The family of a man who died after he was forced to email his GP surgery for an urgent appointment – and the practice failed to respond for three days – have called for an immediate crackdown on the escalating trend.
Last night they asked: ‘How many more lives have already been lost?’ The Mail on Sunday revealed last month that some practices had told patients they could only book appointments by filling out an online form, raising fears that the old and vulnerable could be denied access to vital healthcare.
But the growing scale of the problem has now been laid bare in shocking detail by the scores of readers across the country who have contacted this newspaper to complain that their own surgeries have implemented similar controversial policies.
Heartbreakingly, some elderly readers, who say they have no IT skills or access to the internet, have ‘simply accepted’ that they cannot see a GP any more, while others are avoiding contacting their local practices until their health conditions worsen.
Others expressed huge concern about the implications of the new policies for their loved ones – especially those who have adult children with learning difficulties.
The family of Allan Hamilton, died after he was forced to email his GP surgery for an urgent appointment, have called for a crackdown on GPs failing to respond to appointment requests
Vicki Doyle, whose brother, keen runner Allan Hamilton, 51, died at home of pneumonia and ischemic heart disease after emailing his surgery in Mossley, Greater Manchester, about breathing problems, has now issued a heartfelt plea for the Government to force GPs to end the ‘harmful’ policy, which is in breach of GPs’ contracts with the NHS.
She is joined by politicians and campaigners such as shadow health minister Saqib Bhatti, who hit out at the ‘deeply concerning’ treatment of patients.
Ms Doyle, 56, told The Mail on Sunday: ‘How many other people like Allan have also died because they couldn’t get hold of a doctor? How many cases like his have not been recognised?
‘Allan was intelligent and IT-savvy, but it still backfired on him because he couldn’t speak to a human being. Nothing can replace that human contact. It shouldn’t be a battle to get access to your GP.
‘So many people have no choice. They wait and their condition escalates. That’s the sad part. More will die unless we make sure everyone can access their GP when they need them, by whatever method.’
Mr Bhatti said: ‘These cases are truly heartbreaking and deeply concerning. NHS organisations, including GP surgeries, have a duty to ensure patients can access services – and this includes making sure people can ring their GPs in time of need, particularly those more at risk or vulnerable.
‘These cases should be investigated and any breaches of contracts dealt with. We will always stand up for patients and hold this Government to account to ensure this right of access is maintained.’
Readers from as far afield as Lancashire, Essex and Devon have told The Mail on Sunday that their GPs have issued blanket instructions forcing them to make appointments using online forms that are then triaged by doctors.
In theory, this is intended to save time and ensure that those most in need can be seen most urgently. It also avoids the unpopular 8am rush to book appointments on surgery phone lines.
But it should not be the only way to get an appointment.
An NHS spokesperson said last week that GP surgeries were ‘contractually required to offer equal access to patients regardless of how they contact a practice, whether that’s online, by phone or walk-in’ to make sure no patients are excluded.
Yet it is clear from readers that this is not followed everywhere.
Keen runner Allan, 51, died at home of pneumonia and ischemic heart disease after emailing his surgery in Mossley
One sent a text they recently received from their GP in Milton Keynes, Buckinghamshire. It read: ‘Dear patient, as a reminder, reception cannot book appointments with the GP or minor-illness nurse. Please fill out the online questionnaire which opens at 7.30am Monday to Friday and your request will be triaged by the GP.’
Some readers said they, their loved ones or friends had given up trying to see a doctor because they could not access the online systems or work out how to use them.
One is veterinary surgeon Dr Martin Lowe, 69, of Totnes, Devon, who said that despite ‘numerous health issues’ he avoided contacting his practice at all – raising fears that many other patients are opting to endure unpleasant symptoms until they can stand it no longer. However, in the process they may be storing up more serious concerns. Dr Lowe wrote: ‘My GP insists that appointments are made through the filling-in of an online questionnaire. If a patient walks into the surgery, they are directed to a screen to do it!
‘My experience of this is that it can take several days to get a response. As someone with numerous health issues I find that the form often makes it impossible for me to address the problem I am getting in touch about.
‘As a result I find I don’t make contact and simply “wait and see”. Am I being cynical in thinking that is what the GPs want, hoping patients will simply get better without their assistance? GP practices that don’t take phone calls are putting patients’ lives at risk.’
In one example, Joy Reid, 60, from Frinton-on-Sea, Essex, wrote that her disabled 85-year-old mother was ‘refused help’ by her GP surgery when she could not book online. ‘She went in and was turned away, they refused to help when she phoned and ignored her desperate pleas for help by letter (she ended up in hospital on some occasions),’ Mrs Reid wrote.
‘I had to ring and insist she was seen, threatening them with media exposure and [referral to the local care board]. Eventually they gave in and she saw a locum who has finally sorted out her tablets.’ But Mrs Reid is now being forced to go online at her own GP surgery, which she is ‘very unhappy about’.It is not just the elderly at risk. Debi Kirk, 57, a learning-disability nurse from Lancashire, says she ‘sees these issues all the time’ among those she cares for.
BUT she also has first-hand experience because her 29-year-old son has autism and dyslexia. ‘He has been told he must complete online forms and can no longer ring or walk in to book an appointment,’ she wrote.
‘I have emailed to explain his needs to the GP and received no reply. This resulted in my son having such a severe ear infection his eardrum perforated.
‘This system is so wrong. As a nurse who has practiced for 30 years I no longer recognise or respect our caring profession.
‘What happened? It’s a disgrace.’
One reader described seeing a GP receptionist turn away a mother with an unwell child.
Dennis Reed, from Silver Voices, a campaign group for the elderly, said: ‘This is the tip of the iceberg and it wouldn’t be surprising if there were more cases like Allan Hamilton’s which go unnoticed.
‘We know patients are going straight to A&E because they can’t get through their GP’s systems, and contacting private doctors if they can afford it.
‘They don’t want to complain in case they’re punished by surgeries and thrown off the list. NHS England is failing to clamp down on GPs who are in breach, and must do more to stamp this out.’
It was the NHS itself that encouraged doctors to reduce walk-in requests during Covid in 2020 by adopting a system called ‘total triage’. This allowed patients to provide information about their problem to the practice before booking an appointment.
It reduced the workload for receptionists and GPs by discouraging people from booking needless appointments and ensuring those most in need had priority.
But post-pandemic the system continues to be used because it was found to have other benefits.
Patients who need to see a nurse or a physiotherapist rather than a GP can be referred directly, while test results and sick notes can also be sent digitally rather than wasting an appointment
This is all needed to relieve pressure on GPs. There are 27,000 full-time family doctors in England – nearly 2,000 fewer than a decade ago – while the number of NHS patients has risen by six million in the same period. Last month, GPs decided to take industrial action – including limiting their hours – over a contract dispute which, in part, relates to this increasing workload.
Little wonder, then, that public satisfaction with GPs is at an all-time low, with many saying they’ve given up trying to see their doctor altogether, according to the GP Patient Survey.
Allan with his sister Vicki Doyle, who has now issued a heartfelt plea for the Government to force GPs to end the ‘harmful’ policy, which is in breach of GPs’ contracts with the NHS
Professor Kamila Hawthorne, chair of the Royal College of GPs, said practices should offer patients a range of ways to book an appointment – but also called for ‘proper investment’ in the workforce and IT to ensure ‘safe, timely and accessible care’. ‘There is clearly a place for technology in healthcare, but when it is introduced it is essential it is done so safely and in a way that helps patients to access our care and services as well as supporting practices to ensure patients are receiving timely and appropriate care,’ Prof Hawthorne said.
‘Many patients find online booking convenient and easy, but this is not the case for everyone – especially those who struggle with new or changing technology, or who may have limited access to a computer or the internet.’
As many patients told the MoS, while they have largely welcomed moves to free up GPs with technology, the latest development is – as one put it – ‘a step too far’.
One 75-year-old said she supported the technology to manage GP workloads and that online requests for repeat prescriptions appear ‘to work effectively’. But she added: ‘Employing total triage technology under the guise of improving the service for patients to access a GP appointment will put more patients at risk of delayed treatment.’
An NHS spokesperson encouraged patients to complain about access problems to GPs and local Integrated Care Boards, and said there was support for practices that were struggling to offer ‘appropriate access’.
The Department of Health and Social Care said: ‘Every patient should be able to easily reach their GP, book an appointment or be directed to emergency services.’
’Who has it helped? This is why A&E is clogged up’ – readers comments
My surgery doesn’t allow patients to make appointments by phone or in person. Patients have to go online, using a system called PATCHS, and complete a form and wait for a reply. You also have to register to use this system – even if you are already a registered patient at the surgery.
John James, 70, The Wirral
To make an appointment at my GP surgery, we have to complete a PATCHS online form before 7.30am, detailing your query and symptoms – and then wait for a reply.
I tried to make an appointment by going into the surgery, but was directed to PATCHS. I tried telephoning the surgery, but was again directed to PATCHS. I mentioned to the receptionist that GPs were contractually obliged to make appointments via the phone or in person, but the receptionist just dismissed me.
Janet McKenna, 69 Merseyside
My GP practice is now insisting that patients fill in a form to access appointments and that receptionists can no longer make them.
Generally, I think my practice offers a pretty good service, but find this very off-putting. I have known for some time that there is always a doctor daily operating a triage system, but this now feels a bridge too far.
I worry that this is a deliberate attempt to put patients off seeing a doctor, knowing they daren’t complain for fear of being banned from their list.
Jane Harper, 76, Cheadle, Greater Manchester
I am a computer-literate woman. However, when I was discharged from hospital this spring after six weeks in ICU with pneumonia and sepsis, I became very unwell.
I could not cope cognitively with anything at that stage – reading or using my smartphone, for example. My husband tried calling the surgery to speak to a GP on my behalf, but was not allowed. Instead I had to answer all the questions, despite being extremely ill, including: ‘How worried are you about your condition, on a scale of one to five.’
Who has it helped? The GPs and the practice staff, NOT the patients. This is why A&E is clogged up.
My fear is that if there’s a campaign to pressure GPs to allow phone calls and walk-ins for appointments, as we have a Labour government the GPs will strike and get exactly what they want – the Government will amend their contracts.
Anna Cox, 69, Twyford, Berkshire
My doctor introduced online booking. I tried phoning. After being on hold for over an hour, was told to book online.
When online, I thought I would see a list of appointments available. No – you have to say why you need to see a doctor, then someone checks to see if you can get appointment.
I then received a text saying my appointment was three days later.
Alison Hynds by email
My practice has been using PATCHS online system for at least a year. Appointments must be requested on this system for the request to be triaged.
At the moment I am elderly and fit and fully able to use technology, but I worry about when I can’t – and there are many already in that situation.
Robin Adams, 75, Chester
I am 86, not very bright in using the computer. I can no longer phone or walk into my surgery to make an appointment.
Fortunately my very kind son-in-law took it over for me. Now if I need to see the doctor I have to tell my son-in-law the problem so he can request an appointment online for me. A friend at the same surgery just gave up and accepted she couldn’t see a doctor.
Margaret Gale, 86 Beckenham, Kent
