Digital appointments could be ‘storing up problems for the future’

In a Twitter post, Martin Marshall asked “what problems are we storing up for the future”, after digitally consulting with a number of patients who had “significant” coronavirus-related mental health problems.

In a comment to HSJ, Professor Marshall added that, while remote consultations are “necessary” to prevent the spread of coronavirus, some mental health patients “may find it difficult” to adapt to digital appointments.

There has been a surge in the uptake of digital GP services to support the response to coronavirus, with many tech companies offering their services to the NHS for free.

NHS England has also fast-tracked procurement of digital tools for GPs who do not have the resources to provide online consultations during the pandemic.

However, while coronavirus has been said to spark a “black swan moment” for tech in the NHS, Professor Marshall said remote appointments could make some patients with mental health problems feel less comfortable approaching their GP. 

He said: “Patients often feel that face-to-face consultations provide a more comfortable and open environment to discuss mental health as they enable the patient to feel listened to and that their mental health needs are being taken seriously. Physical examination is also an important part of a holistic assessment for some presenting problems.

“Our concern, therefore, is that the system of remote consulting during covid-19 may make patients with mental health problems feel uneasy and in some instances less likely to contact their GP.

“This will make it more difficult for GPs to diagnose and manage patients’ mental health problems during the pandemic.

“We know for some mental health conditions, early intervention is key to treating patients effectively, so it is important that patients continue to report any mental health concerns to their GP, and be reassured we will strive to deliver an equivalent level of care remotely as we would do in person.”

At the end of March, practices were urged to move to a triage first model of care as soon as possible, as well as provide online services where they can to support the national coronavirus response. 

An RCGP spokesman said it is likely that many patients will want to revert back to face-to-face consultations once the pandemic has ended.