Cancer goes undetected as GPs shut out patients

GP surgeries are “shutting out” patients despite a fall in deaths from coronavirus, raising fears that potentially serious illnesses are going undetected.

Clinicians and patient’s groups have warned that many people are still either too afraid to visit their doctor or have been told no face-to-face appointments are available as part of continued coronavirus social distancing measures.

Rachel Power, the chief executive of the Patient's Association, said: “The NHS must provide services that work well for patients, and that includes those who value face-to-face contact.

“Some patients are effectively shut out from GP services at the moment, which is worrying for them, and risks health issues going undetected and untreated.”

Figures from the Royal College of GPs (RCGP) show that in the four weeks to April 12 routine GP clinical activity fell dramatically by 25 per cent on the same period in 2019, although it has slowly increased in the past month to reach near normal levels.

NHS Digital’s GP appointment data shows that from March to July inclusive there were an estimated 102 million appointments in general practice, though only just over half of (52 million) were face to face, and a similar proportion (54 million) were on the same day.

However, surgeons have told The Telegraph the number of patients referred to them by GPs for treatment has plummeted by as much as 50 per cent, building up a potential time bomb of ill-health and death across the population in years to come.

The Royal College of Surgeons in Edinburgh, the largest of the royal medical colleges, says it fears a sharp increase in fatalities because conditions such as cancer will have gone undiagnosed.

Professor Michael Griffin, President of the RCSE, said: "There's no doubt that there are many patients who have not presented to their GPs and are experiencing delays in getting diagnostics done to establish their cancer. As a result there will be large numbers of patients who will die because their cancers have not been detected."

The college, which has members across Britain, has called for a nationwide campaign to reassure people it is safe to begin using their GPs and hospitals again.

Professor Griffin said: “People with cancer are receiving treatment, but there are patients who have not been diagnosed yet and this is a real worry. It comes down to them being scared of going to their doctor or going into hospital, even if they’ve been given an appointment, for fear of getting Covid.”

This continued reluctance comes despite the latest available figures showing that deaths from Covid-19 in England’s hospitals are declining at the fastest rate yet.

The figures, obtained by the Health Service Journal, show that the national rolling weekly total for Covid fatalities in hospitals stood at 183 on 3 July, 97 per cent lower than the peak of 5488 recorded on 11 April.

Coronavirus deaths peaked between 9 and 13 April in all seven NHS England regions, at a time when London was reporting a daily average of over 200 deaths. The region is now reporting two deaths.

The North West and Midlands are the only two regions with more than five average daily deaths and the South West region, which has had the fewest deaths of the seven NHS England regions, has reported only one hospital death between 27 June and 3 July.

Some doctors worry the growing reliance on telephone appointments during the pandemic could lead to doctors missing vital signs of more serious problems.

Chris Moulton, an A&E consultant in Bolton, said: “We need to get back to face to face medicine and open access for patients immediately. Virtual consultations are great for patients in some situations but they are no replacement for clinical examination in many acute conditions. The reputation of our profession depends on it.”

Dr Jonathan Leach, Honorary Secretary for the Royal College of GPs, emphasised that GP surgeries had remained open throughout the pandemic.

He said: “Whilst general practice services have been available for patients, the way care has been delivered has been different, with most consultations being made remotely – however, if face to face appointments are necessary, they are being facilitated. This way of working will suit some patients better than others, but generally throughout the pandemic, feedback from members is that patients have been receptive and understanding about the changes.”

An NHS spokesperson said: “Face-to-face appointments remain available for everyone who needs one, with over 50 million appointments delivered by GPs and their teams over the course of the pandemic, in addition to a three-fold increase in remote consultations which offer a convenient, safe option for patients to access care.”