GPs should continue to provide a combination of remote and face-to-face consultations, the Royal College of GPs says today.

The College’s new report, ‘Future of remote consulting and patient triage’, focuses on what consultations should look like once the pandemic is over. The authors say while both options have their advantages, the decision about how care is delivered and accessed should be one made by GP practice staff, based on their knowledge of their patient population, with their patients, based on their individual needs.

During the COVID-19 pandemic, the GPs introduced “total triage” and consultations were delivered remotely, by telephone, video or online, unless clinically appropriate. The RCGP says there is huge potential in remote consulting and other digital ways of working but anticipates a “rebalancing” between remote and in-person care.

The report says: “Face-to-face appointments will always remain a major element of general practice, and remote consultations will continue to be delivered where appropriate and useful. The mode of consultation should be determined through shared decision-making between a patient and practice staff.”

The organisation is calling on the Government to invest £1 billion in digital infrastructure and capabilities for general practice by 2024, including significant investment for ongoing upgrades to digital technology and supporting infrastructure. Today’s report distinguishes between remote consulting and patient triage, and questions the Government’s plans to embed total triage into general practice, saying: “we are not convinced that the ‘total triage’ model or digital-first triage platforms should be the automatic default for all practices once the need for social distancing has lifted.”

Professor Martin Marshall, chair of the RCGP, said: “It is possible to build relationships via video or phone consultations, but it’s a very different skill to doing so in person, in a consultation room, which GPs have been trained for. GPs deserve credit for the remarkable way in which we swiftly transformed the way we deliver care in general practice once NHSE issued its pandemic guidance – both in terms of consulting remotely and implementing ‘total triage’ across the board. This was necessary so that we could continue delivering general practice services to patients whilst maintaining infection control in surgeries and keeping people safe.

“The pandemic has shown us that high quality care can be delivered remotely and many practices now have the appropriate means to do so effectively. There is certainly going to be a place for it in the future of general practice, and for this we need significant investment in the service, particularly in hardware and connectivity, so that GPs can deliver high quality remote care for patients where appropriate. But we know many patients prefer to see their GP face to face – and that many GPs prefer consulting in person, as well.”

He added that there is evidence showing triage leads to an increase in consultation numbers and that remote consultations can take longer.

“As we move out of the pandemic, it needs to be down to individual GP practices to be able to decide how they deliver services, based on their knowledge of their patient population,” he said. “Ultimately, we want to be able to offer patients the choice as to how they want to access GP services based on their health needs.”