‘Useless’ rescue plan will ‘increase workload and bureaucracy on GPs and their colleagues, reduce the number of appointments available, and impact the quality of patient care’

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In a BMA survey, GPs in England have overwhelming rejected the Government’s new emergency winter plan for general practice.

Of 3453 GPs who took part in the online survey over the weekend, 93% said that the package is an unacceptable response to the current challenges in general practice.

The Winter Access Fund announced by Health Secretary Sajid Javid last week will provide £250 million to general practice to deal with pressures over the winter period, but only for practices that improve access to urgent, same-day, and face-to-face appointments. Practices who are not achieving pre-pandemic appointment levels by November will not be able to access the fund.

Practices will receive a share of the funding to, for example, provide more sessions from existing staff, extend opening hours, and put in place contingency planning for bank holiday working. The plan also requires greater use of 111 routing calls to general practice.

Smaller practices offering unacceptable access may be expected to partner with other practices, federations, or primary care networks; failing to do so will result in contractual action.

Data will be collected and published on practices with appointment numbers lower than in the pre-pandemic period. The 20% of practices locally with the lowest level of face-to-face GP appointments will also be named, as will those with the highest levels of 111 calls from patients during GP hours and those with the most significant rates of accident and emergency attendances.

Care Quality Commission groups will be required to provide NHS England and NHS Improvement with data on feedback from patients at regional and practice level, including concerns, complaints, and whistleblowing allegations. A new, real-time measure of patient satisfaction with access is to be rolled out nationally as early as April 2022. Patients will automatically receive a message following their appointment, which will ask a series of questions about how they rate their access to care.

The BMA says that the ‘rescue’ package is effectively useless and will in fact ‘increase workload and bureaucracy on GPs and their colleagues, reduce the number of appointments available, and impact the quality of patient care, while threatening to name-and-shame and penalise practices that need the most help’.

The BMA is warning that the plan will have a disastrous effect on staffing levels. The latest GP workforce figures show that England has lost around 1800 full-time equivalent, fully-qualified GPs since 2015. It says that Sajid Javid could be to blame for this number plummeting further.

In addition to today’s survey results, a separate survey of more than 6000 GPs in England, conducted in the week before the announcement, asked GPs if they would be prepared to reduce the number of sessions they provide or even leave the NHS in response to the current crisis in general practice. Two-thirds (66%) of respondents were prepared to reduce their hours to protect themselves from the current crisis, and more than half (54%) said that they would consider leaving the NHS all together if the Government did not provide them with the support they needed.

The union says that the fact that 93% of survey respondents rejected the package ‘is the clearest articulation yet that frontline GPs working across the country do not believe the plan will go any way to addressing the pressures facing general practice, staff, and patients’.

Dr Richard Vautrey, BMA England GP Committee Chair, said that the survey result ‘shows the profession has out and out rejected this shambles of a plan from the Government and NHS England. If the Health Secretary thinks it is enough to provide a lifeline to surgeries this winter, let alone save general practice in the long term, this response shows how wrong he is.

‘The BMA provided the Health Secretary with a clear plan to help address the crisis in the short term, that could improve patient access and guarantee safe, high-quality care, while also putting forward longer term solutions. He chose to ignore that and instead we have a shambolic plan that has failed before it has begun. These survey results show how angry and despondent GPs are. The profession clearly sees the Government’s name and shame approach as a bully’s charter, which will intensify existing problems.’

Dr Vautrey added: ‘Patient care will suffer because imposing these measures could very well result in doctors having to spend even more time on paperwork and admin. But it may also result in GPs leaving the profession altogether. We have already lost the equivalent of more than 1800 full-time, fully qualified GPs in the last 6 years, and with a majority of family doctors now saying they could be forced to reduce their hours or leave the NHS all together because of a lack of support, the situation could get far, far worse. This will be on the Health Secretary’s watch. He will be to blame.’

The GP Committee will meet later this week to discuss the package and decide the BMA’s next steps.

The Royal College of General Practitioners (RCGP), meanwhile, has described the package as a missed opportunity that will do little to improve the intense pressures that are preventing GPs from giving their patients the care they need and deserve.

RCGP chair, Professor Martin Marshall, said that the focus on access ignores the other challenges GPs face in providing high-quality, personalised care.

‘The RCGP has always been very clear that a blend of remote and face-to-face consultations are necessary, and that post-pandemic, this should be a shared decision between GP and patient. We know some patients prefer to see their GP face to face, but good care can and is being delivered remotely and some patients prefer it’, he said.

‘We are particularly concerned at plans to increase the scrutiny of hard-pressed practices and the introduction of an arbitrary text message service to rate the performance of particular GP practices. There are already ways for patients to feed back on their experience—the introduction of more measures will further demoralise a profession that is already on its knees, and demonise practices that are struggling.

‘We knew we were unlikely to get a silver bullet to solve all the challenges GPs and our teams are facing, but we hoped to see more tangible solutions to improve the care that can be delivered to patients’, Dr Vautrey said.

This article originally appeared on Medscape, part of the Medscape Professional Network.


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