The Daily Telegraph

GPS ‘named and shamed’ if they fail to see patients

Surgeries will receive extra £250m to help provide face-to-face appointmen­ts and extend opening hours

- By Lucy Fisher and Lizzie Roberts

GP surgeries will be “named and shamed” if they fail to offer sufficient face-to-face appointmen­ts under an NHS drive to improve patient access.

The Government will today unveil a proposal for doctors that includes pouring an extra £250million into general practices over the winter to increase capacity.

GP practices will be told that they must “respect preference­s” for face-toface care and should consider using the fund to extend opening hours and offer walk-in consultati­ons to allow more patients to see GPS in person.

Doctors who fail to offer enough inperson appointmen­ts will be denied access to the fund.

The measures, to be announced by Sajid Javid, also include a review of social distancing in GP surgeries which is said to be hampering patients’ access to their doctors in person.

The Health Secretary will say that he is “determined to ensure patients can see their GP in the way they want, no matter where they live”, and that “this will tackle underperfo­rmance, taking pressure off staff so they can spend more time with patients and increase the number of face-to-face appointmen­ts”.

Since the beginning of the pandemic, the number of face-to-face GP appointmen­ts has fallen dramatical­ly and failed to recover. The latest monthly data showed that 58 per cent of appointmen­ts took place in doctors’ surgeries, down from 80 per cent of all consultati­ons before the pandemic.

The true number is likely to be lower, as The Daily Telegraph disclosed this week that some telephone consultati­ons are being counted as 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. A key part of Mr Javid’s plan will, from spring next year, be to publish GP appointmen­t data to help the NHS increase oversight of practices with “the most acute issues in relation to access”.

Currently the data are only published by clinical commission­ing groups, meaning individual surgeries that fail to offer face-to-face appointmen­ts do not face scrutiny.

Patients will also be able to rate their general practice by text message under a survey scheme being piloted in around 60 surgeries. It will be rolled out across the country next year.

Critics said the plan amounted to “naming and shaming” surgeries that do not offer enough face-to-face appointmen­ts. The proposal will ask general practices to devise local plans for increasing in-person consultati­ons, with money available from the new pot.

Greater use of pharmacist­s, paramedics, advanced nurse practition­ers and nursing associates is also set to form part of the solution.

Mr Javid paid tribute to GPS and their teams for their “enormous efforts in the most challengin­g times in living memory”, after carrying out 300 million appointmen­ts in the past year and performing the majority of Covid jabs.

In turn, a “zero-tolerance” campaign to tackle abuse and harassment of staff at surgeries will also be devised by the NHS, in partnershi­p with the Government and Academy of Medical Royal Colleges. An extra £5million funding to provide physical security at GP sites, including CCTV cameras, will also be announced today. GPS and unions have reported unacceptab­le levels of abuse.

It is understood that Mr Javid wants to introduce a new covenant for NHS workers, setting out the Government’s commitment to them. He introduced a similar covenant for police officers when he was Home Secretary.

The move is intended to enhance transparen­cy and accountabi­lity, as monthly data published at present focuses on large clinical commission­ing groups.

Dr John Hughes, chairman of the campaign group GP Survival, said:

“There’s never any money without major strings attached.” Dr Hughes decried the plan to publish GP surgery level data as “inappropri­ate” and said it could “name and shame practices”.

Steve Brine, the former Tory health minister, welcomed the push for greater transparen­cy, however, as a “good thing” as long as it helped improve access to in-person care.

He argued it should not be viewed as negatively “naming and shaming” surgeries, but as a positive move to drive up standards in partnershi­p with GPS.

The role of pharmacist­s is also set to be elevated under the plan, to relieve some of the workload on GPS.

NHS England is examining a scheme in Scotland called Pharmacy First that allows pharmacist­s to pick up more of doctors’ work, including handing out prescripti­ons. Pilots have commenced.

In a further attempt to reduce the administra­tive burdens on GPS and free up more time for appointmen­ts, the

NHS will widen the circle of profession­als that can provide medical evidence and certificat­es such as Fitness for Work notes and DVLA checks.

Some of the money provided will be spent on upgrading telephone systems, so patients can speak more easily to GP staff and avoid long waits when contacting surgeries by phone.

Amanda Pritchard, the newly appointed chief executive of the NHS, said it was a “personal priority” to improve access to high quality general practice. The health service is “taking both urgent and longer term action to back GPS and their teams with additional investment and support”, she added. Last night the British Medical Associatio­n said it was “hugely dismayed” at the rescue package and claimed it showed the Government was “out of touch” with the GP crisis.

Dr Richard Vautrey, the BMA GP committee chairman, said: “Throughout our discussion­s with ministers and NHS England in recent weeks, the BMA has been clear that without a concerted effort to reduce bureaucrac­y, admin and red tape in practices, patient access and care was at risk.

“Unfortunat­ely, today’s offer merely tinkers around the edges, and will not reduce the unnecessar­y burden practices carry and therefore free up any more time for doctors to see more patients.” He added GPS will be “horrified” the package is being presented as a “lifeline”, “when in reality it could sink the ship all together”.

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