A thread on the suggestion by @MattHancock that the most primary care consultations should be carried out remotely by telephone or video. Such a shift would create a style of clinical practice (call-centre medicine) that would be unattractive to many patients and doctors.

There is scope to for a proportion of primary care work to be carried out remotely. Remote consultations reduce the risk of infection for both patients and doctors. They will also be more convenient for some patients.

However, some patients won’t like remote consultations and will struggle to communicate effectively with their doctors, nurses and other clinical staff using telephone or video. This will disproportionately affect already marginalised groups of patients.

There is also some loss of information in remote consultations, which will increase the scope for errors and delays in diagnosis, as well as failure to communicate management plans effectively to patients and ensure they understand their treatment.

We can increase the proportion of work done by video and telephone compared to clinical practice during pre-pandemic levels but I don’t think we can carry out the “vast majority” of work this way. We also need to consider the impact on clinical examination skills of doctors.

We also need to evaluate carefully any change in practice to identify any unintended negative consequences such as errors and delays in diagnosis, patient safety incidents, and an increase in patients attending UCCs and A & E because they want a face to face consultation.