NHS searching for the "sweet spot" as future of GP appointments a mix of face-to-face, phone and digital, says top York doctor

The legacy of the coronavirus pandemic will see a permanent radical shift in doctors’ appointments as the crisis has forced a rapid transformation of remote access plans in the NHS, according to a senior figure in healthcare.

Despite practices facing orders from NHS England last month to revert back to face-to-face as standard if patients want them, many GP surgeries are struggling to re-implement in-person appointments as the norm.
Despite practices facing orders from NHS England last month to revert back to face-to-face as standard if patients want them, many GP surgeries are struggling to re-implement in-person appointments as the norm.

Professor Mike Holmes, a former vice chairman of the Royal College of GPs who is based in York, said the NHS is yet to find the "sweet spot" between remote and face- to-face appointments.

But he admitted that a hybrid model between phone, digital and face to face appointments is likely to become normal in the post pandemic world.

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Despite practices facing orders from NHS England last month to revert back to face-to-face as standard if patients want them, many GP surgeries are struggling to re-implement in-person appointments as the norm.

The NHS said earlier this week that waiting lists for hospital care had risen to above five million for the first time amid rising concerns on the knock-on effect on cancer diagnosis and care.

Digital NHS appointments were already being used in some areas before the pandemic, and apps including Livi and Babylon had already begun a surge in popularity particularly among younger people.

Remote GP appointments were introduced en masse at the start of the first lockdown in March last year, although guidance has always been to see patients face-to-face if necessary.

Professor Holmes said: “We probably evolved, five years in less than a month.

“In the early phase of the pandemic, we were asked to shift to more and more remote appointments.

“And now, what we’re looking for is to swing it back, but to find the sweet spot. Some people really like remote access, it suits their lifestyle

“We’ve got to swing the pendulum back. Somewhere is the sweet spot between where we were before the pandemic and where we got to at the height of the pandemic. In the middle is a good place, which is probably the future of general practice.

“The world is moving and technology is advancing so quickly. This is to be expected and what we try to do is embrace technology to help us do things better. Sometimes you don't know it's better until you've tried it.”

Professor Holmes also suggested that shorter online consultations could free up time for GPs who are dealing with complex issues.

He said: “The days of 10 minute consultations for everybody need to evolve as well.

“Before the pandemic we were doing 15 minutes per patient. But if I can free up time by having shorter consultations for less complex issues online, and give the elderly, complex patients more time, would that not be a great outcome?

“Often in times of crisis, technology advances quickly whether that's a war but in this case it's a pandemic.

“We've not only seen remote consultations, we've seen the introduction of new technology including vaccines which have been amazingly successful.