Doctors across swathes of the country have been advised to stop face-to-face appointments with millions of patients, as charities warn that elderly and frail people will struggle with replacement telephone consultations.

Health chiefs have advised all 7,000 GP surgeries in England to start conducting as many telephone or video consultations as possible to reduce the risk of someone infected with Covid-19 turning up at a surgery.

The pandemic, which is expected to peak around the May half-term holidays, on Saturday claimed the lives of ten more patients, doubling the total number of fatalities in the UK to 21. 

Senior doctors have said that “telephone triage” sessions, which may last several months, will become widespread from Monday, with only those who require urgent care scheduled for physical appointments.

Under the plans, patient visits will also take the form of video, online or text contact, with many surgeries already informing people not to come in for pre-booked appointments next week.

Charity groups have warned that the new system will unfairly impact on elderly people who struggle using technology or have hearing difficulties.

It is also feared that the epidemic of loneliness among pensioners will worsen if face-to-face contact is reduced and home visits are limited to protect medical professionals from infection.

Caroline Abrahams, Charity Director at Age UK, said: “Of course we understand that there is huge pressure on GPs at the moment but it’s important practices take into account the vulnerability of those older people who may struggle to use the phone instead of a face to face appointment, for example because they have hearing problems.”

“Telephone triage systems certainly have a role to play and some practices were routinely using them even before this virus outbreak.

“However, it’s important for staff to remember that not every older person finds using the telephone straightforward, especially if they are hard of hearing or living with cognitive decline. In addition, there are nearly four million older people in this country who have never used the internet and therefore unable to book appointments via web based applications or emailing their surgery.”

The new system has been defended by medical bodies who insist that a significant departure in current policy is needed to face the “unprecedented challenge”  of coronavirus on public services over the coming months.

Prof Martin Marshall, Chair of the Royal College of GPs, said: “Even without the added COVID-19 pressures, over 1 million patients are treated in general practice every day, and we need to keep GPs and their teams as healthy and as well as possible if they are to continue working on the frontline.

“Telephone triage and video consultations will help with this,  but no two practices are the same so individual teams will need to decide how to make this work to meet the needs of their own patients and staff.”

The move comes as doctors call for increased protection amid fears that people with Covid-19 symptoms are not following government advice and coming into contact with them in surgeries rather than staying at home and calling NHS 111.

Some are wanting to be provided with eye visors in addition to the standard gloves, aprons and face masks they are already given.

Dr Farah Jameel, who sits on the British Medical Association GP Committee told The Sunday Telegraph: “We have examples of patients with coronavirus symptoms coming in to GP practices and healthcare professionals having to say ‘sorry please take yourself home and following the government’s self isolation advice’ which then puts the staff at risk.

“If staff at the GP practice get exposed and later go on to develop symptoms themselves, that is seven days at a time that GP practice staff will have to isolate themselves, which then leaves a whole community without a practice.”

“At this moment we have reports where GP practices have received very small quantities of personal protection equipment (PPE) and there is a question about the rationale of the protection being supplied, and if it is adequate protection,”  she added.

An NHS Spokesperson said: “As a precaution to protect patients, staff and the public, GP appointments will be triaged online or over the phone to make sure that patients are cared for by the right person, in the right place for their illness and GP surgery doors will be kept open where possible.”

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