GPs raise alarm over urgent conditions being reported online amid access changes

Changes to online access in GP surgeries has led to people submitting requests about life-threatening conditions on non-urgent forms, family doctors have said.

It comes as more than two-thirds of GPs raised concerns about patient safety in a new poll.

From October 1, GP surgeries in England have been required to keep their online consultation platform open for the duration of their working hours for non-urgent appointment requests, medication queries and admin requests.

Family doctors told Pulse magazine they have since had reports from patients about difficulty breathing, rectal bleeding and severe vomiting on the forms, which are designed for non-emergencies.

The poll of 431 GPs and practice managers by Pulse found 67% are concerned about patient safety since the change.

Dr Caroline Delves, a GP partner in Norfolk, said she has had clinical queries about a six-week old baby with a growing red lump and another about a five-week old who was lethargic and vomiting.

Another patient who filled in a non-urgent medical form saying he could not breathe managed to go to A&E, but could have been left waiting longer to be signposted, according to Dr Delves.

She added: “That’s on a form that’s supposedly non-urgent – he could have sat there until we’d got through the other 70 forms we had to look at, which would have been unsafe.

“We had someone on a Monday who disclosed they had been vomiting blood all weekend on a Monday morning via a change of address admin form.

“I think there’s probably a level of health literacy expectation in the policymakers that doesn’t exist for everybody on the ground.”

One GP from the West Midlands said the change has caused a surge in demand for staff.

They told Pulse: “We’re doing 340 to 400 medical triages on a Monday, and other days, 200 to 300. It’s overwhelming and unsafe. Patients are dealt with quickly often through further symptom questionnaires but it will burn us out.

“By the time 5pm comes and admin needs to be done it’s hard to concentrate on the septic, suicidal or end-of-life patients that we try to prioritise between all the queries that are overwhelming us.”

Another GP warned: “Processing online requests and triaging after a 13-hour intensive clinical day is unsafe and unsustainable.”

It comes after the British Medical Association (BMA) entered a dispute with the Government over changes to online access.

The union argues that certain safeguards have not been put in place to support the change and no additional staff have been hired to manage the requests.

It claims this could risk patient safety as staff try to find the most urgent cases, with fears that reviewing online requests will take up too much time.

Dr David Wrigley, deputy chairman of the BMA’s GP committee, said: “It’s deeply worrying – and sadly unsurprising – that GPs are concerned for patient safety as a result of these contract changes.

“We warned the Government repeatedly in the past six months that allowing unlimited online consultation requests without the necessary safety measures or additional resources would overwhelm already stretched teams, divert doctors from face-to-face appointments and risk urgent cases being missed.

“General practice is not against the use of technology and have been embracing it for over 30 years, but innovation without safeguards is dangerous.

“We believe there is significant risk to patients and to our practice teams from this new initiative, and the Government must provide the protections it committed to back in February.”

Dr Amanda Doyle, national director for primary care and community services at NHS England, said: “It is right that patients should be able to contact their GP practice online – in addition to by phone and by walking in – which is why it was agreed by the BMA’s General Practice Committee in February.

“In the many practices already offering this service, patient satisfaction is higher.

“Patient safety remains our priority and guidance and support has been provided to practices to help them put the necessary safeguards in place for urgent clinical requests.”