Even fewer face-to-face GP appointments are being held than feared because some phone consultations are wrongly being recorded as having taken place in-person, it emerged today.
Officials have admitted the error, blaming it on the way appointments are booked.
But the true extent of the issue is unknown, with a cloud of doubt now cast over the official statistics.
Face-to-face appointments have still not returned to pre-Covid levels, despite family doctors being ordered to offer them to those who still want them.
Statistics for England from NHS Digital show only 58 per cent of GP appointments in in August were held face-to-face. This is well below levels seen before the pandemic struck, when 80 per cent of consultations were carried out in-person.
But campaigners fear the actual figure has been ‘fiddled’, following the revelation that some appointments have been incorrectly classified in official data.
The number of GP appointments taking place face-to-face dropped dramatically at the beginning of the pandemic, as virtual appointments were encouraged in an attempt to keep social mixing low and hospitals virus-free. In-person appointments began to increase last summer, before dropping again during the second wave. Despite being on the rise, the figures are still much lower than pre-pandemic levels
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
In a caveat in its official data, which is classified as experimental, NHS Digital explained that since the start of the Covid pandemic some GP appointments have classified some remote interactions as face-to-face.
It says: ‘From March 2020, face-to-face appointment mode data may not be entirely reflective of what happens in the practices.’
The body adds: ‘Appointment types have been assigned to appointment modes prior to the pandemic.
‘Thus, even if the appointment was carried out through a different mode, the appointment registers as a face to face appointment on the system.’
A NHS Digital spokesperson added: ‘We do acknowledge that there may be data quality issues with the data and instances where the data may not be a true representation of what may be happening in all practices.’
One potential scenario for this to happen would be if a patient booked for a face-to-face appointment was then told to self-isolate as they may have Covid.
The GP in this situation could change the consultation to happen over the phone but since it was originally booked as a face-to-face appointment that is how it could be recorded in the official data.
As the NHS Digital dataset details, although there are national guidelines for GPs to record appointment data, these are not standardised across all practices, making drawing conclusions on the data problematic.
Further muddying the waters is so called ‘block booking’ appointments which involves classifying a large amount of consultations as a single type of appointment.
For example, if a GP were to enter into their appointment system a single telephone consultation but actually call 10 different patients this would still only be classified as one appointment in the data.
If the above scenario were to occur this could vastly underestimate the actual number of telephone consultations.
While starting in March 2020, some patients are also reporting misclassification of their appointments as happening recently.
Anne Bedish, 68, told The Telegraph that after checking her patient record online she was surprised to learn all 12 of her telephone consultations had been classified as face-to-face.
This included those held just one month ago, she told the newspaper.
Silver Voices, a campaign group representing elderly Britons, called for the issue to investigated.
Its director Dennis Reed suggested the figures may have been massaged by GP practices under pressure.
‘This needs to be investigated. How many of the figures have been fiddled in this way? It is really worrying,’ he said.
‘I know that practices are under a lot of pressure to increase the number of patients getting a face-to-face appointment, and it worries me that we could see more and more of this.’
Questions over official data represents the latest blow to the trust between patients and GPs, following a string of reports of missed diagnoses due to a lack of face-to-face appointments.
Yesterday, a grieving husband claimed his cancer-stricken wife would still be alive if a GP hadn’t refused to make a home visit.
Anton, a father-of-three from Bromley, begged a doctor to visit his 44-year-old wife who was in ‘severe pain’. But a nurse was sent instead, who only checked her pulse and temperature.
By the time his wife eventually made it to hospital, it was ‘too late’, he told LBC in a heartbreaking interview yesterday. She died three months ago after her disease had spread to her brain.
The widower’s comments came as fury erupted yesterday over other government-backed data showing that the average GP who earns around £100,000 a year — was working just 6.6 sessions each week before Covid.
The news prompted outrage and calls from campaigners for family doctors to work a minimum number of hours a week in return for their taxpayer-funded training.
It can cost up to £230,000 to train up a doctor over the course of several years, but the Government makes some money back through student loan repayments.
Reacting to the news Mr Reed told MailOnline: ‘If people are put through very expensive health training all that is partly provided for free, there should be an expectation that they will work a certain amount of hours.’
He blamed the drop in sessions for being one of the main reasons why patients are struggling to see their GP in the flesh. Other critics said it was ‘disgraceful’ doctors were earning six-figure salaries for working three-day weeks.
Mr Reed was reacting to a report which showed the number of sessions the average GP works has dropped from 7.5 to 6.6 sessions per week in the last decade.
And the number of hours doctors work for each week has dropped from 46.4 in 1998 to 40 in 2019, according to the National GP Worklife Survey of 1,332 GPs, carried out by the University of Manchester.
A doctor consults with a patient in April 2020, during the first Covid lockdown (stock image)
Just 0.6 per cent of appointments in August were home visits, down from one per cent before the Covid crisis. Doctors have long called for them to be scrapped because they are too time-consuming
Meanwhile, practitioners’ salaries have increased dramatically, with the proportion of doctors earning less than £100,000 falling.
In 2010, just 2.6 per cent of GPs were making £170,000 or more — a larger sum than the Prime Minister — but 7.1 per cent were making that much by 2019.
And 5.9 per cent were making between £150,000 and £170,000 in 2019, compared to 3.3 per cent making the sum in 2010.
The British Medical Association, the trade union for doctors, argued the notion of a ‘part-time GP is often anything but’.
It said the average doctor still works 40 hours per work — just split into fewer sessions, and the current levels of workload were made worse by ‘piles of admin and bureaucracy’.
It called for family doctors to be relieved of red tape, in a move it claims would allow them to devote more time to patients.
The BMA’s calls come after it was revealed GPs could be stripped of responsibilities to free up their time. Under plans being considered by ministers, pharmacists could also be given the power to dish out prescriptions.
The Royal College of GPs has blamed rising a workload and falling numbers for the ‘tremendous pressure’ doctors are under. This has led to many burning out, working less than full-time or leaving the profession, it said.
There is now just one practitioner for every 2,000 patients, with the rate having risen 5 per cent since 2015. In the worst-affected parts of England, the rate is nearly one in 3,000.
Matthew Lesh, head of research at the Adam Smith Institute (ASI) thinktank, told MailOnline: ‘The NHS is systematically broken.
‘Millions of people are on waiting lists, it can take weeks to see a GP and many are still unable to get a face-to-face appointment.
‘Now we discover that GPs, who earn six figure salaries, were working just three days a week on average before the pandemic. This is simply disgraceful.
‘We urgently need to reassess the structure of the NHS and GPs to ensure it delivers for patients.
‘The top-down, bureaucratic nature is letting far too many people down.
‘It may be time to move from a bulk payment per patient to a per appointment funding structure, to encourage doctors to actually see patients as quickly as possible.
‘It may be time to allow for co-payments, so patients can pay small amounts to see a doctor faster.’
GP practices are currently paid by NHS England on the basis of how many patients they have registered.
John O’Connell, head of campaign group TaxPayers’ Alliance said: ‘Taxpayers expect a certain standard of care, given the huge amount they pay for the NHS.
‘Health professionals should ensure that all patients get the level of service they need.’
And Tory MP Peter Bone told MailOnline there were a ‘small number’ of GPs that were ‘to some extent using Covid as an excuse’ not to provide face-to-face appointments.
Boris Johnson and his ministers promised in May to ensure face-to-face appointments were offered to all.
But the Royal College of General Practitioners warned MPs this would be an empty promise if there was still too little capacity.
The Daily Mail has been campaigning for in-person GP appointments to be the default option