£160m NHS backlog plan shows 'grave misunderstanding' of GP workload, says BMA

A £160m plan for 'accelerator sites' to speed up the NHS recovery from COVID-19 is 'disingenuous' and reflects a deep misunderstanding of current pressures on general practice, the BMA has warned.

BMA chair Dr Chaand Nagpaul (Photo: JH Lancy)
BMA chair Dr Chaand Nagpaul (Photo: JH Lancy)

NHS England unveiled a £160m plan on 13 May to 'tackle waiting lists and develop a blueprint for elective recovery' - with funding to be spread across 12 areas and five specialist children's hospitals.

The plan will see these 'accelerator sites' trial ways to drive up the number of elective operations they deliver, eventually aiming to exceed pre-pandemic levels.

Schemes that will go ahead at the sites will include 'a high-volume cataract service, one-stop testing facilities, greater access to specialist advice for GPs and pop-up clinics so patients can be seen and discharged closer to home'.

GP workload

The plans also include 'virtual wards and home assessments, 3D eye scanners, at-home antibiotic kits, "pre-hab" for patients about to undergo surgery, AI in GP surgeries and "Super Saturday" clinics - where multi-disciplinary teams come together at the weekend to offer more specialist appointments'.

BMA chair Dr Chaand Nagpaul warned that with a record high of almost 5m people currently waiting to begin treatment, at least £4bn would be needed to clear the backlog.

NHS England said in December that the government had provided 'an additional £1bn of funding for elective recovery in 2021/22' - but Dr Nagpaul added: 'To trumpet a cash boost of £160m is wholly disingenuous. Even if the money being promised was enough to fund the care for all those who are waiting, those patients face being treated by an exhausted and depleted workforce; a workforce that has not had any kind of respite in the past 14 months.'

He added: 'The idea of GPs providing specialist clinics, or "super Saturdays", also shows a grave lack of understanding of the rocketing workload and demand already facing GPs, which includes delivering the largest vaccination programme in the history of the NHS.'

NHS funding

The BMA warned last month that GP practices were 'at breaking point' after a 20% surge in appointments in March compared with the previous month - and GPonline has reported on GPs facing a 'tsunami of workload'.

Dr Nagpaul added: 'The government is already aware that many of the technological innovations, such as "pop-up clinics", previously launched during this pandemic have ended up actually increasing workload, so it is crucial that there is adequate engagement with relevant staff from across the health service and from those who will be most impacted by these measures to ensure that this approach will be effective and ultimately sustainable.

'Technological innovation should be used to address some really basic and simple issues, which the BMA has been calling for, such as enabling hospitals to be able to prescribe electronically for patients and to have direct access to community diagnostics, something that is currently creating significant burden on GP practices.

'Another example is the administration of waiting lists; currently huge numbers of patients are taking up GP and hospital clinician time chasing up their waits, and wanting to know more about when they will be seen or treated. There should be local systems so to keep patients up to date about their waits with helplines for queries.'

Primary care stretched

The BMA chair demanded a 'workable plan' with reasonable funding and resources that 'caters to the needs of primary, secondary and community care – all of whom have been completely stretched in the past year'.

The north London GP also called for a renewed drive to expand the medical workforce and retain doctors and other NHS staff working under intense pressure.

NHS chief operating officer Amanda Pritchard said: 'Treating around 400,000 COVID-19 patients over the past year has inevitably had a knock-on effect on non-urgent care, but our incredible staff still managed to perform more than 2m operations and other treatments in the first two months of this year when the hospitals were at their busiest with COVID-19 patients.

'With COVID-19 cases in hospitals now significantly reducing thanks to the extraordinary success of the NHS vaccination programme, our focus is now on rapidly recovering routine services. Early figures show local teams are already well ahead of schedule, but we want to go further, faster which is why we are investing £160 million to find new ways to tackle waiting lists.

'The additional support announced today will help us create a blueprint for continuing that progress over summer and beyond, in a way that doesn’t heap extra pressure on staff.'

NHS England has suggested there are no plans to mandate GPs to take part in 'super Saturday' clinics.

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