Practices have been ordered to ensure they offer face to face appointments in new guidance for the NHS on the next stage of reopening services following the pandemic.

NHS England instructions encourage practices to continue to use remote triage, video, on-line and phone consultation – but says they must consider those unable to access digital services. Last week health secretary Matt Hancock stated that all consultations should be conducted remotely unless there were “compelling” clinical reasons. NHS statistics show that most remote consultations have been by phone rather than video.

However NHS England chief executive Sir Simon Stevens has now said that practices must ensure they can provide face to face appointments in the latest guidance. Mr Hancock’s comments had alarmed the Royal College of GPs, whose chair Professor Martin Marshall said: “A totally, or even predominantly, remote general practice service wouldn’t be in anybody’s best interests long-term, and throughout the pandemic face to face appointments have been facilitated when they’ve been necessary.

“Remote consultations have benefits – they can be convenient for patients, and GPs have reported they have found them to be an efficient way of delivering care – but there are some things that simply can’t be done remotely, for example, when a physical examination is necessary or for a vaccination. Many patients also prefer seeing their GP in person, and many GPs prefer this too, particularly for patients with complex health needs who really value the relationship-based care that GPs excel at delivering.”

According to the Health Service Journal, some practices may have ceased totally offering face to face consultations. It cites a letter from NHS England primary care medical director Dr Nikki Kanani, who warned that not offering physical consultations could lead “to significant incidents and events.”

The guidance also calls for practices to reach out “proactively” to clinically vulnerable patients. It also calls for rapid progress in tackling the backlog of childhood immunisation and cervical screening.