Outcry over proposal for face-to-face GP consults
GOVERNMENT plans to force GPs to offer more face-to-face appointments have caused “significant anger and upset” among doctors in the region.
And the boss of Bristol, North Somerset and South Gloucestershire (BNSSG) CCG says she is frustrated with the “political load of nonsense” over the issue, insisting new ways of dealing with many people remotely are better for patients and the NHS.
Chief executive Julia Ross said health chiefs needed to remain focused on “the right thing to do” for residents and not be “buffeted by all the noise”, although she accepted not everyone had fully embraced digital access to surgeries because Covid had forced the changes to happen suddenly.
She was speaking at a CCG public meeting on Tuesday, amid the fallout from the Government’s £250 million plan announced earlier this month to increase in-person GP consultations.
The doctors’ union has rejected the proposals which include “naming and shaming” practices that fail to improve access and denying them money from the new fund.
Health Secretary Sajid Javid’s winter plan gives patients the right to demand face-to-face appointments, and surgeries could only refuse requests if there are good clinical reasons.
The British Medical Association’s GP committee has agreed to hold a ballot on possible industrial action, which means family doctors could go on strike.
A meeting of BNSSG CCG primary care commissioning committee was told the region’s practices had received a letter from NHS England on October 14 outlining the proposals.
CCG senior programme lead for primary care networks and workforce development Bev Haworth said: “We know we will face a very challenging winter, and access to general practice is an essential part of the plans. The letter also comes at a time when our current workload pressures on general practice are intense and the workforce isn’t increasing as fast as other areas.
“Our practices are managing our patients’ frustrations with the changes to the normal, with different modes of care and face-to-face not being the only appropriate method of consultation, so not all appointments need a GP.
“It is fair to say these national proposals have caused significant anger and upset across general practices, locally and across the country, with the professional body rejecting this approach.
“There is a national pot of money of £250 million which would mean around £4 million for our area.”
She said the money would be used to improve access to urgent sameday primary care, such as extra sessions at GP surgeries, while pharmacists are expected to treat more people with minor illnesses.
“In order for this funding to be released there are some significant asks, so our plan in response needs to clearly outline what we will use the funding for and the impact, be clear on the actions, and plan to increase access for patients in an agreed list of practices who are struggling the most,” she said.
As part of the CCG’s local plan, which has to be submitted to government by today, it must identify practices with the lowest 20 per cent of face-to-face appointments and take “immediate further steps to support improved access”.
Ms Ross told the meeting there needed to be a clear balance between in-person and digital services.
She said: “There is a political load of nonsense going on which we’re all a bit frustrated by because we always knew we wanted primary care to have a much more digital front end – it’s better for patients, better for primary care and better for resourcing.
“So we know it’s a good thing. But because of the way we had to do it quickly in Covid, of course, the public hadn’t really come with us.”
The chief executive said the CCG must not be “buffeted by political things” and instead “focus on what’s the right thing to do for our population, the practices and the system”.
“That includes how we address health inequalities for people who can’t use digital but it’s also about how we get consistency of offer across BNSSG,” she said.
Clinical lead for primary care development Geeta Iyer said: “The balance of digital and face to face is really tricky because it does depend on the population. There are people who can’t access or do not feel comfortable accessing that and want to see people face to face, and we need to offer that and have some consistency.” She said work was required to “tweak” services so they were right for people following the pandemic and that “no one has the answer just yet”.
Ms Ross said this should be done “proactively rather than being buffeted by all the noise that exists”.
The NHS England letter said: “A minority of practices are now offering wholly inappropriate access, with very low levels of face-to-face care. In August 2021 over 15 per cent of practices recorded less than 20 per cent of their GP appointments being held face to face. That is likely to be contrary to good clinical practice, even if it were to reflect the preferences of their patients.”