ONLY a third of GP appointments in South Cheshire are face-to-face, new figures show.

While more people were able to see a doctor in person in July than during March and April when the country was gripped by lockdown concerns have been raised that some older people are still missing out.

Charity Age UK has issued a warning that rolling out digital technology to improve communication could be problematic for the elderly who are better catered for by a face-to-face conversation with a doctor, especially as most over-75s are not online.

NHS England has written to all GPs practices to make sure they are communicating the fact doctors can be seen in person, face-to-face if necessary, as well as virtually.

Face-to-face appointments plummeted sharply after lockdown was imposed and while they have risen since figures show there are no areas in England where GPs are offering the same percentage of face-to-face consultations as pre-lockdown.

Nationally, there were 21.7 million face-to-face appointments in January, but that fell to 11.2m in July 2020.

Across the 115 Clinical Commissioning Group areas in England the number of face-to-face appointments has fallen by an average of 50 per cent.

Figures covering the Crewe area are complicated by the fact that the former South Cheshire CCG was merged with Vale Royal CCG, West Cheshire CCG and Eastern Cheshire CCG to form the Cheshire CCG in April of this year.

Before the merger the number of face-to-face appointments in South Cheshire dropped from 86 per cent of 75,842 in January to 60 per cent of 45,056 appointments by March.

Figures for the merged CCG showed face-to-face consultations dropped even lower to 26.5 per cent of 45,930 appointments in April, but then picked up through May and June where 30.7 per cent of 75,310 appointments were face-to-face and that was up to 35.7 per cent of 98,407 appointments in July.

But total appointments for the merged CCG have fallen 64 per cent on the combined 272,826 appointments recorded by the four previous area CCGs at the start of the year in January.

Caroline Abrahams, charity director at Age UK, said: "Over half of older people would be comfortable or very comfortable attending an online appointment, but we also know that some older people not only struggle to use digital services but remain wary about accessing face-to-face services while the pandemic still has us in its grip.

"We have also heard from older people struggling to get through to GP surgeries, facing long waits on the phone to be able to speak to a receptionist and feeling like their GP hasn't really been open for business."

But Chairman of the Royal College of GPs Professor Martin Marshall says NHS England's intervention has caused "a mixture of bemusement and anger" among GPs.

"It has been very clear throughout that if someone needs to be seen face-to-face, for things such as a blood test, then they need to be seen. That is a clinical decision," he said.

"But the advice was that consultation should be done with remote triages at the front end. Now that guidance appears to be changing. To suggest that GPs should open up their doors on the basis that a small number of patients are unhappy that they can't see their GP just seems frankly silly to me.

"The number of face-to-face contacts has gone up. At the peak of the pandemic our own figures show about one-in-ten appointments were face-to-face, now it is about one-in-three and I think that is about right.

"It's all about infection control. Even when the patient is wearing a mask and the GP is wearing PPE there is a risk patients will spread infection, certainly in the waiting room."

He added: "The concern is we weren't seeing people who did need to be seen - people who had symptoms suggesting cancer. But we have been saying all along that if you have symptoms suggesting cancer please come along."

An NHS England spokesperson said: "It's entirely right more GP appointments are now available by phone and online and that is completely consistent with also saying that there still needs to be options of face-to-face appointments."