In a letter to Mr Hancock, BMA GP committee chair Dr Richard Vautrey demands more support for general practice from both the government and NHS England – and sets out a string of measures the government must take to help practices.
Dr Vautrey condemned calls from NHS England for GP practices to offer face-to-face appointments to all patients who want them – warning the demands showed ‘a worrying disconnect with the reality facing general practice’ and had created ‘widespread anger, frustration and disappointment’.
GPonline reported earlier this week that an NHS England letter setting out the demands for practices to ‘respect preferences for face-to-face care unless there are good clinical reasons to the contrary had led to calls for NHS England’s primary care medical director to resign. A petition supporting this call had attracted nearly 600 signatures by the afternoon of 18 May.
Writing to the health and social care secretary, Dr Vautrey said primary care staff had been left ‘feeling increasingly demoralised by the suggestion that they are failing their patients’ simply because they have been ‘following national guidance around triage and remote consulting’.
NHS England itself has said that half of appointments in general practice during the COVID-19 pandemic have been carried out face-to-face – in addition to tens of millions of in-person encounters as part of the vaccination campaign.
This huge level of face-to-face care has been delivered despite NHS England instructions at the outset of the pandemic for practices to adopt a ‘total triage’ model.
Dr Vautrey wrote: ‘Clinicians are delivering face-to-face appointments, but can only do so when it is safe for our patients. Face-to-face consultations are at the heart of good general practice, but we need real and meaningful support to reduce the current unsustainable workload burden, rather than creating unrealistic expectations without the resources to deliver them.’
The letter sets out a series of actions the government and NHS England must take to support general practice:
- A clear statement from the CMO about when it is safe and appropriate to remove social distancing measures and when to use PPE for face-to-face consultations in GP premises.
- A major public campaign, that explicitly supports general practice, and honestly informs patients about the challenges impacting primary care.
- An end to directive letters, and instead practices and other GP services must be allowed to deliver patient care in the most appropriate manner, meeting the reasonable needs of their patients and based on their knowledge of their local communities.
- Commitment to fund premises development to improve ventilation and space in waiting areas.
- Practices not to be the automatic default for patient queries which should be directed to other parts of the NHS.
- An extension and increase to the various types of funding which have supported practices during the pandemic recovery.
- Access to and support from mental wellbeing services for GP staff.
Dr Vautrey added: ‘It is beyond doubt that general practice is under unparalleled pressure, delivering a far greater number of consultations than at the same time two years ago.
Demand for services has increased significantly through use of additional means of patient communication, including e-consultations, alongside responding to vaccination, shielding and COVID-19 issues. GPs and their teams have worked tirelessly to meet this need, alongside delivering COVID-19 vaccinations quickly and effectively, which has brought benefit for the whole nation.
‘However, they are now also tackling the huge NHS backlog, all while GP recruitment and retention is nowhere near the levels needed.’