Accessing your GP remotely

Healthwatch Barnet carried out a review between May and July 2021 to understand local people's experiences of accessing GP services remotely following the introduction of telephone, online and video consultations during the COVID-19 pandemic. The project gathered 376 experiences through surveys, telephone interviews and focus groups involving a diverse range of residents, including older people, disabled people, carers, refugees, people with sensory impairments and those with long-term health conditions. 

The report found that experiences of remote GP access were mixed. Overall, 46% of respondents said they were satisfied or very satisfied with remote appointments, 18% were neutral, and 36% were dissatisfied or very dissatisfied.

Many people identified positive aspects of remote consultations. They appreciated the convenience of online booking systems, the ability to avoid travelling to surgeries, shorter appointment waiting times in some cases, and the flexibility of receiving care from home. Some respondents found it easier to explain health concerns in writing through online forms, and many praised the efficient handling of prescriptions and referrals following remote consultations. 

Working adults, parents and some disabled people particularly valued the convenience of remote appointments. Respondents reported that remote consultations reduced time away from work, eliminated travel difficulties and, during the pandemic, reduced concerns about contracting COVID-19 in healthcare settings. 

However, the report also identified significant concerns. One of the strongest themes was frustration with the lack of patient choice. Many residents felt they were unable to choose between remote and face-to-face appointments and believed that face-to-face consultations should remain available based on personal preference as well as clinical need. People often felt that remote appointments were suitable for simple issues but less appropriate for complex, ongoing or new conditions. 

Many respondents criticised online consultation systems, particularly eConsult forms. They described the forms as lengthy, repetitive and difficult to complete, especially for people with long-term conditions who felt they had to repeatedly provide the same information. Some users reported that the system incorrectly advised them to contact NHS 111 or attend A&E when their condition was not urgent. 

Concerns were also raised about the quality of diagnosis through remote consultations. Many residents lacked confidence in receiving a diagnosis over the telephone or through video calls, believing that physical examinations were often necessary. Some respondents felt their conditions were missed, misdiagnosed or subject to delays because face-to-face assessments were not available sooner. 

Accessibility was a major issue throughout the report. Older people, people with hearing impairments, visual impairments, learning disabilities, autism, mental health conditions, limited English proficiency, or low digital literacy often experienced additional barriers. Some found it difficult to communicate effectively remotely, while others lacked the technology, internet access or confidence needed to use online systems. In some cases, people reported abandoning attempts to access care altogether because of these barriers. 

Telephone access to GP practices was another widespread source of frustration. Residents described long waiting times, busy phone lines, calls being disconnected, and difficulties obtaining appointments even after lengthy waits. Some respondents reported spending hours trying to contact their surgery without success. 

The report also highlighted concerns about communication. Patients described poor communication between GP practices, pharmacies and hospitals, delays in responses to queries, and a lack of information about changes to services or the availability of face-to-face appointments. Many felt better communication would reduce anxiety and improve their overall experience. 

Privacy and confidentiality concerns were raised by some residents. These included worries about sharing sensitive medical information online, sending photographs to surgeries, discussing personal matters in non-private locations, and uncertainty about how personal data was stored and protected. 

The report concluded that while remote consultations worked well for many people and offered genuine convenience, they were not suitable for everyone. Experiences were influenced by personal circumstances, health needs, digital skills and individual preferences. Healthwatch found that a single approach could not meet the needs of all patients.

Healthwatch Barnet recommended that GP services adopt a hybrid model combining remote and face-to-face appointments, offering greater patient choice and flexibility. Additional recommendations included simplifying online booking systems, reducing appointment waiting times, improving telephone access, addressing data protection concerns, improving communication with patients, and ensuring services better meet the needs of people with disabilities, sensory impairments, language barriers and other accessibility requirements. 

In response, the North Central London Clinical Commissioning Group acknowledged the findings and agreed that a blended approach to appointments would be important moving forward. The CCG highlighted ongoing work to improve digital inclusion, interpreting services and communication, while recognising that different groups of patients have different preferences and needs when accessing primary care services.