Statement: Our responses to the new ‘GP access recovery plan’

You may have seen coverage in the media recently about the Government’s new ‘GP access recovery plan.

The two big points you might have heard were tackling the ‘8am rush’ of people phoning for appointments, and people needing to be told on that day how their request would be managed (i.e., patients not told to call back another time).

We know long waits to have a call answered or for an appointment to be scheduled can be frustrations for patients.

However, we want to add some context to this plan – what it does and doesn’t include – and the situation in which it is being enforced.

Background

GP practices deliver 500,000 more appointments every week than before covid.

Yet the demand still outstrips the capacity, caused by a combination of factors such as a growing, ageing population and more people experiencing increasingly complicated physical and mental health issues.

The Plan

First, the government’s plan has not been created in partnership with GP practices or groups.

In February, the proposal was rejected by the GP Committee (GPC) of the British Medical Association (BMA).

It was described as ‘eking out’ more from practices without providing necessary resources. The GPC also said the plan risked patient safety and could lead to more Doctors leaving the NHS.

Despite this, the government choose to enforce the contract change of GP practices without any further consultation or negotiation.

How this plan will be applied to our practices in Gosforth and Jesmond is still to be confirmed with the North East and North Cumbria Integrated Care System (the NHS group that commissions services in our region)

The Headlines

As mentioned, the two headlines you may have seen are that the plan will end the ‘8 am rush’ and an ‘immediate assessment of need’.

This means patients must be told of what outcome they can expect on the day they first contact their GP, essentially that patients can’t be asked to call back on another day.

The support

The only support offered to GP practices in the plan is an investment in new telephone systems. Practices with older analogue systems can be funded to upgrade to digital systems.

The benefit to patients will be to not just get an engaged tone and potentially to get an automatic call back.

However, many practices already have similar systems, and where they don’t, new systems could only come into place as existing contracts expire.

There is no additional funding for staff – either reception or admin staff to handle calls or clinical staff to provide more same-day appointments.

Possible Impact

As the Royal College of GPs (RCGP) said in their response, the “GP access recovery plan [is] not the silver bullet that we desperately need”.

They also said that while investment in telephone systems is welcome “the best way to improve access to GP care and address the intense workload and workforce pressures GP teams are working under, is to increase numbers of fully trained, full-time equivalent GPs through effective recruitment and retention schemes.”

There are also concerns that the demand to give patients a same-day outcome will pressure GP staff even more, potentially leading to inappropriate referrals to other services, such as NHS 111.

The targets that the NHS sets for practices have changed as well – with the number of different measurable health outcomes reduced greatly and much more emphasis applied to quick outcomes.

It is valuing the speed of the outcome more than how much that outcome will benefit a patient’s health.

What we are already doing

Demand for GP services has never been higher. More appointments than ever are being requested and delivered, with the proportion of those being face-to-face at its highest since before the pandemic.

There are also lots of things GP practices working in partnership with Primary Care Networks (PCN) are already doing to provide quick, efficient, high-quality, personalised care.

As well as Doctors, our practices have experienced, highly qualified clinical teams including Practice Nurse, Healthcare Assistants and Advanced Nurse Practitioners who are able to deal with a wide range of common ailments.

Many Advanced Practitioners are also able to prescribe medication and can deal with issues people may previously have seen a Doctor for.

We are heavily promoting other ways for patients to access our services aside from calling us.

The NHS App offers incredibly easy ways to reorder a prescription or check your medical records, for example. It also allows patients to get self-help advice or contact the practice digitally.

We have also invested in websites that can serve as an effective ‘first port or call’ for many patient queries. From health updates, self-help tools, service patients can refer to directly, and guidance on how to best access NHS services, we aim to give patients information that will help them get quicker, easier solutions, reducing unnecessary phones calls or visits to the practice,

Our PCN team here in North Gosforth are also providing a new tier of high-quality, expert services to patients at Park Medical Group and our neighbouring practices.

Key parts of our team include:

• Clinical Pharmacists who provide expert advice in longer, structured medication reviews to optimise people’s treatment.
• Our Home Visits team respond quickly to requests for assessments for acute illnesses where people can’t visit their GP. We have also launched a Same-Day Access service where GPs can book patients into our Network hub.
• Nursing services to help patients with long-term conditions, including home visits.
• An expansive Social Prescribing team that supports people with low-level mental health problems, mobility issues, health and wellbeing coaching and wider support with non-medical problems that impact people’s health.
• An Enhanced Access service that provides traditional General Practice appointments are evenings and weekends, including GP consultations, cervical screening, blood pressure readings, taking blood samples etc.

Every month our network team help thousands of patients, giving them the care and support they need while freeing up more capacity for patients to be seen at GP practices.

Conclusion

While the ambition to make access easier and solutions quicker is welcome and a central part of what we are all striving for, the government’s plan does not provide the necessary support to make it happen overnight.

All GP practices and staff already work exceptionally hard, and adding pressure through unrealistic targets that risk compromising patient care and safety is not going to help.

As the RCGP concluded in their response:

“The public need to be aware of what’s achievable. Politicians think that promising faster access will improve services and win votes, but many practices are already struggling for lack of GPs and other clinical staff, particularly in communities with large numbers of patients with complex needs and disproportionate health inequalities.

“We need thousands more GPs, as we were promised at the last Election in 2019, so that we can look after the increasing numbers of patients who need our care – and we look to the long-awaited NHS workforce plan with anticipation, to see how this will be achieved.”