Patients are being reminded of their rights to request in-person GP appointments, as legal experts warn that some surgeries may be falling short of national guidance. Under current NHS rules, GP practices are expected to offer face-to-face consultations where patients request them, unless there are valid clinical reasons not to do so.
An NHS GP said: "Practices in England must offer face-to-face appointments if requested. GPs who fail to make the necessary arrangements for patients to make an appointment without having to spend hours on the phone or who are not available for face-to-face appointments are, in the strictest terms, breaking the law."
Guidance from NHS England states that surgeries should respect patients' preferences for in-person care, although it also allows doctors to decide when a remote consultation is clinically appropriate, such as in cases involving Covid symptoms. Patients are still entitled to be assessed within 48 hours when necessary.
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Sophie McGarry, a solicitor at Fletchers Group, said patients should not hesitate to request an in-person appointment if they feel it is needed. She advised explaining clearly why a face-to-face consultation is important and, if refused, escalating the issue to the practice manager or making a formal complaint.
GP surgeries are also expected to provide clear information on how to access care, writes Charlotte Smith from Liverpool Echo. According to NHS England correspondence sent to practices, they must display up-to-date guidance on their websites explaining:
- How to contact the GP and request help
- How to access face-to-face or walk-in services
If this information is not readily available, patients can request it directly and remind the practice of its obligations. McGarry said: "If the GPs or receptionists continue to refuse to examine you in person, you could escalate the matter to the practice manager and ask them to explain why your wish and request for a face-to-face examination are being refused."
Patients can arrange, change or cancel GP appointments by using an online form via the surgery's website or the NHS App, by phone or in person at the reception desk. Practices may ask questions about symptoms before booking to assess urgency and direct patients to the most appropriate healthcare professional.
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While remote consultations can be useful for minor issues, McGarry argues that in-person assessments are often safer and more thorough. She said: "Telephone and remote assessments have their place for certain minor issues, but overall, I believe in-person appointments are safer and you are less likely to be misdiagnosed than if you had a remote assessment."
She added: "If a GP is assessing someone by telephone, there is no opportunity for them to conduct any tests or examinations. If a GP is assessing someone in person, even if they just want to perform the examinations as a precautionary measure, this is more likely to identify an abnormality than a telephone appointment."
Face-to-face appointments can also help identify unrelated or 'incidental' issues that might otherwise go unnoticed. They may also make it easier for patients to discuss sensitive concerns. "Remote appointments can leave patients feeling like there is a disconnect between them and their GP. It may be easier for them to open up to a GP in an in-person appointment, where they are receiving face-to-face, hands-on, human care," McGarry added.
The solicitor also highlighted that remote consultations can take place when patients are distracted, such as at work or travelling, meaning they may not be able to give their full attention. Certain conditions are particularly difficult to assess remotely, especially those requiring physical examination. These include infections, chest pain, abdominal pain and potential cancer symptoms.
McGarry explained that identifying issues such as lumps requires direct examination: "It's crucial to both see and feel any lump to determine its location, dimensions, texture (whether firm or soft), and whether it causes discomfort when pressed."
She added that some procedures simply cannot be carried out remotely: "An example is a digital rectal examination to assist in diagnosing prostate cancer, or vaginal examinations with a speculum to visualise cervical abnormalities... GPs need to see and feel the prostate or cervix to decipher whether or not there are suspicious features which require further investigation."
NHS England also cautions against patients sharing images of intimate areas during remote consultations and states that such cases should be handled in person with appropriate safeguards.
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Patients who are concerned about a diagnosis made over the phone or via video are advised to request a follow-up in-person appointment or seek a second opinion. McGarry said: "If you believe that you have been misdiagnosed over the telephone or in a video consultation... you can ask your GP to arrange an in-person appointment for further assessment." If necessary, patients can book another appointment with a different GP and explain their concerns in detail. If refusal continues, the issue can again be escalated to the practice manager. For urgent or worsening symptoms, patients should seek immediate care through walk-in centres, urgent care services or A&E.
Some groups may find remote consultations particularly challenging. McGarry highlighted children, older people and those with mental health or communication difficulties. She said: "Children can have difficulties expressing themselves... The elderly may be hard of hearing... and may also be less technologically skilled."
She added that many patients feel more reassured by in-person care: "In stressful and emotional situations, patients will find comfort in the GP's physical presence and human touch."
Patient Rights
Patients referred for further treatment also have legal rights. In most cases, they can choose which hospital or service they attend, including some private providers delivering NHS care, provided the cost is no greater than a standard NHS referral. Appointments are typically arranged through the NHS e-Referral Service, and patients can request to switch providers if waiting times exceed recommended limits.
McGarry added that while remote care can be useful, 'every demographic is vulnerable to health issues, which can be difficult to assess remotely'.
