The dramatic change in general practice in the last six months may have led to activity being under-reported, it has been suggested.

Practices are now receiving new guidance on how to record appointment data amid concern that telephone conversations and triaging procedures are not treated the same across practices. The new guidance says some clinical interactions are not being recorded because of lack of clarity over the definition of an appointment, according to the NHS England guidance.

The Health Service Journal quotes concern in NHS Digital that an apparent slump in GP appointments in the last year may not reflect the true picture. According to NHS Digital there were 21.3 million primary care appointments in June compared with 24.5 million a year earlier.

The organisation stated: “The total number of planned and scheduled appointments recorded in GP practice systems has declined during the coronavirus outbreak. It is important to note that this decline does not necessarily imply that GPs are having fewer interactions with patients. Practices are likely to be operating very differently in response to the pandemic and consequently may be recording encounters and interactions in different ways.”

Official data has shown that nearly half of appointments are now being conducted by telephone – but only a minority by video. The guidance says that an appointment is a “discrete interaction” between a healthcare worker and a patient. It does not include “administrative actions” such as receptionists answering queries.

The guidance states: “What constitutes an actual appointment is not as well defined and well understood as it could be by all the different health and care professionals involved in providing general practice. To ensure consistency in counting actual appointments, the following definition has been agreed: ‘Discrete interactions between a health or care professional and a patient, or a patient’s representative.’”