes after the NHS’s eco chief this month said that fewer face-to-face medical appointments are a good thing because they cut down traffic pollution.
Record waits in A&E have been partly blamed on desperate patients turning up at casualty units because they can’t get an appointment with their family doctor.
It comes after the Health Foundation warned the GP crisis is going to get ‘substantially worse’ over the next 10 years, with thousands expected to quit or scale back their hours.
The think tank estimated family doctor shortages could climb to 10,700 full-time equivalents by 2031, based on current trends, in relation to the number needed to meet the rising care need.
A separate survey earlier this year revealed that patient satisfaction with their GP surgery has plummeted to its lowest ever level, fuelled by the appointments crisis.
A quarter of consultations are taking five minutes or less in some parts of the country.
Doctors say squeezing in so many appointments raises the risk of missing diseases and prescribing the wrong drugs.
In order to make it easier for millions of patients to be seen, GPs have been told to start offering weekday evening and weekend consultations from October.
But family doctors, who pocket an average of £100,000 per year, have threatened industrial action over the NHS contract because they feel overwhelmed and fear the move will spread them even thinner.
Overall, there are now nearly 1,700 fewer full-time equivalent GPs than in 2015.
Many are retiring in their 50s, moving abroad or leaving to work in the private sector because of soaring demand and paperwork.
The row over current levels of face-to-face appointments, in particular, has also been named as one factor for GPs quitting.