The Mail on Sunday

I never thought I’d say it, but NOT being able to see patients in person is good for them, me and the NHS

- by Dr Ellie Cannon

IT’S strange to think back to life before the pandemic – just seven months ago a world with Covid- 19 didn’t even exist. Family and friends could be greeted with hugs, and evenings and weekends were whiled away in packed, noisy restaurant­s and bars. When old footage of a crowd pops up on TV, I now have to remind myself it was normal to stand closer than a metre or two apart.

Hopefully a vaccine can soon be found and some sense of normality will return. But there are some things which I hope will stick.

Before Covid-19, getting an appointmen­t at my GP surgery – and most others – was a scramble. Demand vastly exceeded supply.

But every day there would be no-shows – patients would simply not turn up for their appointmen­t. No call, no cancellati­on.

It made me so cross. I even wrote an article suggesting that everyone should be charged 50p to see their GP – a bit like the plastic bag ‘tax’ we all now pay. The whole situation was a shambles.

For years we’ve been shopping, banking and ordering takeaways online, but the NHS was lagging well behind. It was clear it needed an upgrade, but far too much time was being wasted, agonising over what might go wrong.

Some doctors were dragging their feet too, fearing technology might change the essence of the patient-GP relationsh­ip.

Then lockdown happened. There was no time for red tape or indecision. We had to work out quickly how best to deliver care to patients at home.

And almost overnight, GPs were catapulted into the 21st Century.

Suddenly, video and phone GP consultati­ons became the norm, appointmen­t-booking processes were overhauled and the patients who really needed help fast, got it.

The shift, made possible thanks to tech firms implementi­ng fit- for- purpose systems in record speed and practice staff who rose to the challenge, has been breathtaki­ngly fast.

When the first case of Covid-19 was reported in the UK back in January, 71 per cent of GP consultati­ons were carried out face-to-face, figures from the Royal College of GPs show.

Now the picture is reversed: the proportion of appointmen­ts held remotely has soared to 71 per cent.

If you’d shown me these numbers before the pandemic, I would have found them alarming. Face-to-face appointmen­ts are essential for building rapport with your patients, and you can also pick up on symptoms or problems that you might otherwise have missed without seeing someone. I believed technology might limit this vital contact, but it hasn’t.

BEFORE lockdown, I thought it was a great innovation that I could send a text message to my patients. They couldn’t reply, but it meant I could let them know quickly if their blood results were fine, send reminders or useful links to online informatio­n.

Just 48 hours after the announceme­nt of strict restrictio­ns on our lives, the options at my disposal expanded vastly, and we were given the green light to have video consultati­ons with patients.

Using this technology I have seen new babies with their mums and keyworkers who were unable to get to an appointmen­t, and checked up on shielding patients and care home residents too.

My patients can now reply to texts, and I can send them documents such as fit notes (once known as sick notes) or referral letters securely to their phone. If you need a prescripti­on, it’s sent straight to your pharmacy – meaning you no longer need to pick up a green slip from reception.

Most surgeries now ask patients who wish to book an appointmen­t to fill out an online form, giving plenty of informatio­n. If it’s just a letter that they need, admin staff can handle that. Complex problems can be forwarded on to your doctor – you might need a face- to- face appointmen­t, or you might not.

There have been understand­able concerns that many cancer diagnoses are being missed. Last month, Cancer Research UK said an estimated two million people were waiting for breast, bowel or cervical screening.

But during lockdown, patients who have come to me with symptoms have been diagnosed quicker than ever – with most seen within 48 hours instead of the usual two, three or four week wait for that first GP appointmen­t. One of my patients was diagnosed with breast cancer after a video consultati­on raised alarm bells and then after she came in for a quick face-to-face appointmen­t she was immediatel­y referred. Another was diagnosed with bowel cancer after speaking to me on the phone.

Our tech system now allows patients to send us images from their phone, say of a strange growth. This has been transforma­tional in the diagnosis and treatment of skin troubles. A friend who had a skin infection on his face sent pictures to his GP at 10.23am on a Friday morning. A treatment cream was prescribed and sent to his pharmacy, and at 10.49am he was told it was ready to be collected.

But if you don’t have a smartphone, you won’t be left behind. The reception telephone lines are now freed up, so you can speak to a member of staff directly, without wasting any time on hold.

And no-shows are a thing of the past too. Last year, the magazine GPonline revealed that patients fail to attend an estimated 16.4 million appointmen­ts over a 12- month period. That’s the equivalent of 375 average GP surgeries opening every day of the year without their doctors seeing a single patient.

But this problem has evaporated. We have a list of people we need to call, and we just work through it. If we don’t get an answer, we’ll move on to the next appointmen­t then try again later, perhaps three to five times depending on how concerned we are to speak to the patient.

These changes will be long lasting. NHS guidelines now recommend that practices permanentl­y move away from the old first-come,

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