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May 2021

College recommends mix of virtual and in person consultations



General practice consultations post-COVID should be a combination of remote and face to face, depending on patient need, according to a new report by the RCGP.

Face to face consulting is an essential element of general practice and remote consulting should be an option but not the ‘automatic default’ for general practice services once things get back to normal after the pandemic, the RCGP says.

Both options have their advantages and the decision about how care is delivered and accessed should be a shared one between GP practice staff, based on their knowledge of their patient population, and patients, based on their individual needs.

Looking at the Future of remote consulting and patient 'triage' the College acknowledges the huge potential of remote consulting and other digital ways of working, and sees a significant role for them moving forward, but anticipates a ‘rebalancing’ between remote and in person care.

Currently around half of consultations in general practice are being delivered face to face. At the peak of the pandemic, the ways in which patients accessed their GP reversed from around 70% face to face and 30% by phone, video or online pre-pandemic to around 30% face to face and 70% remote.

However, a number of patient groups have recently highlighted a lack of satisfaction with remote access to general practice and the RCGP is calling on the Government to invest £1 billion in digital infrastructure and capabilities for general practice by 2024. This includes significant investment for ongoing upgrades to digital technology and supporting infrastructure.

The College also challenges questions Government plans, currently in NHS planning guidance for 2021/22, to embed 'total triage' into general practice, saying ‘We are not convinced that the “total triage” model or digital-first triage platforms should be the automatic default for all practices once the need for social distancing has lifted.’ It says that digital triage systems must not present a barrier to care, and will never be appropriate for all patients at all times – traditional routes such as telephone and in person appointment booking must remain available.

Practice Nurse 2021;51(4):11