The BMA’s comprehensive rejection of the £20m enhanced service deal is the latest sign of the breakdown in relations between GPs and NHS leaders.
BMA GP leaders also hit out at the government – warning delays in providing basic support for growing numbers of healthcare staff with long COVID were ‘unacceptable’.
BMA GP committee chair Dr Richard Vautrey said the weight management enhanced service – unveiled as part of an update to the 2021/22 GP contract alongside a £30m enhanced service for long COVID and additional PCN funding – was ‘clinically flawed, overly bureaucratic and shows a lack of trust in GPs and their teams’.
The scathing response to the enhanced service offer comes just a month after the BMA GP committee passed a vote of no confidence in NHS England’s leadership after officials told practices to offer face-to-face appointments to all patients who wanted them.
The committee also voted last month to suspend all formal meetings with NHS England and vowed not to resume them until NHS England had taken ‘sufficient steps to restore the committee’s confidence’.
Four weeks on the BMA says NHS officials have yet to respond to the call for work to restore GPs’ confidence – and the weight management service now looks to have driven a further wedge between the two.
The BMA said the long COVID enhanced service unveiled alongside the weight management deal ‘has more merit’ and came after the association lobbied for more support on tackling the condition, which affects as many as 1m people UK-wide according to the Office for National Statistics.
Citing GP appointment data published on 17 June that showed practices delivered 31.5m appointments in April including those required as part of the COVID-19 vaccination campaign, BMA GP committee chair Dr Richard Vautrey said: ‘Practices are already buckling under the pressure of unsustainable workloads as they struggle to meet demand and provide care that patients so desperately need.
‘While the BMA believes that it is vitally important as a nation much more is done to help and support people with weight management – and particularly for government to take greater steps to address the underlying issues behind rising obesity levels – today’s announced enhanced service is fundamentally flawed, will have little to no impact in tackling the problem, and will present a significant rise in workload at a time when practices are at breaking point.’
The Leeds GP said obesity could have a devastating impact and that GPs were keen to support patients in ‘the best way possible’.
But he added: ‘This enhanced service is not the right way to do it. It is clinically flawed, overly bureaucratic and shows a lack of trust in GPs and their teams to do what is best for patients. It tries to micromanage practices and creates a laborious tick-box exercise, the very limited funding for which does not match up with the work involved, with a cap on funding that could limit people who could benefit from it.
‘Meanwhile, it is no use having such a scheme in general practice when receiving specialist services are so patchy across the country, with many having long waiting times or being already full.
‘The enhanced service focusing on long COVID follows our lobbying and has more merit, providing much-needed additional funding to support practices in this crucially important and developing area.
‘Long COVID is becoming a serious problem within our communities – something practices are already feeling – and we note that funding is available for practices to help with the management of patients living with the debilitating after-effects of the virus. This programme must be kept under review, however, with more resources provided to keep up with demand as necessary, while ensuring additional, specialist support for patients with long COVID is available beyond general practice.’
The BMA GP committee chair called for urgent measures to support growing numbers of healthcare workers experiencing long COVID themselves – including access to occupational health and financial support.
He added: ‘It is unacceptable that over a year since the pandemic began, frontline healthcare workers continue to have to make the case for such basic requirements from the government.
‘GPs and their colleagues in the wider practice team care for their patients, and want to give them the best treatment possible for their conditions, but there is a limit to what they can do. Ultimately practices need to be given the trust and flexibility to do what they can within resource, time and staffing constraints to meet the needs of their patients, based on their expert knowledge of their communities.’