More than 25 million GP appointments have been lost to the coronavirus pandemic, with the NHS watchdog warning that the crisis could fuel cancer deaths.
The Care Quality Commission (CQC) said access to family doctors remains worse than it was before lockdown, raising concerns that people with worrying health problems were struggling to see a physician.
Cancer Research UK said that, since March, more than 350,000 people who would normally have been urgently referred to hospital with suspected cancer have not been.
It said too many patients had been left struggling to get an appointment or had been scared off seeing their GP for fear of being a burden on the health service or catching Covid-19.
It follows studies suggesting that delays in diagnosis this year could mean an extra 35,000 deaths.
The CQC’s annual state of care report said the pandemic had caused “a seismic upheaval” that risked causing chasms between different parts of society, especially the vulnerable.
Official figures show that, between March and August, there were 26.7 million fewer consultations than was the case last year.
Ian Trenholm, the chief executive of the Care Quality Commission, said: “As as the country locked down, the number of GP appointments fell significantly. And there was a very, very definite move towards non face-to-face appointments, be that on the telephone or video and online.”
While GPs were working hard to increase access for patients, it remains the case that fewer patients are being seen, he said, adding: “If looked at across the whole of the year, the number of lost GP appointments translates into millions of people, potentially, not seeing their GP, not getting conditions diagnosed early.”
Officials raised concerns that some parts of the NHS were sending out “inadvertent signals” deterring patients from getting care, with signs on doors and messages about service restrictions, while some patients were struggling to navigate phone and online systems.
Offical statistics from NHS Digital show that even in August, long after lockdown had been lifted, GPs had 2.7 million fewer appointments than in the same month in 2019. The figures include phone and video consultations, which made up almost half of appointments in August.
In total, 119.5 million appointments were carried out in the six-month period, compared with 146 million in the same period in 2019.
Dr Rosie Benneyworth, the chief inspector of primary care at the QCC, said: “We know there has been a reduction in cancer referrals and that is likely to have an impact longer term on people getting appropriate cancer diagnosis and treatment.
“We know that people sometimes haven’t had their long-term conditions followed up, and that is likely to also have a long term impact. It’s really important that actually all the needs of the people are met, and not just the people with Covid-19.”
Sarah Woolnough, Cancer Research UK’s executive director of policy and information, said the findings were “concerning” and warned of “devastating” consequences if diagnosis of the disease is delayed.
She said the fall in GP appointments largely explained why more than 350,000 people who would normally be urgently referred to hospital with suspected cancer symptoms have not been since the start of lockdown.
“We urge anyone who has noticed a change in their health, or has a symptom that they’re worried about, to make contact with their GP to get their symptoms checked out, and attend any tests their doctor thinks are needed,” she said. “Many people have told us they’ve been unable to get an appointment and, although it might be frustrating, we would encourage them to keep trying.”
The watchdog said there could be a number of reasons for the lower number of patients being seen, including patients avoiding their GP for fear of being a burden or worried about catching Covid-19.
Mr Trenhold said health services must ensure “no-one is left behind”, adding: “There needs to be an active effort to go back and look for those people that are maybe sitting quietly at home that maybe have a lump or a bump and haven’t gone to see their GP.”
Professor Martin Marshall, the chairman of the Royal College of GPs, said: “The Covid-19 pandemic has been the biggest challenge for the NHS – and general practice has been no exception.
“GPs and their teams worked incredibly hard from the start of the pandemic to change the way they deliver services in order to keep patients as safe as possible, stop the spread of the virus, and allow staff to continue working, delivering patient care.
“General practice has been open throughout the pandemic, although care is currently being delivered differently to usual, in line with official guidance, with most consultations being delivered remotely.”