Plans to increase face-to-face appointments cause 'anger and upset' among local doctors

Health boss says there has to be a balance between digital and in-person services

Author: Adam Postans, Local Democracy Reporting ServicePublished 28th Oct 2021

Government plans to force GPs to offer more face-to-face appointments have caused "significant anger and upset" among doctors in the region.

The boss of Bristol, North Somerset and South Gloucestershire (BNSSG) CCG, Julia Ross, said she is frustrated with the "political load of nonsense" over the issue.

She insisted on new ways of dealing with many people remotely are better for patients and the NHS.

Ms Ross also said health chiefs needed to remain focused on "the right thing to do" for residents and not be "buffeted by all the noise".

Although she accepted not everyone had fully embraced digital access to surgeries because Covid had forced the changes to happen suddenly.

Dealing with practices that fail to offer face-to-face appointments

The doctors' union has rejected the proposals which include "naming and shaming" practices that fail to improve access and denying them money from the new fund.

Health Secretary Sajid Javid's winter plan gives patients the right to demand face-to-face appointments, and surgeries could only refuse requests if there are good clinical reasons.

The British Medical Association’s GP committee has agreed to hold a ballot on possible industrial action, which means family doctors could go on strike.

A meeting of BNSSG CCG primary care commissioning committee was told the region's practices had received a letter from NHS England on 14th October outlining the proposals.

CCG senior programme lead for primary care networks and workforce development Bev Haworth said: "We know we will face a very challenging winter, and access to general practice is an essential part of the plans.

"The letter also comes at a time when our current workload pressures on general practice are intense and the workforce isn’t increasing as fast as other areas.

"It is fair to say these national proposals have caused significant anger and upset across general practices, locally and across the country, with the professional body rejecting this approach."

As part of the CCG’s local plan, it must identify practices with the lowest 20% of face-to-face appointments and take "immediate further steps to support improved access".

There has to be a clear balance between in-person and digital services

Ms Ross told the meeting there needed to be a clear balance between in-person and digital services.

She said: "There is a political load of nonsense going on which we’re all a bit frustrated by because we always knew we wanted primary care to have a much more digital front end – it’s better for patients, better for primary care and better for resourcing.

"So we know it’s a good thing. But because of the way we had to do it quickly in Covid, of course, the public hadn’t really come with us."

The chief executive said the CCG must not be "buffeted by political things" and instead "focus on what’s the right thing to do for our population, the practices and the system".

"That includes how we address health inequalities for people who can’t use digital but it’s also about how we get consistency of offer across BNSSG," Ms Ross said.

'Tweak" GP services to suit everyone

Clinical lead for primary care development Geeta Iyer said: "The balance of digital and face-to-face is really tricky because it does depend on the population.

"There are people who can’t access or do not feel comfortable accessing that and want to see people face to face, and we need to offer that and have some consistency."

She said work was required to "tweak" services so they were right for people following the pandemic and that "no one has the answer just yet".

Ms Ross said this should be done "proactively rather than being buffeted by all the noise that exists".

The NHS England letter said: "A minority of practices are now offering wholly inappropriate access, with very low levels of face-to-face care.

"In August 2021 over 15 per cent of practices recorded less than 20 per cent of their GP appointments being held face to face."

"That is likely to be contrary to good clinical practice, even if it were to reflect the preferences of their patients."

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