Era of face-to-face GP appointments is over in Norfolk

How will GP surgeries carry out appointments going forward?

GP appointments are set to take on a mixed approach in future as surgeries across Norfolk and Waveney say they "won't go back" to their former ways of working after the pandemic. - Credit: Getty Images/iStockphoto

The era of guaranteed face-to-face appointments with your GP is over, according to medical bosses in Norfolk and Waveney.

Covid has forced surgeries to reduce in-person consultations and increase phone and video chats.

And, while old-style appointments are expected to increase post-pandemic, a report to Norfolk and Waveney Clinical Commissioning Group said the other ways were here to stay.

Mark Burgis, the group's locality director, said as practices began restoring services they would not revert to the previous model.

Phone appointments more than tripled between February and April last year from 11pc to 36pc and have remained on average 28pc of all responses in Norfolk and Waveney.

Face-to-face remains the main way GPs have seen patients in the last 12 months, though they are down from 84pc last February to 66pc in February 2021, according to NHS Digital.

Video consultations in the region have made up less than 1pc of all appointments, reaching a peak of 1.4pc or 8,931 appointments in October.

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Among the practices set to continue adopting phone and video appointments in addition to face to face meetings is the Elmham group of practices based in Mid-Norfolk.

Judith Wood, practice manager, said it had been a "massive challenge" to adapt its three practices in Dereham, Swanton Morley and Toftwood over a weekend.

Mrs Wood said: "We have always done telephone consultations as patients will ask 'can someone ring them back?'.

"We did not do any video calls - video was completely new. 

"We won't go back. This was on the cards, this was in Simon Stevens' plans for GPs.  We will be using a mix of technology."

Charlotte Chapman and the team at Elmham Surgery infront of the new mural. Picture: Carol Dunne-Bath

Staff at Elmham Surgery pictured with the mural painted by Charlotte Chapman. Picture: Carol Dunne-Bathurst - Credit: Archant

To meet the demand of patient calls extra phone lines have been installed and a second delivery van has been acquired to take medication to those living in remote areas, to reduce the number of people coming to the surgery.

The Swanton Morley surgery has also acted as a vaccination hub, distributing 20,000 vaccines since December.

Mrs Wood said staff had needed to learn to note changes in patients when they were not in the same room, but said they would always have appointments for those who needed regular reviews and physical examinations or checks.

Mrs Wood said: "We will keep triage. It will not go back to what it was 18 months ago. 

"It will be a mixed picture based on what patients need and the reason for needing an appointment."

Ardyn Ross. Picture: Ardyn Ross

Dr Ardyn Ross said the new ways of working had improved response time for patients, but some colleagues had struggled. Picture: Ardyn Ross - Credit: Ardyn Ross

GP board members on Norfolk and Waveney Clinical Commissioning Group said at the group's governing body meeting on Tuesday that phone and online consultations had helped to improve same-day responses.

Dr Ardyn Ross, of the Millwood Partnership in Great Yarmouth, said: "I think it has enabled us to work so much more efficiently with patients.

"Response times have massively improved so people can expect to have a response within the same day.

"My only caveat would be is I don't think it has worked so well for some GPs and other clinicians. I am aware of colleagues that really do struggle with it.

"I think moving forward we need to find a way that suits everybody and can play to all of our different strengths."

Trustee Doris Jamieson urged the CCG to hear the patient experience, raising concerns about patients not knowing when they would get a call back from a GP - a problem exacerbated by the return to work and the "new normal".

Dr Hilary Byrne, a partner at Attleborough Surgeries, she felt there would be long waits if there was a return to a more traditional model. 

She said: "Having the right kit has been absolutely crucial in making this work.

"I think we do need this flexibility and the technology to be able to manage the work load. I think patients are getting very quick responses which is excellent and we want that to happen. In order to maintain that we just couldn't physically go back to the way we were doing things before."

More than 600 comments showed readers across Norfolk and Waveney had strong views on the subject, with a balance of support for the mixed approach and for face-to-face appointments.

Among those wishing for face-to-face, there were concerns that consultations were not necessarily accessible for all or easy for staff to pick up symptoms that needed treatment.

Claire Hubbard said: "A mix of both would be good. Mild problems could be discussed over video call, with something more serious dealt with face-to-face. Would need good triage though."

Sarah Cooke Richardson said: "Face-to-face definitely. I fear so many issues have gone undiagnosed or misdiagnosed because of not actually being able to see a doctor."

Ross Chettleburgh said: "I'm happy to have initial phone/Zoom and make an 'in person' appointment if required."

Katie Dee said the online system allowed her to make an enquiry before work, send photographs on her break and pick up antibiotics from the pharmacy on her way home after a diagnosis.

She said: "No need to book time off work. Job done. Face-to-face appointments were always a nightmare for me."

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