MailOnline has found that less than half (50%) of appointments with a GP are made now by actual doctors. It is the lowest level of this percentage in the past 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.
Despite the fact that October saw 2million more GP visits than October 2013, figures showed that 47.2 percent of those who visited a doctor were not with a qualified physician. This is the lowest number since October 2001, when the pandemic.
Today, nurses, pharmacy assistants and physiotherapists see more patients than doctors combined.
These figures also show that close to four-in-10 consultations (35.6%) are not yet in person in October. This despite Sajid javid, the health secretary, warning practices to get back up to pre-pandemic levels when nearly 80 per cent of them were face-to face.
Lincolnshire had the lowest percentage of visits with qualified doctors, with just 32.6 percent of all patient interactions with them.
North East Essex followed suit, with just 3.2% of all appointments (33.2%) being made by 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
For the first year in a row, the number of appointments at GPs with a doctor present dropped below 50%. Staff members like nurses, pharmacy assistants and even acupuncturists saw more patients than GPs.
North East Lincolnshire also performed poorly, only 34.5 percent of appointments were made 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 exception, as 59% of the GP appointments were made in London by physicians.
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. This was the only area in which more than half of all appointments were made by doctors.
Last month Mr. Javid started a civil war against England’s General Practitioners. He threatened to take a number of steps if they fail to increase their patient numbers, which could include naming and shameing specific practices.
After it became clear that face-to-face visits between patients and their GPs had fallen to pre-pandemic levels, just half of patients were able to visit their family doctor for most of the year. This is compared with eight out of 10 in 2019, which was only one-third.
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.
The threat seems to have worked partially, as GP offices across England held nearly 19.5million face-to-face appointments during October. This is 2 million more than September.
This means that 64.4 percent of GP appointments were conducted face-to-face in England last month, compared with 60.7% in September. The drop was due to a decrease in phone consultations.
While it is not nearly the same as October 2019, where 81.1% of appointments were conducted in person, this still represents a significant improvement.
MailOnline’s analysis of NHS Digital data revealed that although more appointments were made face-to-face than ever before, only 47.2 percent of them were actually with doctors. Patients instead saw other staff like nurses, pharmacist assistants, and even acupuncturists.
The number of qualified physicians who actually ran appointments decreased month-on-month by nearly 200,000 in September and October, for an overall total of 14.3 million.
Comparatively, appointment selections by non-practice staff like nurses, physiotherapists and counselors increased by an astounding 1.8million over the last two months, to 14.8million. Now, this represents 49.3 percent of all appointments.
NHS Digital has a list of acupuncturists.
It is clear that the increase in patient interaction and appointments has resulted from more visits with non-qualified staff.
In the NHS Digital data, 3.5% of all staff appointments in England remain unreported.
Martin Marshall, Chair of Royal College of GPs said that staff at practices were extremely busy heading into winter.
He stated that “GPs, our teams are busier, busier and more busy as we enter what’s likely to be an extremely difficult winter,”
Professor Marshall also pointed out that almost two-thirds of English appointments were given face-to face, despite all the pressures on staff.
He said that although general practice had been stretched beyond its limits prior to the pandemics, the increased workload and worker pressures caused by the crisis have exacerbated the situation.
‘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 all this, there was a drop in the workforce of qualified equivalent full-time workers between September 2015 to August 2021. However, patient numbers have continued to increase so that patients are more likely to see GPs.
“We’re facing a crisis in workload that could adversely impact patient care.”
The Government was asked to keep its word on providing an additional 6,000 general practitioners by 2024. Javid admits that this is not the case.
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.
However, some campaigners claim they fear that some patients are being diverted to alleviate some of the pressure on GPs.
Recent figures aren’t significantly different to pre-pandemic information on activity within GP practices. In October 2019, a similar dip was seen in the number of appointments with doctors.
According to GPs, they work hard and manage a mixture of flu jab campaigns for Covid booster and influenza and the enormous backlog of patients caused by this pandemic.
Regionally, the lowest likelihood of patients visiting a doctor in October was in Salford and South-east London. Only 49, 55.7, and 56.7% of those patients saw a physician in person, respectively.
A mere third (32.6%) and 33.2 percent (33.2%) of Lincolnshire’s patient appointments were made with an actual doctor. In third place was North East Lincolnshire where 34.5 per cent of patient appointments were with a qualified medic.
On October 10, Mr Javid presented a series of steps that would name and shame those surgeries who fail to treat enough patients. Javid also stated that a “hit squad” would be deployed to underperforming doctors to increase the number of appointments face-to-face and to review the management.
But the announcement was met with consternation by GPs who moaned about the initiative, branding it ‘unfair, demoralising and indefensible’. Unions warned that it might trigger an influx 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.
While the number of sessions doctors work per day has declined over the last decade, their wages have grown. The average GP used to work 7.3 hours per week in 2012, but that has dropped to 6.6 sessions per week. This is equivalent to just under three days of work per week. In the same period the average GP income went up by more than £6,000. Sessions are the basis of a GP’s day. A full-time GP typically works eight sessions per week. Sessions are usually two-hour sessions that start at 8am and end at 6:30pm. However, these times can change.
In a variety of cases, families or individuals claim they missed critical signs of serious health issues due to a lack of face-to–face visits.
Andrew and Anne Nash shared their story last month about the’shambolic calls’ that their son received from NHS 111 following four failed visits by GPs.
David Nash was 26 years old and had four distant consultations over the course of 19 days with doctors, nurses, and other staff at a general practitioner.
According to his relatives, none noticed the fact that he suffered from mastoiditis. This caused him brain abscessive and triggered meningitis.
Andrew and Anne believe that their son could have had mastoiditis detected and treated by antibiotics.
They believe that phone consultations later in the day were missed opportunities to help their son with his life-threatening condition.
Now, they are spending thousands on an independent neurosurgeon in order to find out how their son died.
“Our son would have survived if he saw a GP face to Face”
According to his family, the student in law would have survived if he was seen by a GP face-to-face.
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 was 26 years old and had four distant consultations over the course of 19 days with doctors, nurses, and other staff at a general practitioner.
According to his relatives, none noticed the fact that he suffered from mastoiditis. This caused him brain abscessive and triggered meningitis.
Andrew and Anne think that the mastoiditis might have been detected earlier and could have been treated with antibiotics had their son undergone a full examination last year.
They believe that phone consultations later in the day were missed opportunities to help their son with his 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.
David, a law student, died just two days after his surgery at Leeds General Infirmary failed to save him. The Nashs have paid thousands for an independent neurosurgeon who will investigate the cause of their son’s death. They hope an inquest next month will reveal all.
56-year-old Mr. Nash was an airline pilot. He said that mastoiditis can be treated with modern antibiotics. It should not have been allowed to progress to the point where it could cause a brain abscess.
‘He should never had gone to A&E in that condition. This is something that should’ve been sorted way earlier. Having approached his GP on four occasions and not being seen, I believe that is what caused them to fail to recognize his condition and to treat it. They hope that GPs will change their attitude towards face-toface 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 said that David was charismatic, caring and funny. He could find humor in even the most mundane things. His height was 6ft 7in so you could see him when he entered the space.
Both the Leeds GP Practice and St James’s Hospital Trust said that they could not comment on the incident prior to the inquest.
The NHS spokesperson stressed that all GP practices must make it as easy as possible for patients to access primary care via telephone or online.