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Wednesday, October 20, 2021

GP rescue plan to boost face-to-face consultations


GPs in England are being told to see more patients face-to-face as long waits in A&E rise to their worst level since records began.

Ministers have established a £250 million emergency winter rescue package to allow GP surgeries to hire more temporary staff.

It comes amid growing concern about the decline in face-to-face appointments since the outbreak began.

Lack of access to GPs has been identified as a major contributor to the increasing pressures on A&E departments.

In September, one-quarter of A&E patients in England waited more than four hours for treatment.

This is the worst performance since 2004, when the four-hour target was implemented. According to the most recent data, four out of every ten patients in Northern Ireland are waiting more than four hours.

Those who were then admitted to a ward in England faced record-long waits for a bed, known as “trolley waits” – they tend to be the most seriously ill and frail patients.

More than a quarter of the 386,000 admitted waited more than four hours for a bed to become available. Over 5,000 people had to wait for more than 12 hours.

The £250 million funding for GPs is part of a £5 billion Covid fund announced last month to help the NHS get through the end of the year, and it is in addition to the £12 billion set aside for GP services this year.

Along with locum doctors (doctors who fill in for others temporarily), GP practises will be able to use the funds to hire other temporary workers such as physiotherapists and podiatrists. Pharmacists are also being encouraged to see patients with minor illnesses in order to relieve pressure on general practitioners.

Sajid Javid, the Health Secretary, stated that the new GP rescue package would help relieve pressure on the entire system.

Only 58 percent of patients were seen face-to-face in August, the first full month after restrictions were lifted.

This compares to 54% in January and more than 80% prior to the pandemic.

Patients have also expressed dissatisfaction with the length of time it takes to book an appointment over the phone.


‘GP would not see my 84-year-old mother in person’

Kevin Fogarty claims that his 84-year-old mother was initially denied face-to-face contact with a GP despite having an infection in her leg as a result of a biopsy.

“She hadn’t been seen in over a year. However, an infection developed in the wound, and the doctor refused to see her. We had to put them under pressure.”

Mr Fogarty, 60, said the Somerset practise eventually agreed to see her in person, and she is now receiving home visits from a nurse to care for her wound.

“GPs appear to be the only group that has not returned to normal services, while shop workers and the rest of the population have.

“Telephone and video calls are useful for initial consultations, but if the patient insists or there is a requirement, the GP must see them.”

Along with the extra money, social distancing rules in GP surgeries are expected to be relaxed, and responsibility for signing fitness-to-work and fitness-to-drive certificates will be passed on to other staff.

Mr. Javid stated: “I’m determined to ensure that patients can see their doctor whenever and however they want, regardless of where they live.

“Our new strategy invests in general practise teams and provides targeted support. This will address underperformance by relieving stress on staff, allowing them to spend more time with patients and increase the number of face-to-face appointments.”

If GP surgeries are judged to have failed to provide an adequate level of “access,” they will be listed in league tables.

GP plan will not help – doctors’ leaders

The British Medical Association’s Dr Richard Vautrey, on the other hand, was “hugely dismayed” by the package. “It offers very little and demonstrates a government that is out of touch with the magnitude of the crisis on the ground.”

He predicted that patients would “continue to suffer” and find it more difficult to schedule appointments.

“It’s disheartening to see that there’s no end in sight to the obsession with face-to-face appointments.”

He said in-person appointments were still important in GP care, but the pandemic had shown that phone or video consultations were “completely appropriate and appreciated” by many patients.

The rescue package comes amid the government’s ongoing efforts to increase the number of general practitioners.

Despite successive government efforts to increase numbers, the total number of full-time positions has decreased over the last five years.

NHS Providers, which represents health executives, said its members were especially concerned about A&Es, as well as mental health and cancer services.

“The NHS is fighting fires on multiple fronts as they try to recover care backlogs, increased demand for emergency care, treating patients with Covid, and preparing for what is likely to be the most challenging winter for the NHS,” said Deputy Chief Executive Saffron Cordery.

“We’ll be facing our first winter with both flu and Covid in circulation in a matter of weeks.”

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