United Kingdom

Boris Johnson urges GPs to offer more in-person consultations with patients

Boris Johnson last night piled pressure on GPs to offer more in-person consultations.

His spokesman said every patient had the right to a face-to-face appointment if they wanted one.

A day after the Mail launched a campaign to improve access to family doctors, Downing Street said: ‘The public rightly may choose to want to see their GP face to face – and GP practices should be making that facility available to their patients.’

Charities and politicians have been clamouring for the Prime Minister to act amid fears that cancers and other serious health conditions are being missed in remote consultations. 

Just 57 per cent of GP appointments are now in person compared with 80 per cent before the pandemic.

‘The relationship between the GP and his or her patient really depends on face-to-face consultation,’ said Tory former health secretary Kenneth Clarke.

‘I find it difficult to see how anyone can diagnose totally accurately symptoms described over the telephone. 

'I think face-to-face appointments should go back to pre-pandemic levels and I don’t see why they can’t.’

A day after the Mail launched a campaign to improve access to family doctors, Downing Street said: ‘The public rightly may choose to want to see their GP face to face – and GP practices should be making that facility available to their patients.’

‘The relationship between the GP and his or her patient really depends on face-to-face consultation,’ said Tory former health secretary Kenneth Clarke. ‘I find it difficult to see how anyone can diagnose totally accurately symptoms described over the telephone

Just 57 per cent of GP appointments are now in person compared with 80 per cent before the pandemic

As the Mail’s campaign to restore in-person appointments to normal levels gathered momentum: 

Doctors say telephone and video appointments allow them to get through more patients. 

But critics believe the pendulum has swung too far and that doctors are more likely to miss the signs of a more serious illness if they don’t see someone in the flesh.

Pressed on the issue yesterday, the Prime Minister’s spokesman said: ‘The NHS has been clear to every GP practice that they must provide face-to-face appointments, and we fully support that

Caroline Abrahams of the charity Age UK said older people were struggling with telephone triage. She added: ‘We urge NHS England to challenge and support GP practices that have moved too far, too fast, in their use of technology.’

Pressed on the issue yesterday, the Prime Minister’s spokesman said: ‘The NHS has been clear to every GP practice that they must provide face-to-face appointments, and we fully support that.

‘GPs throughout the pandemic have worked hard to see patients and appointment numbers have returned to pre-pandemic levels. 

'It’s right that the public expect to be able to see their GP in person, if needed.’

There have been calls to change the way GP practices are funded to incentivise doctors to see patients face to face. 

The pressure group Silver Voices is campaigning for a statutory duty to be placed on them to hold in-person surgeries if patients want them.

Caroline Abrahams of the charity Age UK said older people were struggling with telephone triage.

She added: ‘We urge NHS England to challenge and support GP practices that have moved too far, too fast, in their use of technology.’

The BMA said: ‘The move to an initial telephone consultation to assess a patient’s needs was, and is, in line with NHS England’s and the Government’s guidance. 

'Many patients have really appreciated the benefit of alternative types of consultations, which can then be followed by a face-to-face appointment if needs be.’ 

Three case studies reveal to the Mail how they were affected by GPs reluctance to meet face to face

CASE STUDY ONE

I was fobbed off... then found I had a tumour 

A new mum who suspected she had bowel cancer has told how she was ‘fobbed off’ by her doctor for months – before belatedly being diagnosed with the disease.

It then took a year before marketing worker Jenny Carter had surgery to remove a tumour.

The 37-year-old initially tried to get a face-to-face appointment in March last year when she was three months’ pregnant with her first child.

As her mother Christina was seriously ill with bowel cancer and she had an uncle suffering with the disease, she feared the worst when she experienced bleeding.

But her GP told her over the phone that she was too young to have bowel cancer and without seeing her, diagnosed piles – which is common in pregnant women.

The surgery had refused an appointment in person but in July 2020 agreed for her to pick up a stool-sampling kit.

When her sample was lost, Miss Carter, of Hornchurch, Essex, switched GPs – calling it ‘the last straw’.

Jenny Carter (pictured with daughter Penelope) was 'fobbed off' by doctors for months before being belatedly diagnosed and undergoing surgery to remove a tumour a year later. The 37-year-old initially tried to get a face-to-face appointment in March last year when she was three months’ pregnant with her first child.

Her daughter Penelope was born two months later and her mother died in November from the bowel cancer. 

Although Miss Carter’s new doctor immediately took her concerns seriously, the pandemic backlog meant she could not have a colonoscopy until as late as February this year – almost a year after she first contacted her previous GP.

Medics found a malignant growth and the next month she had a tumour removed, which left her needing a life-altering stoma to process her waste.

She fears that if she had been she been examined in person a year earlier, she may have been spared the ordeal.

Miss Carter told the Mail how her first fears back in March 2020 were dismissed, despite recognising symptoms due to her mother’s illness.

She said: ‘I started experiencing the same symptoms I knew all too well like heavy bleeding and called my GP multiple times to express my concerns.

‘They said I was too young for bowel cancer despite knowing my family history. They said I had piles, which is quite common in pregnant women, without giving me an internal examination and gave me various creams to try but nothing worked.

‘It got to the point where I knew it was something more sinister. I called my GP in floods of tears but they told me they could not see me and if I had any problems I should go to the antenatal clinic. I was fobbed off the whole time.’

And she explained how devastated she was when the cancer diagnosis came almost a year later.

‘I knew it was going to be bad news when they asked me to come into a side room to discuss my results. My partner, Joel, was there with Penelope.

‘The doctor told me to sit down, but I didn’t want to. I just wanted to pace around the room. The doctor told me they’d found a “large suspected malignant lesion”. The rest was just a blur.

‘I was still grieving for my beautiful mum. I kept thinking I didn’t want to die. I had too much to live for.’

Miss Carter added: ‘It was only two days after my 37th birthday and my daughter was just five months old. I feel like I am on the road to recovery now. But when I had time to think about it after my operation I was very annoyed.

‘I have got a stoma now. If I had been diagnosed back in March 2020, I might not have needed such major surgery.’

CASE STUDY TWO       

I cried down the phone, but still no appointment

Racked by a painful skin condition, a mother of three tried repeatedly to see her GP – only to be told: ‘If it’s that bad go to A&E.’

Jenni Payne, 42, said: ‘I suffer from psoriasis, which dramatically worsened last year in around August. I went from having one type of psoriasis to two and my condition was out of control.

‘I was calling the GP surgery, crying down the phone, but I was unable to get a face-to-face appointment.’

Jenni Payne, 42, said: ‘I was calling the GP surgery, crying down the phone, but I was unable to get a face-to-face appointment.’

Mrs Payne, who lives with her husband Richard and their children in Maidenhead, Berkshire, said: ‘Trying to get an appointment was impossible, even trying to get through on the phone was a nightmare.

‘It would take nearly an hour to get through to reception, who then tell you there are no appointments with the GP, not even phone appointments, and that I have to contact them via their online service.

‘I did this, filling in details about who I was, what my condition was, and why I wanted to talk to my GP.

‘The following day I got a call saying I needed to send images, so I got my husband to take photos and upload them. Fourteen weeks later and still not having heard anything, my condition had deteriorated so badly that nearly 70 per cent of my body was covered with psoriasis.

‘The skin on my back was so split that it was bleeding, but when I rang the doctor’s surgery I was told, “We have done all we can for you – if it’s that bad go to A&E”.

‘I thought to myself, this is ridiculous, I can’t go to hospital for a skin condition in the middle of a pandemic, so I found a number and called my local hospital who told me to call 111, which I did, only to be told I needed to see my GP. It was just like going round in circles – back to square one. I’ve still not seen my GP.’

In the end, Mrs Payne was forced to pay for her own light-therapy treatment at a suntan booth.

She said: ‘Now my psoriasis has improved so much, I’m down to about 10 per cent – but not through any help from my GP.’

CASE STUDY THREE 

Mouth cancer was missed because I couldn’t get a GP

Nicole Freeman is lucky to be alive after her mouth cancer was misdiagnosed because she couldn’t see her GP in person during the pandemic.

The 25-year-old was four months’ pregnant when she noticed a sore at the back of her tongue in November last year.

Unable to see her GP due to Covid restrictions, she had five phone conversations and sent photographs of the sore to her family doctor over five months. Each time she was told not to worry because it was an ulcer and she was prescribed Bonjela gel and medicated mouthwash.

It was only when hospital doctors looked at her tongue when she was in labour in March that they insisted on a biopsy and the cancer was diagnosed.

The mother of two, from York, said she was backing the Daily Mail’s campaign.

‘GPs need to start offering more face-to-face appointments,’ she said. ‘If I hadn’t been pregnant I would have been dead by now. My cancer would have been caught much quicker if I could have seen a doctor, instead of sending a picture. You just can’t tell from a picture what is going on.

Nicole Freeman is lucky to be alive after her mouth cancer was misdiagnosed because she couldn’t see her GP in person during the pandemic

‘To this day I still have to chase my GP for the simplest thing, such as my medications on repeat prescription. I’ve still had no face-to-face appointments with my GP even though we keep asking.’

Mrs Freeman – who has a second child called Holly, five – also suffers from a neurological condition. She said: ‘My health is rubbish at the moment and I’m in a lot of pain, which could be better managed if GPs were doing their jobs right. Instead we have to rely on the district nurse. I haven’t had any morphine to help with my pain for a week because they keep messing up.’

She also said she was ‘absolutely terrified’ when she was diagnosed with cancer, adding: ‘I just looked at my baby girl and cried – she was only a week old. It should have been a happy time but instead I was making every day with my baby count until I had to go into hospital for a month for surgery and treatment.’

Her husband Jake, 28, added: ‘It was really frustrating. We weren’t getting anywhere with the doctors – there was no support at all. The doctors said if Nicole hadn’t been pregnant and in the hospital to give birth she would’ve died by June.’

Three weeks after giving birth to Nevaeh, Mrs Freeman, who runs a charity for impoverished families with her husband, had a 15-hour operation to remove the tumour and she lost half of her tongue.

Surgeons used skin and veins from her left arm to rebuild her tongue. They also had to remove her lymph nodes in her neck after discovering the cancer had spread.

Mrs Freeman, who uses a wheelchair because of her neurological condition, spent four weeks recovering in intensive care, using a tracheotomy to breathe.

She had to learn how to talk and swallow again, before undergoing courses of chemotherapy and radiotherapy.   

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