Doctors criticise 'barmy' rules forcing them to treat patients who refuse to wear face masks

GPs cannot refuse to treat patients who refuse to wear a face covering, according to new NHS guidance which doctors have denounced as "barmy".

Under laws introduced last month, people can be fined for failing to wear a mask in shops or on public transport. Those powers will be extended to cover cinemas, museums and places of worship from Saturday.

Government advice, updated on Friday, says face coverings are needed in NHS settings, including hospitals and primary or community care settings such as GP surgeries. However, advice sent to GPs the same day says they cannot refuse to treat patients who will not wear them.

In a bulletin to GPs, NHS England said patients "should not be refused entry to a premises or access to care if they are unable to or refuse to" wear a face mask.

The email said: "It is not a legal requirement in healthcare settings for people to wear a face covering. Government advice says you should wear a face covering in enclosed spaces if you can, including places such as primary care services.

"However, a patient should not be refused entry to a premises or access to care if they are unable to, or refuse to, wear a covering. This should be clearly communicated to all patients."

Dr Grant Ingrams, a GP in Leicestershire, told Pulse, the monthly news magazine and website on UK primary care: "It is barmy to state that practices must not only see patients who just refuse to wear a face covering but must advertise that they will do this. Practices have a duty of care to other patients, carers and staff in the practice."

The advice comes despite concern from health officials and scientific advisers in recent months that coronavirus infections in the community are being fuelled by transmission within healthcare settings.

The letter from NHS England to all GPs said practices must now offer face-to-face appointments, while continuing to use video, online and telephone consultation whenever appropriate.

It said "remote triage" should be used to assess which patients should be seen in person.

Last week, Matt Hancock, the Health Secretary, said all NHS consultations should be carried out by phone or video unless there was a "compelling clinical reason not to".

The statement prompted concern from patient groups that older people and those without access to technology could lose access to care.

The letter from NHS England said:  "All GP practices must offer face-to-face appointments at their surgeries as well as continuing to use remote triage and video, online and telephone consultation wherever appropriate – whilst also considering those who are unable to access or engage with digital services."

GPs should also contact clinically vulnerable patients and those "whose care may have been delayed", with catch-up programmes for vaccinations and screening programmes, the letter added.

It also called for swift action to deal with backlogs, adding: "In restoring services, GP practices need to make rapid progress in addressing the backlog of childhood immunisations and cervical screening."

A Department of Health and Social Care spokesman said: “It is mandatory for face coverings to be worn on public transport and in enclosed spaces like shops and supermarkets, and we strongly encourage the wearing of face coverings in other public spaces, such as healthcare settings, where social distancing may be difficult and where you come into contact with people you do not normally meet."