Only one in 10 patients using an online system actually requests to see their GP face-to-face, according to study of more than 7.5 million records.

The new data, from experts at the Health Foundation working in partnership with NHS England, found that most patients were happy with telephone calls.

Researchers behind the study said the data “provides further evidence that online consultation systems can facilitate choice and flexibility” in how GP care can be delivered.

It comes after medics faced a backlash over how many appointments they offer in person.

NHS data for England shows that 60% of GP appointments in January were face-to-face compared to about 80% before the Covid pandemic.

All of the 6,800 GP practices in England have been told by the NHS to run online consultation systems to help manage bookings and offer remote appointments.

The new study looked at the use of the askmyGP online service in 146 GP surgeries in England, which have a combined list size of 1.35 million patients.

As of last September, the askmyGP service is being used in 216 practices.

This service was selected for the study as it enables researchers to track all patient interactions, whether digital or not, and follow the patient’s journey from their initial point of contact to receiving treatment or advice.

The new analysis was carried out by the Improvement Analytics Unit (IAU), a partnership between the Health Foundation and NHS England, looking at data from March 1 2019 to September 30 2021.

Of more than 7.5 million patient-initiated requests for care, just 10% of people in September 2021 wanted to see a GP in person, the research found.

This was down from 30% of requests before the pandemic. At the start of the pandemic, 4% of people wanted to be seen in person.

The most popular preference was for a telephone consultation, favoured on average in 44% of requests pre-pandemic, and by 55% of patients in both 2020 and 2021.

A quarter of people before the pandemic wanted a response via text or online messaging, rising to more than a third in 2020 and 2021. Fewer than 1% of patient requests were for a video consultation.

The study authors said that, while more work is needed on whether online consultation systems create problems with access, those who did not use online systems did not seem to be at a disadvantage.

Practices were still able to offer traditional routes into care, with those aged over 74 up to 28% more likely to have a face-to-face consultation than those aged 25 to 44.

Those asking about new medical problems were also two-thirds more likely to be seen face-to-face than those with existing conditions.

The analysis also found that, at practices adopting a “digital-first” approach, 72% of all patient requests were initiated online rather than by telephone or in person.

And once patients had accessed their GP online, they were 25% more likely to do so next time than those who had not.

Arne Wolters, head of the Improvement Analytics Unit at the Health Foundation, said: “Since the start of the pandemic the use of online consultation systems such as askmyGP has accelerated.

“But a common concern around use of digital tools is their potential to create inequalities by making it difficult for some patients to access care.

“While this is certainly a risk, our analysis shows that patients often choose remote over face-to-face consultations and that GP practices can mitigate the risk of digital exclusion via a blended approach.

“Our analysis provides further evidence that online consultation systems can facilitate choice and flexibility in how primary care is accessed and delivered.

“With patient demand at an all-time high due to the care backlog that has built up during the pandemic, digital tools can help practices manage this pressure, enabling them to triage patients to the right person or service and prioritise face to face consultations for those that need them most.”

Ruth Rankine, director of primary care at the NHS Confederation, said: “For many, this new way of accessing general practice has become the norm and we should not use pre-pandemic rates of face-to-face appointments as a yardstick for what good looks like.”

Dr Richard Van Mellaerts, GP committee executive officer for the British Medical Association (BMA), said GPs had suffered “deeply unfair” abuse as a result of criticism, even though the majority of appointments were in-person.

He added: “Face-to-face continuity of care will always be a crucial part of what makes general practice so valuable, but with a shrinking workforce we must embrace different ways of working to maintain the highest quality of care.

“Going forward it’s crucial that patient choice, clinical need, and staff and practice capacity are at the centre of decisions around how people can interact with their surgery, rather than pressure from politicians or the press.”