Less than half of GP appointments are now with an actual doctor, a MailOnline analysis of NHS data has revealed, the first time this figure has dropped below the 50 per cent level this year.

This is even lower in some parts of the country where less than one in three patients are actually seeing a qualified doctors when they go to the GP, such as Lincolnshire.

Even though there were 2million more GP appointments in October than the previous month, figures show that only 47.2 per cent were with a qualified doctor, the lowest level since October last year, during the pandemic. 

Nurses, pharmacy assistants, physiotherapists and even acupuncturists are now seeing more patients combined than GPs.

The same figures show that nearly four in 10 consultations (35.6 per cent) were still not-in-person in October despite health secretary Sajid Javid issuing a stark warning to practices to get back to pre-pandemic levels, when over 80 per cent were face to face.  

Lincolnshire recorded the lowest proportion of appointments with a qualified doctor with only 32.6 per cent of total patient interactions being with a GP.

This was followed by North East Essex, where just under one in three appointments (33.2 per cent) were with a doctor. 

Less than one in three appointments with patients were carried out with a qualified doctor, an analysis of NHS data has revealed with areas such as Lincolnshire recording particular low rates

Less than one in three appointments with patients were carried out with a qualified doctor, an analysis of NHS data has revealed with areas such as Lincolnshire recording particular low rates

Less than one in three appointments with patients were carried out with a qualified doctor, an analysis of NHS data has revealed with areas such as Lincolnshire recording particular low rates 

The number of GP appointments with a doctor present fell below 50 per cent for the first time this year, with staff members such as nurses, pharmacy assistants, physiotherapists and even acupuncturists seeing more patients in total than GPs

The number of GP appointments with a doctor present fell below 50 per cent for the first time this year, with staff members such as nurses, pharmacy assistants, physiotherapists and even acupuncturists seeing more patients in total than GPs

The number of GP appointments with a doctor present fell below 50 per cent for the first time this year, with staff members such as nurses, pharmacy assistants, physiotherapists and even acupuncturists seeing more patients in total than GPs

North East Lincolnshire was also a poor performer, with just over a third, 34.5 per cent of appointment there with a GP.

Regionally, the North East and Yorkshire was the worst in the country for GP appointments with doctors, with only 41.6 per cent of them with a qualified GP, this was followed by the East of England (43.1 per cent), the South West (43.3 per cent), the Midlands (47.3 per cent), the North West (48.5 per cent), and the South East (49.3 per cent).

London was the only region to tip over the 50 per cent mark, with 56.9 per cent of GP appointments in the capitol carried out by doctors. 

Patients in the Herts Valleys are of west Hertfordshire were the most likely to see a doctor when visiting their GP in England, with 59.6 per cent of appointments. It was one of only 24 areas that had over half of appointments carried out by GPs. 

Last month, Mr Javid entered a war of words with England’s GPs, threatening a range of measures if they failed to boost the number patients they saw in person, including naming and shaming individual practices.

The health secretary’s threats came after it was revealed face-to-face appointments between patients and GPs were well below pre-pandemic levels with only just over half of patients managing to see their family doctor in person in for the majority of this year compared to eight in 10 patients in 2019.

The data prompted concern that vital warning signs of life threatening health conditions could be missed by a lack of in-person examinations with Mr Javid later arguing worried patients seeking help were overwhelming A&Es. 

His threats, appears to have been partially successful, with GP practices across England holding nearly 19.5 million face-to-face appointments in October, 2million more than in September.  

This means a total of 64.4 per cent of GP appointments in England were held face-to-face last month, compared to 60.7 per cent in September with the drop coming from a reduction in telephone consultations. 

While this is nowhere near the levels for the month of October 2019, when 81.1 per cent of appointments were held in person. 

Additionally MailOnline analysis of NHS Digital data has revealed that while more GP appointments were held face-to-face, less than half of these, 47.2 per cent, were with actual doctors, with patients instead seeing other staff such as nurses, pharmacy assistants and even acupuncturists. 

Top 10 areas for seeing a doctor at GP appointment 

  1. Herts Valley 59.6 per cent
  2. South West London 59.3 per cent
  3. North Central London 59.3 per cent
  4. South East London 58.6 per cent
  5. North East London 57.5 per cent
  6. Stockport 56.9 per cent 
  7. Manchester 56.3 per cent
  8. South Sefton 56.1 per cent 
  9. North East London 55.6 per cent   
  10.  Surrey Heartlands 55.5 per cent
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Bottom 10 areas for seeing a doctor at GP appointment 

  1.  Lincolnshire 32.6 per cent 
  2. North East Essex  33.2 per cent  
  3. North East Lincolnshire 34.5 per cent
  4. Norfolk and Waveney 34.7 per cent 
  5. Doncaster CCG 34.8 per cent  
  6. Portsmouth 35.6 per cent
  7. Bury 36.1 per cent 
  8. Bradford District and Craven 36.2 per cent
  9. Calderdale 36.9 per cent
  10. Ipswich and East Suffolk 36.9 per cent

 

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Month-on-month, the number of appointments actually run by qualified doctors declined by almost 200,000 between September and October for a total of 14.3million.

In comparison, the amount of appointments being picked by other practice staff staff such as nurses, physiotherapists, and counsellors has increased by 1.8million between the two months to 14.8million, now accounting for 49.3 per cent of the total number.

NHS Digital lists acupuncturists, osteopaths and chiropodists, as well as health visitors and counsellors, as some the non-GP health staff who may see patients. 

This means the growth in appointments, including face-to-face patient interactions has been driven by more appointments with staff who are not qualified doctors.  

The remaining 3.5 per cent of staff appointments in England are listed as unknown in the NHS Digital data.  

Royal College of GPs chair, professor Martin Marshall said practice staff were incredibly busy as the country headed into winter.

‘GPs and our teams are busier and busier as we head into what is likely to be an extremely challenging winter,’ he said.

Professor Marshall also highlighted how nearly two thirds of appointments in England were delivered face to face despite the pressures staff were under.  

‘General practice was stretched to its limits before the pandemic, but the intense workload and workforce pressures have been exacerbated by the crisis,’ he said. 

‘Today’s figures show GPs and our teams are working incredibly hard delivering safe, timely and appropriate care for patients, as well as two huge vaccination programmes to protect patients. 

‘Despite this, the size of the qualified full-time equivalent workforce fell by almost 6 per cent between September 2015 and August 2021 while the number of patients has continued to grow meaning that the ratio of patients to GPs has increased by more than 10 per cent. 

‘We are facing a workload crisis that risks negatively impacting patient care.’

He called on the Government to make good on its promise to provide an additional 6,000 GPs by 2024, a target Mr Javid has admitted it not on track.   

The RCGP has previously defended the portion of GP appointments attended by doctors, claiming that family doctors were not always the most appropriate person for patients to see.

But some campaigners have claimed they feared that patients were being diverted to take some pressure off of GPs’ workload.  

The latest figures not vastly different from pre-pandemic data on activity in GP practices, with a similar dip in appointments with doctors being observed in October 2019. 

GPs have said they are working incredibly hard, dealing with a combination of Covid booster and flu jab campaigns and dealing with the massive backlog of care caused by the pandemic.

On a regional basis, patients in Salford and south-east and and south-west London were the least likely to get a face-to-face appointment in October, with only 49, 55.8, and 56.7 per cent of patients seeing a member of GP staff in person. 

In terms of seeing an actual doctor, less than third of patient appointments in Lincolnshire (32.6 per cent) and North East Essex (33.2 per cent) interacted with their actual GP after booing an appointment. In third place was North East Lincolnshire where 34.5 per cent of patient appointments were with a qualified medic. 

In October Mr Javid boldly unveiled a package of measures threatening to name and shame surgeries that failed to see enough patients. He also said a ‘hit squad’ would be sent to underperforming GPs to boost the number of face-to-face appointments and review management at the practice. 

But the announcement was met with consternation by GPs who moaned about the initiative, branding it ‘unfair, demoralising and indefensible’. Some unions even warned it could trigger a wave of retirements.

Earlier this month, the health secretary went as far as to attributed a lack of face-to-face appointments as contributing to England’s A&E crisis with Mr Javid warning a group of MPs patients are resorting to turning up at emergency departments because they can’t access a doctor in person.

Anger over a lack of face-to-face appointments from doctors has come from the public partly due data showing GP salaries have increased by £6,000 on average while the number sessions they work a week has decreased.

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP¿s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP¿s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP’s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

A lack of face-to-face appointments has been attributed as a factor in a number of heartbreaking cases where people or their families claim that critical symptoms of health problems were missed.  

last month Andrew and Anne Nash spoke of the ‘shambolic’ calls their son had with NHS 111 after GPs failed to see him face-to-face four times.

David Nash, 26, had four remote consultations with doctors and nurses at a GP practice over 19 days.

Relatives said none spotted that he had developed mastoiditis in his ear which caused a brain abscess, sparking meningitis.

Parents Andrew and Anne suspect that the mastoiditis could have been spotted and treated with antibiotics if their son had a face-to-face examination at his first appointment last year.

The couple, from Nantwich, Cheshire, believe later phone consultations were further missed opportunities to diagnose their son’s life-threatening condition.

They are now paying thousands of pounds for an independent neurosurgeon to investigate how their son died and are hoping an inquest next month will provide answers.

‘Our son would not have died if he had seen GP face to face’

The family of the law student believe he would not have died if he had been seen face-to-face by a GP

The family of the law student believe he would not have died if he had been seen face-to-face by a GP

The family of the law student believe he would not have died if he had been seen face-to-face by a GP

The family of a student who died of meningitis believes he would have lived if he had seen a GP face-to-face.

David Nash, 26, had four remote consultations with doctors and nurses at a GP practice over 19 days.

Relatives said none spotted that he had developed mastoiditis in his ear which caused a brain abscess, sparking meningitis.

Parents Andrew and Anne suspect that the mastoiditis could have been spotted and treated with antibiotics if their son had a face-to-face examination at his first appointment last year.

The couple, from Nantwich, Cheshire, believe later phone consultations were further missed opportunities to diagnose their son’s life-threatening condition.

They said when David deteriorated dramatically he and his partner Ellie had five ‘shambolic’ calls with the NHS 111 system – including one which categorised his problem as ‘dental’ – ending in him being taken to St James’s Hospital in Leeds by ambulance.

His parents said he was left alone in A&E despite being in a confused and serious state, and fell, suffering an injury to his head.

Law student David died two days later despite efforts to save him by neurosurgeons at Leeds General Infirmary. Mr and Mrs Nash are paying thousands of pounds for an independent neurosurgeon to investigate how their son died and are hoping an inquest next month will provide answers.

Airline pilot Mr Nash, 56, said: ‘The mastoiditis is readily treatable with modern antibiotics and it should never have been left to get to the stage where it caused the complication of a brain abscess.

‘He should never had gone to A&E in that condition. It is something that should have been sorted out way before then and, having approached his GP practice on four occasions, not to see him I think is the primary reason that they failed to recognise his condition and treat it.’ The couple hope there will be a change in attitude from GPs towards face-to-face consultations.

Mr Nash asked: ‘How do you diagnose an ear infection – what type of ear infection it is – without actually looking in the ear?’

He added: ‘David was caring, charismatic and funny, managing to find humour in almost everything, however mundane. He was 6ft 7in tall so when he walked into the room you noticed him.’

The Leeds GP practice and the trust which runs St James’s Hospital said they were unable to comment ahead of the inquest.

An NHS spokesman stressed: ‘Every GP practice must provide face to face as well as telephone and online appointments as part of making primary care as accessible as possible.’

 

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Source: | This article originally belongs to Dailymail.co.uk

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