NHS England has said GP practices must start opening their receptions and allow their patients to book face-to-face appointments — scrapping the controversial ‘total triage’ rule — for the first time since the early days of the coronavirus pandemic.
Since last spring, NHSE guidance has said that face-to-face appointments must generally only take place after a phone, video or digital consultation. Consequently, many GP practice receptions have been closed to people wanting to make routine appointments. NHS Digital statistics show that 90 million fewer face-to-face GP appointments were carried out last year. Data revealed by the Daily Mail shows 147.85million in-person consultations happened between April 2020 and this March — down from the 238.26million during the same 12-month spell the year before.
A triage system which was introduced by most GP practices during the pandemic sees a person checked by phone, video or online. A decision is then made by the GP to ascertain whether the patient needs to be seen in person.
NHS England has issued a letter to GPs revealing that imminent new guidance would scrap the ‘total triage’ rule.
The letter says, ‘GP practices must all ensure they are offering face to face appointments… while the expanded use of video, online and telephone consultations can be maintained where patients find benefit from them, this should be done alongside a clear offer of appointments in person.’
The letter stresses that ‘half of all general practice appointments during the pandemic have been delivered in person’, but these have normally only been permitted after phone/video/online consultations.
The letter adds: “Patients and clinicians have a choice of consultation mode. Patients’ input into this choice should be sought and practices should respect preferences for face to face care unless there are good clinical reasons to the contrary, for example the presence of covid symptoms.’
Importantly the letter says, ‘All practice receptions should be open to patients, adhering to social distancing and IPC guidance… Receptions will not yet feel like they did pre-pandemic – for example where space is very constrained patients may be asked to queue outside…
‘Patients should be treated consistently regardless of mode of access. Ideally, a patient attending the practice reception should be triaged on the same basis as they would be via phone or via an online consultation system.’
The letter links the change in guidance to loosening of Covid restrictions, saying, ‘Guidance on the phased easing of covid-19 restrictions continues to be issued by government… As such, ahead of government rules on social distancing changing from 17 May, we would like to draw your attention to a new standard operating procedure which will be published shortly, and which will update and replace previous guidance.
Dr Jeanette Dickson, president of the Royal College of Radiologists, has said that this drop in face-to-face appointments has meant fewer people are being referred for cancer tests and treatments.