Doctors Are Assessing Patients In Phone Calls Before Granting Face-To-Face Appointments

Now you need to PROVE you need to see the doctor: Hundreds of GPs are assessing patients in three-minute phone calls before granting face-to-face appointments

• Approach is being rolled out across 180 surgeries, covering 1.7m people
• Firms training staff say two in three patients need only words of advice
• Concern GPs will miss symptoms they would have spotted at close hand

Family doctors are denying patients face-to-face appointments to try to reduce demand.

Surgeries are offering three-minute phone assessments instead – with proper consultations only for the seriously ill.

The approach is already being rolled out across 180 surgeries, covering 1.7million people. Receptionists take down a caller’s details and a GP rings them back to assess their case.



Family doctors are denying patients face-to-face appointments to try to reduce demand (file photo)

The two private firms training staff in the system say that two in three patients need only words of advice. But campaigners warn that some, particularly the elderly, might be ‘fobbed off’ or end up going to casualty.

They also worry that GPs will miss symptoms that would have been spotted at close hand.

Sir Denis Pereira Gray, ex-president of the Royal College of GPs, said: ‘Doctors cannot see if they’re pale, jaundiced, shaking, altering their walk, if they’ve got a tremor – dressing differently.


‘There are 101 things experienced GPs can see in ordinary consultations. We have evidence it’s extremely worrying and upsetting for patients.’

A major poll today reveals the pressures surgeries are under from high migration, an ageing population and a recruitment crisis.

Only one in ten GPs believe they can offer safe, quality care. Many favour the assessments – ‘telephone triage’ – because they can cut their hours and spend less on locums.



Campaigners worry that GPs will miss symptoms that would have been spotted at close hand (file photo)

One of the private firms – Productive Primary Care – has trained 80 surgeries covering a population of 730,000 to use its Doctor First system.

Practices pay a one-off fee of around £8,000 for several weeks of training and advice. They are advised not to offer any face-to-face appointments before 10.30am – giving over the first two hours of the day to assessing patients by phone. The firm expects to have trained 20 more surgeries by next year, covering a further 150,000 patients.

The other company – GP Access – offers a similar system and is being used in 100 practices covering a population of more than a million. The firms promise to reduce doctors’ workloads and stress levels and enable them to be more in control.

Both insist that patients can secure an appointment – no matter what the doctor thinks.

But they say that an average of 66 per cent cope with simple advice such as to take rest or paracetamol.

Tim Farron, leader of the Liberal Democrats, questioned the approach. ‘It could have advantages but I do worry if we move lock, stock and barrel to a scheme like this we will break the link between a community GP and their patient,’ he said.

‘This is a vital and much loved British tradition that the GP knows his patients and is at the heart of a community.’

Joyce Robins, of the pressure group Patient Concern, said: ‘In some practices this works well but in others patients are being fobbed off.’

And Caroline Abrahams, of the charity Age UK, said: ‘For many older people with complex needs or mental capacity issues a GP will not always be able to assess what is wrong on a phone call. Older people should never hesitate to seek immediate help from the GP or be deterred from having a face-to-face appointment if they are worried.’

Surgeries were encouraged in April to make better use of telephone triage in an NHS report. The review said it would help ‘streamline practice processes’.

Dillon Sykes, of Productive Primary Care, said: ‘We’re getting a lot of interest. The GP can often tell within 30 seconds whether they need to see a patient.

‘A GP may say it’s not necessary to see you at the moment, what you need to do is go to a pharmacy and pick up this cream.’ Harry Longman, chief executive of GP Access, said the system worked and practices could not carry on as before.

Professor Maureen Baker, who chairs the Royal College of GPs, said surgeries would always look at ways to manage demand but stressed that telephone triage was not a blanket solution.

A Department of Health spokesman said: ‘We are investing in primary care precisely to relieve pressure on the frontline, which will improve patient safety – with an extra £2.4billion of funding, 5,000 more doctors in general practice and 1,500 more pharmacists in surgeries by 2020.’

One concern about telephone triage is that patients might miss out on the chance to mention other problems that could turn out to be serious.

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