There are reports of some GP practices refusing requests for face-to-face appointments from patients, despite guidance stating patient preference should be respected unless they are considered a covid-19 infection risk. Government should legislate if necessary to put this fundamental right in law.
The pressures of the pandemic should not be used to introduce a major permanent change to GP services. Without the physical proximity to a doctor, some conditions may not be diagnosed through remote consultations alone. Older patients, in particular, may be uncomfortable with, or ill-equipped for, video or telephone consultations and be unable to describe their symptoms correctly. In a survey of Silver Voices members, over 70% reported difficulty this year in seeing a doctor.
The government's response
Government currently has no plans to legislate for face to face appointments, however practices should respect preferences for face-to- face care unless there are good clinical reasons to the contrary
The Department currently has no plans to legislate for patients to receive timely face to face appointments. Patients should always be able to choose whether they see or speak a GP or member of their team, unless there are good clinical reasons to the contrary. Regardless of how people access GP services, they should receive the same high quality of care- in many cases, remote appointments provide extra flexibility and convenience for patients.
In response to the pandemic there have been big changes to the way general practice operates: by necessity, practice teams rapidly adapted their ways of working in order to keep practices open and vital services going. To manage demand and reduce the risk of infection for staff and patients from Covid-19, general practice teams innovated by providing more remote consultations and utilising triage. This ensured practices prioritised the most urgent care needs and could direct patients to the right service, with the right primary care professional at the right time. We owe them our profound thanks for their outstanding efforts through the most challenging period in living memory.
It is vital as we emerge from the pandemic, that we continue to support general practice teams to provide the best possible care to patients and ensure that patients are able to see their GP in the way they want, and receive the same high quality of care, no matter where they live. We know that general practice is very busy and demand for services is high. We also know that although remote consultations provide extra flexibility and convenience for patients to access services, they are not appropriate for all patients or in all circumstances.
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Appointment numbers have returned to pre-pandemic levels, and in August there were on average 1.14 million general practice appointments per working day, an increase of 2.2% compared to 1.12 million in August 2019 (pre pandemic).
That is why we have published a comprehensive new plan to support GPs, and to make it easier for patients to see or speak to GPs and their teams.
The measures in the plan will help GPs to increase face to face appointments, tackle variation in performance, reduce bureaucracy, and enhance the role of community pharmacists and other clinicians, so that patients everywhere can benefit from the high quality care that our GP practices offer.
The plan includes a £250million Winter Access Fund: a non-recurring revenue fund, ringfenced to protect and expand capacity in general practice for 6 more months until March 2022.
The plan also strengthens our commitment to boosting recruitment and retention, and freeing up capacity for general practice staff, through drawing on the talents of our community pharmacies and their teams.
It also shows how we’ll protect colleagues from the unacceptable abuse from a small minority, including by creating a fund for extra security measures.
Finally, we’re putting in place clearer expectations around appointments. Although the vast majority of GPs are doing brilliant work at a tough time for our health service, there are also a small number that aren’t performing in the way that the public expects. We’ll identify these practices, and intensify our support, for example by expanding the work of our Access Improvement Programme, which supports struggling practices.
The work below highlights additional ongoing work in the department and NHSE, to ensure better access in future for patients:
• The provision of additional funding of £270million from November 2020 until September 2021 to help expand GP capacity to ensure they provide quality care to patients in the challenging circumstances presented by the pandemic.
• Our commitment to support general practice to deliver an extra 50 million appointments a year by March 2024, and to expand the practice workforce so there is more capacity to deliver better care. The Additional Roles Reimbursement Scheme is open to all PCNs to reimburse 100% of employment costs of a range of primary care professionals, such as pharmacists and physiotherapists. We are training more GPs than ever before, with the highest number of doctors accepting a place on GP training in England in 2020 – 3,793 and we have committed to increasing the number of GP training places to 4,000 in 2021.
• NHSEI Access Improvement Programme is supporting practices whose patients are experiencing the greatest challenges in providing good access to patients. NHSEI is currently supporting over 900 practices to design and deliver tailored support packages for those practices.
• Evaluation and learning from rapid service change. NHSEI has an independent evaluation underway to understand the implications for staff, patients of using digital tools in primary care, including the effectiveness of online consultation systems that support triage in general practice. Findings from this evaluation will support improvements to the services practices provide.
Department of Health and Social Care
This is a revised response. The Petitions Committee requested a response which more directly addressed the request of the petition. You can find the original response towards the bottom of the petition page (https://petition.parliament.uk/petitions/587701)