Leading representatives of General Practitioners (GPs) in the UK have warned the government and the National Health Service (NHS) that their blueprint package of measures aimed at ramping up face-to-face appointments could prompt many to “hang up their stethoscopes and leave the profession”.
Forcing GPs to see in person every patient who wants to do so amid an increasing shortage of doctors working long hours due to the ongoing coronavirus pandemic has been denounced as the wrong approach.
Britain's new Health Secretary Sajid Javid holds a face mask, as he leaves Downing Street in London, Britain, June 30, 2021
© REUTERS / Henry Nicholls
The British Medical Association (BMA) criticised the government as being far too “preoccupied” with face-to-face appointments, offering a rescue plan that only “tinkers around the edges, and will not reduce the unnecessary burden” for practices.
A “dismayed” BMA warned that the “flawed” plan would in fact make it harder for patients to get appointments.
According to Dr. Richard Vautrey, the chair of the BMA’s GPs committee, the government was “completely out of touch with the scale of the crisis on the ground”.
“GPs and their teams will now be facing the worst winter for decades, and as a result, patients’ care will suffer. Appointments will be harder to book, waiting times will get longer, more of the profession could leave and GPs will struggle to cope,” he said.
Blueprint Rescue Package
Under the action plan offered by the UK government and NHS England, GPs will be offered a £250mln “winter access fund” to hire more staff, such as locum GPs, physiotherapists and podiatrists. However, the money comes with strings attached, as it is conditional on ramping up in-person appointments.
According to the blueprint, GP practices must “respect preferences for face-to-face care unless there are good clinical reasons to the contrary”.
GPs are required to ask patients if they want to come into the surgery or opt to speak on the telephone or by videocall instead.
Furthermore, as of next spring, GP appointment data will be published every month at practice level, allowing people to see how their surgery compared to others regarding in-person appointments, in what GPs have slammed as a “name and shame” exercise.
In an effort to free up GPs’ time for appointments, there will be a reform of who can provide medical evidence and certificates such as fit notes and DVLA checks.
In line with new guidance on infection control procedures drawn up by the UK Health Security Agency, set to be published imminently, the 2-metre social distancing rule in GP surgeries is to be ditched to allow more patients to arrive in person.
Speaking on BBC Radio 4’s Today programme, Health Secretary Sajid Javid said:
“This whole package today is about support. This is all about helping GPs so that they can do what they do best, which is seeing their patients.”
‘Burnt-Out Workforce’
Medical groups and leading representatives of the profession have questioned the current emphasis on in- person appointments.
Campaign group EveryDoctor was cited as saying that GPs had been instructed to offer initial consultations on the phone or online.
“It’s a bit of a shock for GPs to have been told vehemently by the health secretary last year that all appointments should be via telephone. And now we are told the absolute opposite and, in fact, blamed for the amount of telephone consultations that have been happening,” said Dr Julia Grace Patterson, chief executive of EveryDocto.
Prof Martin Marshall, the chair of the Royal College of GPs (RCGP), weighed in on the narrative that telephone or video appointments were inferior to in-person interactions.
“The narrative being peddled that remote consultations are substandard to those delivered in person is dangerous. Face to face appointments will always be an essential part of general practice, but good and safe care can also be delivered remotely,” he was cited by The Guardian as saying.
Opposition parties also expressed fears that the changes might drive more GPs to quit.
“There is now a real risk that GPs already burned out from working overtime during the pandemic will walk away from the profession in frustration at the government’s attitude towards them”, Munira Wilson, health spokesperson for the Liberal Democrats was cited as warning.
Former Health Secretary Jeremy Hunt erupted in a barrage of criticism on Twitter.
Hunt, who was Health Secretary from 2012 to 2018, referenced his own experience in “trying and failing” to recruit 5,000 more GPs into the system. He underscored that the government’s GP rescue plan for the sector, announced on 14 October, would fail to “turn the tide”.
“This is a burnt-out workforce running on empty,” he said.
This comes as NHS Digital revealed that the number of full-time equivalent (FTE) fully-qualified GPs in the UK had plummeted from 29,403 in September 2015 to 28,023 registered this August.
Taking into consideration the 4% rise in England’s population since 2015, there is now one full-time-equivalent GP for every 2,045 patients, an increase of 182 patients (9.7%) in six years.