GPs face calls to resume more face-to-face appointments

Healthwatch champion survey finds 40% of people have turned to A&E or 111 when they couldn’t get a face-to-face GP appointment
By Bella Saltiel

Photo by CDC on Unsplash
Photo by CDC on Unsplash

In a survey of 350 people conducted in May, June and July, Healthwatch Barnet, independent health and social care champion, found that 40% of people have turned to A&E and urgent treatment centres when just 10% have been offered in-person appointments during the Covid-19 pandemic. The survey found that 8.15% turned to A&E, 13.9% went to urgent care centres or walk-in clinics and 16.3% called 111. It has meant that people are losing confidence in their healthcare providers, with some questioning the diagnosis given remotely.

One respondent, who has remained anonymous, said: “It was impossible to get a same-day appointment without using an online triage system. This resulted in two trips to A&E and funnily enough, we found that we could get an appointment with our doctor via 111.

“There appears no understanding of the additional stress put onto carers and patients.”

Without face-face GP appointments, carers are finding it difficult to get help managing the long-term health conditions of those they provide care to.

Mike Rich, Chief Executive of the Barnet Carers Centre said: “Carers have had a real struggle through the Covid-19 period and one of the main concerns has been the health of the person they care for.”

“When you lose face-to-face you lose the ability to have a discussion sometimes. Some carers are pretty much at it full time and telephone appointments put control entirely in the hands of the GP surgery. Say, if they don’t hear the phone go, for instance, if you’re helping someone you care for go to the toilet and at that point and the phone rings then you miss the appointment.”

“Don’t get me wrong we know it’s difficult for the health service as well. But, there is an underlying concern from carers that people they are caring for with underlying health conditions have been put on the back burner.”

“I don’t think telephone triage is appropriate for the whole population. There needs to be an ability to see a GP face-to-face for carers and those they care for.”

There has been an increase in demand for urgent care at Barnet Hospital. At a meeting in July, Barnet Hospital’s chief medical director Mike Greenberg reported that the hospital experienced its highest attendance on one day in A&E in May seeing 450 patients. The meeting notes report that “patients were finding it difficult to obtain face-to-face consultations with their GPs and The Walk-In Centre at Edgeware had been closed.”

The Walk-In Centre at Edgeware Community Hospital provides urgent care that is not life-threatening. The centre has been closed since March 2020 on the website it says it will not open because of Covid-19 asking people to call their GP, 111 or 999 in an emergency.

The Walk-in Centres in Barnet are commissioned from NHS Trusts by the North Central London Clinical Commissioning Group (CCG).

In a statement the North Central Lon- don CCG said: “Throughout the Covid-19 pandemic GP practices have remained open but it has been necessary to change the way some appointments are provided, offer- ing more by telephone or online to protect patients and staff and help stop the spread of Covid-19.

“Face-to-face appointments, including home visits, continue to be available to all patients in Barnet.”

They went on to encourage people to avoid A&E which is seeing high demand. NHS England figures show 26,665 patients visited A&E at Royal Free London NHS Foundation Trust in July. That was a drop of 3% on the 27,360 visits recorded during June, but 40% more than the 18,995 patients seen in July 2020. The figures show attendances were above the levels seen before the Covid-19 pandemic – in July 2019, there were 25,641 visits to A&E at the Royal Free London.

The majority of attendances last month were via major A&E departments – those with full resuscitation equipment and 24-hour consultant-led care – while 16% were via minor injury units.

On 21st July Dr Angshu Mukherjee, clinical director of Barnet Hospital’s A&E department made a plea to the public in a YouTube video.

He said: “Every day, we’re seeing more and more patients arrive and the demand for our services is growing exponentially.” He asked that people who do not need urgent care please use 111.

Of the rising number of people choosing A&E when they cannot get face-to-face GP appointments Barnet Federated GPs CIC said: “Barnet GP Federation and Practices have continued to provide services for our patients throughout the pandemic including safe face-to-face consultations during the day and evening seven days a week.”

“The Federation’s GPs have also supported Barnet A&E department, hospital step down patients in community beds and the Community Rapid Response Team as part of the NHS recovery programme.”

Dr Leena Mistry, Medical Director, Barnet Federated GPs said: “The whole of the NHS is currently experiencing very high levels of demand for this time of year as more and more of our patients need to access care. During June and July, the Federation increased its staffing by 30% to provide an additional 2,000 patient appointments to help meet the growing demand.

“However, we appreciate that these are worrying and often frustrating times for patients, carers, and staff. All our clinicians and support staff are working very hard to respond to the needs of our patients. We monitor and change our services daily to reflect the needs and feedback from our patients.

“We know how important urgent care is to everyone and that is why the local NHS regularly meets to jointly plan and develop the high-quality services our patients deserve.”

In response to a question about increased demand the Royal Free London NHS Trust said: “We would like to remind residents to call NHS 111 or visit before attending A&E unless it’s a serious or life-threatening emergency.

111 call handlers will help you access the right care for you and if you need to go to A&E, they can book you an appointment.”

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