Health leaders in Derbyshire insist it is a myth that doctors are offering fewer appointments – but admit that more are now done over the phone.

In recent months services provided by GPs around the country have been under the spotlight as the nation attempts to recover post-lockdown.

Details shared by the Derby and Derbyshire Clinical Commissioning Group (CCG) show that GPs have been providing more, if not the same level of appointments as before the pandemic, are giving more on-the-day slots and the majority of consultations are face-to-face.

Claims that GPs are not accepting face-to-face appointments and have not been operating during lockdown have led to aggressive behaviour and assaults on GP practice staff and damage caused to premises, including in Derby.

The statistics show that Derby and Derbyshire GPs offer around half a million appointments every month, which is on par or more than the same months in 2019, before the pandemic.

They also show that the majority of appointments, around 60 per cent (291,747 in July), are face-to-face, though there has been a significant increase in the proportion carried out over the phone.

The stats show telephone appointments rose from around 13 per cent in July 2019 to 36 per cent in July 2021 – also seeing the proportion of face-to-face appointments reducing, from 80 per cent to 60 per cent.

Meanwhile, same-day appointments in July 2021 are up 6.5 per cent (215,667) compared to July in 2019, and now account for 43 per cent of all slots in July.

The CCG says Derby practices "are working harder than ever" and are wading through a colossal backlog of patients needing care, while also giving out Covid-19 jabs and flu jabs to thousands of patients.

It also makes clear that backlogs and pressures on other parts of the health system, such as hospitals, also impact on GPs. Referrals for suspected cancer cases are just one key example.

The CCG says "cuts to drug, alcohol and smoking services and cuts in social care" are further examples.

Health leaders lay out in a report, to be discussed by Derby City Council next week, that the move to telephone and online appointments was already happening before the pandemic.

They say the NHS asked GP practices to carry out a "total triage" (initial medical assessment) over the phone at the start of the pandemic.

The report mentions that all GP practices in Derby are open and offering face-to-face appointments but say this is balanced against reduced capacity for staff and patients in the buildings themselves, the need for infection prevention and demand for appointments.

It says the proportion of face-to-face appointments will likely increase as the heightened demand on staff – caused by lockdown and the vaccination roll-outs for Covid jabs and flu jabs – eases.

However, it says: "If we want an effective and efficient system for patients and practices then we should still aim for a mixed approach – more ways to get help and a wider range of people providing care.

"If we can free up GP time from people they don't need to see then they'll have more time with those they do.

"It's a much better use of patient and GP time if small changes, e.g. tweaks to prescriptions can be dealt with over the phone or online – and practices have had positive feedback from patients about this."

The report lays out that most concerns raised by patients relate to troubles experienced in getting in touch with GP practices on the phone and say access and demand remain "major concerns".

The CCG says concern is rising over GP practice staff welfare over the coming winter, with demand on services already "extremely high" and expected to increase.

It says GP practices are "reporting high levels of staff stress and burnout".

The CCG says the number of flu cases is "likely to be 50 per cent worse than last year and a "surge" in childhood respiratory illness is also expected.

It says: "Demand for GPs is currently surging and practices are working very hard under great pressure. They are open for business and overall the number of appointments offered is at or above pre pandemic levels.

"Staffing is a challenge. There is new funding for non-GP staff and a range of initiatives designed to help recruit and retain key staff but this remains difficult."

The Derby Primary Care Networks will get £3.947 million to invest in additional (non GP or nurse) roles by March 2024. This equates to another 141 full time staff.

GP practices receive more funding for taking on further patients which can then in turn be used to recruit more staff.

However, GPs have highlighted the long time it takes to train up a new GP, with difficulties over recruitment and retention due to the strains and stressors of the job.