GP anger over ‘unsafe’ plans to reduce social distancing and increase face-to-face appointments

GPs have hit back at the Government’s proposals to name and shame surgeries in league tables in a move which will give patients the right to demand face-to-face appointments. 

The NHS is ploughing millions of pounds into a new package of measures aimed at improving access to GPs, but practices which fail to provide an "appropriate" level of in-person appointments will not be eligible for the new funding.

But doctors have criticised the Government for being "out of touch", and claim the description that doctors are underperforming is "insulting".

The number of face-to-face GP appointments has fallen dramatically since the start of the pandemic and has failed to recover. The latest monthly data showed that only 58 per cent of appointments took place in surgeries – down from 80 per cent of all consultations before the Covid crisis.

Face-to-face appointments

The true number is likely to be lower, with The Telegraph revealing this week that some telephone consultations are being counted as face-to-face meetings. Campaigners and patients’ groups have warned that many vulnerable people have been unable to access care, with coroners linking a series of deaths to remote appointments.

But doctor Ellie Cannon claimed that patients were not seeking face-to-face appointments, and in a tweet directed at the Health Secretary Sajid Javid said: "There are not enough doctors to do this. Most people I speak to do not want to see a GP when a timely phone call is enough."

Another doctor, Rachel Warrington, who runs a GP surgery in Bristol said there was no way of reducing social distancing safely and that the "preoccupation with face-to-face appointments is inappropriate".

She added: "We are seeing patients face-to-face, the only difference is that we know who’s coming in the building. We stagger patients so they’re not overlapping in the waiting room and I think it’s a much safer way to practice medicine instead of what the Health Secretary is proposing we go back to."

Her comments were echoed by Dr Jess Harvey, a Shropshire GP, who told the BBC’s Radio 4Today Programme: "The more I read and hear about this proposal the less I think the Government understands general practice, how its run and to be honest and the less in touch they are with what is going on in the real world in the NHS and what we’re facing.

"GP staff are currently sacrificing their own health and well-being to maintain a service in what has been a chronically underfunded and under-resourced area for years.

She added: "I think the public needs to understand the staffing pressures that we’re under. 

"The abuse that my reception staff have got has escalated beyond my imaginations since Covid and we are facing resignations at the moment from my practice because of this. 

"Had there been some sort of defence for us from the Government then that might have helped. 

"General practice  is on its knees. I don’t know anybody in general practice at the moment who isn’t working their knuckles to the bone and frankly for Mr Javid to describe us as underperforming is insulting. I would invite him to see what I’m doing and tell me where I’m underperforming. 

"Where is the evidence? we’re seeing more people than ever. We are seeing more appointemnts than pre-pandemic. 

"We have provided over 70 per cent of the vaccination programme that the Government hail as their great success, and that’s general practice doing that, and that was in addition to our normal work." 

Health Secretary Sajid Javid has defended the Government’s decision to publish league tables for family doctors.

Mr Javid said that providing "more data, more transparency" would help drive up standards at GP practices across the country.

"It is important that patients have this information because I want to see a levelling up of healthcare throughout the country. We do need to understand what the differences are in healthcare provision across throughout the country," he told Sky News.

He said the Government was providing an additional £250 million in support for GP practices.

"This whole package today is about support. This is all about helping GPs so that they can do what they do best, which is seeing their patients," he said.

The bluebrint for improving GP services

The blueprint for improving access, published by NHS England working closely with the Department of Health and Social Care, includes a number of measures including:

  • The new investment will fund locum doctors as well as support for GPs from other health professionals such as physiotherapists and podiatrists.
  • The NHS said GP practices must "respect preferences for face-to-face care unless there are good clinical reasons to the contrary".
  • Local health systems will be given some freedom to determine how to tackle access problems, which could include "walk-in consultations".
  • But the NHS will "increase its oversight" of practices with the most acute issues in relation to access, it said.
  • GP appointment data will be published at practice level by spring – so people will be able to see how well their surgery performs compared to others. The NHS said this will "enhance transparency and accountability".
  • Practices which do not provide "appropriate levels" of face-to-face care will not be able to access the additional funding and will instead be offered support. Though it is not clear what the level of appointments need to be face-to-face.
  • The money will help upgrade GP surgery telephone systems – which will hopefully drive down long waits on the phone.
  • The Government will reform who can provide medical evidence and certificates such as fit notes and DVLA checks – freeing up more time for appointments.
  • – Infection control will be assessed which could lead to social distancing in practices being changed or downgraded.
  • Patients will also be able to see different types of clinicians in general practice including nurses, pharmacists and paramedics.
  • Backlash as doctors hit back at plans

    The plans announced by the Health Secretary has prompted a fiery response from health professionals, including the British Medical Association.

    Many GPs will be deeply disappointed by the tone of comments reported earlier about the rescue package planned for general practice. We’ve been clear what our 4 asks are and it’s imperative that the Govt delivers on these:

    — The BMA (@TheBMA) October 13, 2021

    Dr Harvey said recruiting locum staff would cause GPs to leave the health service. 

    She said: "They talk about recruiting extra locums, I’ve heard the Tory Government talk about a magic money tree – there isn’t a magic locum tree. My practice tried to recruit a maternity locum for a year and didn’t manage it, and we’re a lovely practice to work for. 

    "There aren’t locums out there that are clamouring to work because there’s been such a toxic environment created by the Governments of past times now in general practice. 

    "There is no capacity in the system. If we go to the locum system, the already demoralised GPs thinking of leaving will leave. Then you’re in a disaster zone. You’re going to have an expensive locum market force economically and medically, that’s just poor practice." 

    Dr Amir Khan, speaking on Good Morning Britain about face-to-face appointments, said that the issue was capacity. 

    'We would love to see everyone face to face, but simply we don't have that capacity there.'@DrAmirKhanGP says GP league tables will disproportionately affect inner-city GPs and the £250 million winter access fund 'won't even touch the sides'.

    — Good Morning Britain (@GMB) October 14, 2021

    And Dr David Wrigley, deputy chairman of the BMA, said on Twitter: "’Funding for locum GPs’, says ⁦Sajid Javid. ⁩There are no spare GPs because working in general practice is so toxic and impossible due to your rhetoric and lack of support. This is all on your watch."

    He added: "This Government is completely out of touch and is now telling GPs how to do their job. 

    "I have never seen colleagues at such a low ebb and at rock bottom. 

    "NHS general practice was once the jewel in the crown of our NHS. It is being destroyed by this Government."

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