GP Omnibus

Our survey began collecting responses from GPs focused on patient presentation in Jun 2020. Looking back over this summer period it seems that the number of patients contacting their GPs for advice on symptoms was falling. However, by September this trend had reversed, with many GPs reporting more patients than before the pandemic began.

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Understanding why this change occurred for certain is difficult. For example, some of the shift may have been due to public health campaigns at the time, that encouraged members of the public to visit their GP. We do have a breakdown of the picture for how cancer services have been impacted throughout the pandemic that you can explore here. 

While patient presentation is now showing signs of recovery, GPs reported some concerns around the differing impact for different population groups. 

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Looking at the above graph, we can see that the biggest differences compared to pre-pandemic are for “older adults”, with marked differences also for patients with a learning disability and patients who have English as a second language. GPs remained concerned about these groups fairly consistently between July 2020 and February 2021 (most recent data available).

The pandemic has accelerated the introduction of remote consultation in primary care with services quickly adapting to offer alternatives to face to face.

In February 2020, 14% of GP appointments in England were recorded as taking place over the telephone, rising to around 40% in January 2021. Meanwhile, face to face appointments fell during the pandemic, from 80% in February 2020 down to 56% in January 2021. (Source: NHS Digital Appointments in General Practice Monthly Data).  

While the shift was obviously important in balancing infection control and patient safety against maintaining patients’ ability to have contact with primary care, it brings new challenges and barriers to consider. With this in mind, We asked GPs specifically about how these types of consultation may be impacting on cancer early diagnosis.

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While this survey did not speak to patients directly, some of the same patient groups were highlighted as being disproportionately impacted by remote consultations in terms of how difficult GPs feel it is to try and identify potential cancer symptoms.

We can see that phone consultations can be the most difficult, especially when it comes to understanding question or asking patients to describe their symptoms. Video and e-consultations appear to present less of these ‘communication’ barriers. However, GPs were concerned about the access and technology barriers they posed.

In the context of smoking cessation - 40% of GPs felt that it was more difficult to deliver VBA for smoking cessation via remote consultation than face to face. The proportion of GPs finding remote consultation challenging rose to 80% when dealing with patients whose first language is not English, and 57% for patients with patients from a lower socioeconomic group.

With remote consultations likely to continue after the pandemic, finding the balance of when to prioritise which consultation method will likely also remain a challenge.  

We are continuing to conduct surveys with GPs as well as with patients and other groups to get a better understanding of what is happening. We have more information on remote consultations in primary care available on our website here. If you have any questions or comments about this work, feel free to email us at cancerintelligence@cancer.org.uk.