A new study has found GP appointments over the phone or online risk harming patients as doctors could miss or provide incorrect diagnoses.
An analysis of remote NHS doctor consultations between 2020 and 2023 found that “deaths and serious harms” had occurred because of wrong or missed diagnoses and delayed referrals.
The report was led by the University of Oxford and suggested doctors should stop giving phone appointments to the elderly, people who are deaf, or technophobes.
Patient groups warned that the study was likely to be “just the tip of the iceberg” given the “potential for tragic misdiagnoses because of the limitations of online or telephone consultations”.
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However, researchers said incidents involving death or serious harm were “rare” and that the “vast majority of remote clinical consultations in general practice” were safe.
Experts from the University of Oxford examined 95 serious safety incidents in Britain since 2020 in which patients came to harm.
Errors made over the phone included missed diagnoses or an underestimation of the severity of a range of serious conditions including sepsis, cancer, congenital heart disease and diabetic foot complications.
Communication problems with GP receptionists also caused deaths, the study revealed, with one woman in her 70s who was suffering from sudden breathlessness being told she would be called back, only for the receptionist to be distracted by a patient in the waiting room. The patient died at home that afternoon.
Errors made over the phone included missed diagnoses
The study, published in the BMJ Quality and Safety, cited challenges around communicating effectively with patients remotely.
The report recommends that doctors are not distracted while conducting phone calls and go over treatment plans and next steps with patients at the end of a consultation, giving them the opportunity to ask questions.
Director of Silver Voices Dennis Reed said: “The sobering and hard-hitting study justifies our long campaign to increase the number of face-to-face appointments back to pre-pandemic levels.
He added: “We have constantly referred to the potential for tragic misdiagnoses because of the limitations of online or telephone consultations, and we fear that the examples quoted in this study are just the tip of the iceberg.”
The report recommends that doctors are not distracted while conducting phone calls
Dr Rebecca Rosen, of the Nuffield Trust said: “Every clinician must be aware of high-risk symptoms for which it’s safer to see patients face to face; must listen and respond carefully to patients who say they need an in-person appointment and should consult face to face if a patient has not improved after previous remote consultations.”
“We can also ensure that patients have the knowledge and tools to help them to get the best out of their consultations.”
An NHS spokesman said: “Every GP practice must offer face-to-face as well as telephone and online appointments, and almost seven in 10 appointments are being delivered face-to-face.
“Patient preference must be considered alongside clinical needs, and remote appointments are only provided when clinically appropriate.”
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