GPs are told to screen patients onlin... - British Lung Foun...

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GPs are told to screen patients online or by telephone and discourage face-to-face appointments in latest NHS guidance.

2greys profile image
2greys

Patients should be remotely screened before being directed to the most appropriate health service for their problem, new NHS guidance says.

Doctors are being told the system of 'total triage' must be embedded into general practice, despite the Royal College of GPs' reservations.

The method was brought in during the pandemic and sees a person checked by phone, video or online, unless clinically appropriate.

It comes despite the RCGP saying patients must be able to access both remote and face-to-face doctor appointments in a post-Covid world.

In a new report, general practice leaders said while remote consultations should be an option, they must not become the 'automatic default' for GP care.

dailymail.co.uk/news/articl...

51 Replies

I fear that face to face with a GP will become a rarity. Xx

Catgirl1976 profile image
Catgirl1976 in reply to sassy59

At our surgery there's no waiting room and they make poorly people wait outside in all weathers that they have invited to the surgery to be seen in person.

I don't mind the phone appointments for basic things but some things need a face to face consultation with the gp.

Wrong in so many ways. I’ve recently been diagnosed with both a skin cancer and suspected heart disease. How could the dr diagnose both those conditions without a face to face consultation and examination!?

Damon1864 profile image
Damon1864Volunteer

I agree with Sassy, seeing a GP face to face will be like a lottery in my opinion. How can this be good for anyone's health? We should be able to see a GP when we need too not a phone consultation. You can go and watch snooker and other sporting events and concerts with many people being there, but can't see a GP face to face. Sorry if anyone feels I'm speaking out of turn ,but it's how I fell and not meant to upset anyone. Have a good day and take care 😊 Bernadette and Jack 🐕 xxxxxx

Snackjack profile image
Snackjack in reply to Damon1864

I agree with both Damon1964 and Sassy59😟😟

CDPO16 profile image
CDPO16 in reply to Damon1864

No reason that this should upset anyone Bernadette, very valid points xx

madonbrew profile image
madonbrew in reply to Damon1864

Totally agree!!!

It's ridiculous isn't it and it's just an excuse to hide behind in my view!

Patk1 profile image
Patk1 in reply to Damon1864

I agree with u Bernadette.detists,blood technicians,various clinics,operating theatres etc etc all open - but not able to see go when needed#!

helenlw7 profile image
helenlw7 in reply to Damon1864

I totally agree! I’ve had 3 dental appointments recently with the dentist and nurse wearing pipe, I have blood tests at the drs every 2 months, yet I’m not allowed to see my go.

helenlw7 profile image
helenlw7 in reply to Damon1864

I’ve just read the front page of the paper - ‘The NHS has performed a climbdown over plans to use online and telephone "screening" for GP appointments, announcing that every patient would now have the right to see their doctor face to face.’ It was the Daily Telegraph so may not be100% correct!

Rhey should reduce their inflated salaries accordingly. My surgery is still like the Marie Celeste. No sign of a GP.

Annie31 profile image
Annie31 in reply to Littlepom

Yours and many more by all accounts sadly!

I think we all suspected this could happen. I am very concerned for the future.

I wasn't surprised when I found out!

Not good news.

This makes my blood boil and I hate it. Most people are already hesitant to call their GP because of COVID and fear of being a ‘nuisance’ and now another obstacle in the way which will have people questioning again if they should seek medical help. This needs to stop. It’s scary and we need our GP’s to be accessible.

Annie31 profile image
Annie31 in reply to Kelly100

This has already been proved with people not coming forward with cancer or heart disease worries during the pandemic. We have to be concerned about what the agenda is for this kind of thinking but I think it's all about resources once again.

Kelly100 profile image
Kelly100 in reply to Annie31

It’s horrific it really is. This is a pandemic all itself and it’s sickening to watch it all unfold. Something needs to be done. I don’t think people realise how important it is to maintain a close relationship with their GP for vulnerable patients . For myself I’m 43 and reasonably healthy except for a few anxiety issues but for the more at risk we are going in to risky waters making it more difficult to access healthcare.

Last year my son was constantly on the phone to numerous GP’s about his chronic cough. Not one of them was a GP based at his surgery, all locums and his GP who he has a lovely relationship with was nowhere to be found. A few months later we saw her on bbc news giving an interview. Didn’t know if I should laugh or cry 😂. I feel like we see my sons doctors more on the telly than in real life. We saw his bronchiectasis consultant on GMB a few months ago😂

There’s also the elephant in the room regarding the politics of primary and secondary care that’s so frustrating and you feel like your constantly doing the donkey work to make things run smoothly and not offend anyone. Who takes responsibility! It can’t be all down to the patient and it’s a million times harder without a face to face. Sheeesh!

Don’t get me wrong I am very thankful and don’t mean to sound whiny but I can’t lie it does concern me.

Catgirl1976 profile image
Catgirl1976 in reply to Kelly100

It's frustrating though when you need to see a gp and you can't!

GP discretion really should come into this. Many simple things could probably be dealt with quite well and efficiently with a phone or video consult but in many cases there is no substitute for a face to face consultation. I don't have a video facility for instance and a phone consult in no way allows my doctor to see for himself how I am looking. Visual examinations are very important, even if only observing someone's face and demeanor.

Annie31 profile image
Annie31 in reply to CDPO16

Yes, doctors can pick up on a host of things from your looks and demeanor without us even realising they are. They are trained to use their eyes as well as their ears!

How can they listen to your chest over the phone . Most of the time I'm not sure if I have an infection or not as I don't cough , so I end up taking antibiotics that I don't need . It is very worrying 🤔

I have only seen my GP once (at 2nd Covid jab) since Jan 2020 which was for a medicine review, my last meds review Jan this year was even done via a phone call. Replacing rescue packs are done via phone call to the receptionist. I even have to give my own blood pressure, pulse and o2 readings, I assume they can hear my repository rate, over the phone, .My last face to face appointment with my Oncologist was in Nov 2019. It is a good job that I do not have health anxiety issues with having to self manage 5 chronic diseases.

Having said that, I have been told I am due for a COPD review with an appointment to see the nurse for next Thurs. My first ever at the surgery, now that I have not seen a Respiratory Consultant for 2 years, at the start of the Pandemic in Mar 2020, which was a total waste of time as they could not get me back out of the door a.s.a.p.

CDPO16 profile image
CDPO16 in reply to 2greys

It's really a good job that you deal with your health issues as well as you do but it shouldn't have to be that way.When my GP came to give me my second vaccine she was wearing full PPE but said she didn't want to stay with me too long to ensure I wasn't put at unnecessary risk which may be why they wanted you out of your surgery asap last year.

Hopfully your review next Thursday will be more thorough and productive.

Catgirl1976 profile image
Catgirl1976 in reply to 2greys

Best of luck with your review!

One of the main problems with this is that it's older people who use the health services the most, yet they are the most likely to be without the internet or be able to learn how to use it properly. Unless they have someone who can do it for them they are stuffed!

Annie31 profile image
Annie31 in reply to hypercat54

Absolutely Bev! Both our mobile and internet connections are pretty abysmal at times with 02 and Sky and we are only semi-rural!

hypercat54 profile image
hypercat54 in reply to Annie31

Yes there is that too. Many older people are scared of technology and I am the same but thank goodness computers came into use at my last job so at least I had the rudiments of using one otherwise I probably wouldn't be either!

I can see a lot of problems coming from this idea rather than solutions! Yet another slippery slope back to "normal"! 😱

My last face to face GP appointment was two years ago.Saw respiratory consultant in summer of 2020. Sitting on opposite sides of the room plus masked. He discharged me after getting a new ct scan of my chest.

Isn't this a government decision and not what the GP's want .? In my surgery some gps were gps were only in surgery part of time because they having go and do vaccine injections in the afternoons. I don't think if that is the case elsewhere that they can be accused of slacking.

Annie31 profile image
Annie31 in reply to Jaybird19

This is a proposal being put forward to the GPs by the NHS. Hopefully doctors will have some input into such a decision for the future. The problem of the somewhat deserted surgeries throughout the UK was there before the vaccinations were even discovered ie early days of the pandemic and unfortunately some are still not delivering a service. Those surgeries trying to deal with everything including delivering the jabs are doing a sterling job.

Damon1864 profile image
Damon1864Volunteer

They are all doing a brilliant job I agree with you on that point. Have a good day and take care 😊 Bernadette and Jack 🐕 xxxxxx

Unbelievable, so many changes already at GP. Some interaction just can't be done over the phone. It's a really sad thing when this is going to happen and the hospital's will get more and more people to go in, because the GP's will not see them. Maybe I should try to get a Doctor on eBay sorry, been sarcastic. Would be playing Lotto to get to the doctor then.

Thanks for sharing 2greys. 😃👍🌹😘

NHS is run by government through department of health and social care. The college of GPs. "has reservations about this statement "meaning a polite way of saying no we are not happy about this, and do require patients to be able to have face to face appointments as well as triage .

I have always had to give a breakdown of my reason to request appointment for as long as I can remember.

Well we didn’t see that coming 😉. Before the pandemic there were complaints as folks were waiting too long for GP appointments and going to A&E. What do the politicians think will happen as a result of triage. In my experience very largely from receptionists, which I find very intrusive anyway. Time for MPs to earn their money I think. Xx

Damon1864 profile image
Damon1864Volunteer

With you on that one, have a good night and take care 😊 Bernadette and Jack 🐕 xxxxxx

My feeling is that GPs have not covered themselves in glory in the last year. While the hospitals have been going flat out, many GP practices put up the barricades and are still hiding behind them. Yes, you can see a nurse, chiropodist, physiotherapist etc. face to face but doctors are obviously much more vulnerable (or should that be valuable?) creatures because they have to be protected to a greater extent. Cynical? Moi?

It's disgusting the way some places use the pandemic as an excuse for poor behaviour to hide behind!

This is so wrong. So many of the people who most need the support of their GP, can't navigate the complicated systems needed to be in place for the proposed triage. How dare the people managing the NHS presume that all patients have access to a smart phone or a computer?

teenieleek profile image
teenieleek in reply to Ergendl

Absolutely. I am carer/contact for my very aged mother who has no internet. Dealing with her practice is so frustrating, they want to triage her on the phone but she’s very deaf so they phone me and go all round the houses and up every side street in order to avoid making a house call. They’d rather send an ambulance than a G.P.

My own GP surgery seems to triage this way - at one point we weren’t able to step inside when collecting things yet on the other hand my eldest son is a GP and he has been seeing patients face to face throughout the pandemic admittedly some after having the same problem for a couple of weeks During the complete lockdown it may have been 7 a day but now he’s seeing a lot more and even may make home visits -so different to my own GP surgery. I don’t understand how they can be so different

Perhaps it's a lot to do with internal policy-making within each surgery/trust, and also whether it's rural or urban taking into consideration the risks of transmission with larger communities. Your guess is as good as mine! All I know is my GP has been to see me twice at home during the lockdowns at her offering, not my request and she is pregnant, shortly going on maternity leave. She is one of a large practice so would imagine they all perform accordingly. The Respiratory Nurse only uses the phone as far as I can tell.

He’s in a large practice at Warrington and is one of the partners. Warrington also seem to be more on the ball with the vaccination programme too. X

Maybe larger practices, larger budgets? More personnel in large practices to be able to cover more people and demands? Has your son got any ideas as to why they operate from a different prospective?

When I had a chat about it he reckoned that my practice would be having face to face A dr on the tv said practices were doing face to face throughout but again I dispute that and think only a few were doing this. We will see what happens next. I have my annual asthma review in July. X

Well I tend to agree with you as we have had members here on different posts throughout the lockdowns, stating that there were no face to face appointments in their surgeries and I cannot see the benefit of anyone telling porkies or were likely to over a matter like this. I can remember one or two actually saying their surgeries had even shut up shop like the dentists!

It would be good 🤗🤗🤗

The triage system was in place at my local surgeries pre covid. So much of the diagnostic technique is based on skin colour, texture , how the eyes look, the patient's demeanour etc. So much will be missed without face to face appointments.

It’s so Wrong I have spoken to 5 different Doctors on the phone since February 2020 . They all differ on what my symptoms are ranging from original Cough being down to blood pressure meds , acute sinusitis, post nasal drip , acid reflux and Copd. I have asked to be referred to Consultants either ent or Respiratory, been told that’s not possible with Covid & I couldn’t see a respiratory one anyway as they have to try & treat me 1st & mumbled Something about can only see them if I have bronch problems . I have spoken to the nurse who did my Spirometer readings in 2017 & told me I had copd & she is seeing me next week to go over things as I’ve about given up on the Doctors. I have to thank all of you for advice & information as I have been able to discuss certain inhalers etc on here on phone conversations but I would really like to see any kind of specialist. Despair of ever seeing a doctor!,,

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