More than 150,000 fewer than expected GP appointments were recorded in Herefordshire and Worcestershire in April, in a sign Covid-19 is putting people off trips to the doctor.

The Royal College of GPs has urged patients to seek help if they need it, and said surgeries must have adequate resources to cope with a predicted increase in demand as the lockdown eases.

But the NHS says changes in how practices operate during the pandemic may have affected the figures, with remote sessions underreported.

NHS Digital data shows that patients booked in to see their doctor on 207,801 occasions in the NHS Herefordshire and Worcestershire CCG area in April.

This was down from 370,576 for the same month a year before – a 44% drop.

The decrease was even greater than that across England as a whole, where 7.7 million fewer appointments were made in April than 12 months previously, a reduction of a third.

Professor Martin Marshall, chairman of the RCGP, said people may be worried about overburdening NHS services during the coronavirus crisis, or contracting the virus themselves.

"However, if anyone is seriously ill or concerned about their health, we'd strongly urge them to contact their GP practice or 111 – and in an emergency situation, call 999," he added.

"The reality is unmanaged or untreated conditions may not go away and may get worse and this could cause serious consequences."

In Herefordshire and Worcestershire, 67% of sessions were logged as having been completed over the phone in April, significantly up from just 21% a year previously.

Nationally, the figure jumped from 14% to 48% over the period.

The RCGP's own research showed more than two-thirds of consultations are being carried out remotely, either by phone or video.

Prof Marshall added: "As we move into the next steps of the pandemic it's imperative that the NHS is given the attention and resources it has been at the height of Covid-19.

"General practice must be adequately resourced to deal with the predicted increase in demand as GPs care for patients who may have put off symptoms during the peak of Covid-19, outpatients managing Covid-19 at home, and those suffering from indirect side effects of the pandemic, such as associated mental health conditions."

The NHS said the drop-off in recorded appointments does not necessarily mean GPs are seeing fewer patients.

It said practices are likely to be operating differently in response to the pandemic, including the use of more list appointments, in which contact with several patients is only counted once, while online and video sessions "may also not be routinely captured".

Raj Patel, deputy medical director of primary care at NHS England, said: "Even during these unprecedented times, if people need help from a family doctor they are able to get it.

"Our GPs are quickly adapting to new technology – including phone and video consultations – to continue providing care in a different way."