A study of data around GP appointments conducted over the phone and by video warns that serious health conditions are being missed that would likely be picked up at in person appointments.
Sepsis, congenital heart disease, cancer and diabetic foot complications are listed as having been missed by remote consultations, causing serious complications and fatalities. Those most at risk are the elderly and the young, more likely to struggle with online communication.
Researchers at Oxford University, Plymouth and the Nuffield Trust studied data from nearly 100 UK safety incidents between 2020 and 2023, including complaints, reports and settled negligence claims. Their research was published in the British Medical Journal (BMJ).
They found that poor rapport-building and inadequate information collection means that patients are more at risk of being under-diagnosed or given incorrect treatment.
The data include a 16-year-old girl who died of sepsis after a GP spoke to her sister on the phone and mistakenly diagnosed glandular fever and a woman in her 70s who was experiencing sudden breathlessness and was told she would be called back but was not. She later died at home.
Researchers said that patients with pre-existing conditions were particularly hard to assess by telephone, especially those who had several or they were getting worse.
Clinical conditions difficult to assess remotely included possible cardiac pain, acute abdomen, breathing difficulties, vague and generalised symptoms and symptoms which progressed despite treatment.
Researchers found that GP surgeries were suffering due to understaffing and high demand.
'Errors could become ingrained, leading to diagnostic over-shadowing and missed or delayed diagnosis', the researchers warned.
One of the recommendations is that clinicians make sure the patient understands the next steps in their care, while patients should make clear if they are deteriorating.
Data for England show 71 per cent of GP consultations are face-to-face and 24 per cent are over the phone.
The NHS has been criticised for discriminating against elderly patients since one in six GP practices now taking bookings online only.
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