Patients are being told they can no longer visit or even phone their GP to book an appointment in a move that has sparked fears over access to vital healthcare – and which appears to break NHS rules.
Surgeries are abandoning traditional ways of getting in touch with the doctor, telling patients they must go online instead.
Even anyone with an urgent problem – or parents worried about a sick child – must submit a detailed request form then wait up to 24 hours for a reply. Doctors who back the change say they are dealing with more patients than ever and insist digital systems make it easier to identify and prioritise the most important cases.
But NHS England has warned that GPs are contractually obliged to let patients make walk-in and phone bookings – and could face action if they fail to do so.
Campaigners are worried that patients – especially older ones – may be missing out on crucial consultations because they find high-tech booking systems difficult to use.
Several Daily Mail readers shared messages from their GP practices which stated that walk-ins and calls were no longer acceptable ways to book appointments
NHS England has warned that GPs are contractually obliged to let patients make walk-in and phone bookings
Last month, our resident GP Dr Ellie Cannon said she’d heard ‘worrying’ stories from friends about surgeries no longer taking calls and forcing people to email if they wanted an appointment. She said her practice would never do this and said it was almost beyond belief that any good GP surgery would ban patients from booking by phone.
However, in response, we received a flurry of letters from readers who said their surgeries were making it difficult to get an appointment.
Carole Nicholls, 67, from Hertfordshire, said booking a visit to her GP is now so complicated she has resorted to phoning the NHS 111 helpline to speak to an adviser – who can then book a slot with her own doctor.
Several readers shared messages from their GP practices which stated that walk-ins and calls were no longer acceptable ways to book appointments.
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Graham Moore, 71, from Shropshire, who has diabetes, arthritis and a heart problem, was told to ‘submit an online form to contact the practice rather than phoning or coming into reception to book’. He worries that, when unwell, he might struggle to accurately fill out an online form – and may even miss out crucial details.
‘As an ageing person with health problems, it’s vital to have reasonable access to GP services,’ he said. ‘I can’t believe how difficult they are making it to get an appointment.’
And in a particularly shocking case, one reader reported seeing an elderly man – in tears – ushered out of their surgery after the receptionist refused to let him book an appointment in person, even though he said he struggled to use the internet. Last night, Rachel Power, Chief Executive of the Patients Association, said: ‘We have raised our concern with NHS England about some GP practices insisting appointments can only be booked online. This should not be happening – the GP contract makes it clear patients should be able to book appointments by phone, online or by popping into the surgery.’
For more than a decade, GPs have used online bookings – alongside walk-ins and phone calls – to make appointments. Yet, experts believe the rise in online-only booking systems began during the pandemic and has become more common as GPs struggle with a growing workload.
In 2020, to reduce the spread of Covid, the NHS encouraged doctors to reduce walk-in requests by adopting a system called Total Triage which means every patient provides information to the practice about their problem before the appointment is booked.
While, in theory, this can be done over the phone with a receptionist, many surgeries set up online systems so patients could write out their issues in detail.
This system reduced the workload of receptionists and has largely remained in place because many doctors believe it ensures patients who need an appointment the most get seen first and discourages others from booking needless visits. For example, receiving test results and sick notes is typically done online now, rather than by visiting a GP.
Patients who would be better suited seeing another member of staff – for instance a physiotherapist – can also be referred directly without seeing the doctor.
The need to free GPs’ time is clear. There are around 27,000 full-time GPs in England, nearly 2,000 fewer than a decade ago, according to the British Medical Association. Meanwhile, the number of NHS patients has risen by around six million over the same time period – with 1.4 million GP appointments every working day.
Last month, GPs announced they would be taking industrial action – including limiting their work hours – over a contract dispute which, in part, relates to their increasing workload. Not surprisingly, public satisfaction with GPs is at an all-time low, with many saying they’ve given up trying to see their doctor altogether, according to the GP Patient Survey.
Dame Prof Clare Gerada, a London GP and former president of the Royal College of GPs, argues a greater use of digital technology is crucial for patients and doctors. ‘GPs who go “digital first” aren’t being lazy, they’re just trying to prioritise their activity,’ she says. ‘Most patients appreciate having digital means of accessing their GP.’
She adds that there must always be an option for people who cannot use digital technology. ‘If someone walks in with an emergency, like a sick child, they should be allowed to book an appoinment at the desk. Turning them away and asking them to use the website would be unacceptable. Likewise, there must be options for people who do not have access to a computer or smartphone or are just not tech savvy. Patients absolutely should be allowed to walk in or ring up to make appointments.’
An NHS spokesman said: ‘Practices are contractually obliged to allow patients to walk in, phone or go online to make appointments and if this isn’t possible local commissioners should support practices to address this access issue.’
