Telephone consultations with GPs are being incorrectly classed as “face-to-face” appointments in official statistics, NHS chiefs have admitted, following an investigation by The Telegraph.
In recent weeks, ministers, including the Prime Minister, have intervened to promise patients access to face-to-face appointments, amid mounting concern about the difficulties some are facing.
Before the pandemic, about 80 per cent of consultations took place in a doctor’s surgery. However, the latest monthly figure is just 58 per cent, with little change since officials vowed in May to give all patients the right to a “face-to-face” appointment.
Now, The Telegraph can reveal that even this figure exaggerates the number of consultations which are actually taking place in person.
NHS officials said that because of the way some local systems were set up, some appointments were automatically being logged as face-to-face slots, regardless of how they were actually delivered.
Mix-up impact on vulnerable patients
Anne Bedish, a Telegraph reader, viewed her own patient record online, and was surprised to see that all the telephone appointments she had in the past year had been recorded as “face-to-face” consultations.
The 68-year-old, who suffers from a number of health problems and was on the Government’s clinically vulnerable list, had 12 phone appointments in the past year, which she found had been classed as “face-to-face” visits.
When she contacted Glenlyn Medical Practice, in East Molesey, Surrey, to question the miscategorisation, they confirmed that the appointments had been by telephone, but the record went unchanged.
NHS Digital, which publishes national data on GP appointments every month, suggested this pattern could occur far more widely, because of the way data has been recorded.
GP face-to-face timeline
Officials said: “We do acknowledge that there may be data quality issues with the data and instances where the data may not be a true representation of what may be happening in all practices.
“From March 2020, face-to-face appointment mode data may not be entirely reflective of what happens in the practices, as appointment types have been assigned to appointment modes prior to the pandemic.
“Thus, even if the appointment was carried out through a different mode, the appointment registers as a face-to-face appointment on the system.”
Officials said this was most likely to happen if appointments had been set up in advance as a “block booking of appointments” and was most likely to affect cases early on in the pandemic.
However, neither of these were the case for Mrs Bedish, whose most recent appointments occurred less than a month ago.
Dennis Reed, the director of Silver Voices, a campaign group for the over-60s, said: “This needs to be investigated. How many of the figures have been fiddled in this way? It is really worrying.
“I know that practices are under a lot of pressure to increase the number of patients getting a face-to-face appointment, and it worries me that we could see more and more of this.”
It came as it emerged that the proportion of GP home visits have almost halved since before the pandemic. NHS figures show that while pre-Covid roughly one per cent of all GP appointments were home visits, in July and August they amounted to 0.6 per cent.
Home visits are crucial for the housebound, elderly and dying, campaigners warned, although senior medical figures have been calling for the practice to be scrapped for decades.
Cancer treatment in numbers
On Monday, a grieving husband claimed that his cancer-stricken late wife would still be alive if her GP had agreed to pay a home visit.
Anton, the father-of-three from Bromley, south-east London, told LBC Radio he had begged a doctor to visit his 44-year-old spouse but a nurse was sent instead, who allegedly checked only her pulse and temperature.
He said that by the time his wife went to hospital, her cancer had spread to her brain.
According to NHS figures for August, there were 151,627 home visits paid in England, down from 157,998 in July.
Patients’ groups and campaigners have warned that many vulnerable people have been unable to access care, with coroners linking a string of deaths to remote appointments.
In May, health officials promised to scrap a system of “total triage” introduced during the pandemic, and give patients the right to choose to see a doctor in person.
Boris Johnson recently insisted patients were entitled to be able to see a doctor who could give ‘proper hands-on understanding’ of their medical problems
Credit: AP Photo/Jon Super
However, last month the head of the Royal College of General Practitioners told MPs there was no point making such promises when GPs did not have the capacity to meet them.
But the Prime Minister insisted patients were entitled to be able to see a doctor who could give “proper hands-on understanding” of their problems.
Boris Johnson said: “I am absolutely certain that unless we can deliver that there will be people sadly whose symptoms are not picked up and who will suffer as a result.”
‘A misleading picture’ of health care provision
Mrs Bedish said: “It really worries me that this data is giving a misleading picture of how many patients are actually getting a face-to-face appointment with their doctor, and allowing ministers to claim the situation is improving.
“I have no problem with my GP practice. Some of my appointments, like one for a skin condition, would have been better face-to-face. But my concern really is about the national data, and how it’s claiming most appointments are happening in person when it doesn’t seem that way at all.”
NHS Digital said that the data was “experimental” and only provides an indication of GP activity, as it was pulled from GP practice systems, which record data as they see fit, rather than answering specific questions such as mode of appointment.
Caveats published with the monthly data state: “The mode of the appointment shows the setting of the consultation. For example, face-to-face, telephone, home visit, etc. This is set locally by the practices so may not represent the actual care setting of the appointment. For example, some video conference appointments may be logged by the practice as face-to-face.”