BMA delivers scathing response to updated SOP for general practice

The BMA has offered a scathing assessment of an updated standard operating procedure (SOP) for general practice published by NHS England - dismissing it as unclear and out of touch.

BMA House (Photo: Malcolm Case-Green)
BMA House (Photo: Malcolm Case-Green)

The updated SOP was published on 20 May - a week after NHS England triggered widespread fury among GPs with a letter setting out demands for all patients to be offered face-to-face appointments.

Calls for practices to 'respect preferences for face-to-face care' are reiterated in the updated SOP - despite calls from GP leaders for NHS England to apologise and back down.

Dr Farah Jameel, a member of the GPC executive team, said the updated advice showed a 'critical lack of understanding' of GP premises, was unclear how practices could deliver a major rise in face-to-face appointments safely - and completely ignored the intense pressure practices are working under.

Face-to-face appointments

She said: 'Despite NHS England’s claims otherwise, this SOP fails to clarify how GPs are meant to offer face-to-face appointments to those patients who need them, while at the same time maintaining infection control and social distancing measures.

'In writing such an SOP, NHS England displays a critical lack of understanding of what the average GP surgery estate physically looks and feels like and how many patients it can safely accommodate at any given time.'

Dr Jameel added: 'The impact that the inevitable increased demand - when practices are already working at their limits - will have on patient care has also been completely ignored.

'While GPs are best placed to work with patients in providing more face-to-face care, they need to do it safely, and if NHS England is keen for doctors to follow this guidance then it needs to tell them how to keep staff and patients safe.

GP workload

'It’s yet another example of how little understanding NHS England has of the day-to-day pressures GPs are under and of the stresses they face trying to do the best they can for their patients.

'Worse still, it appears to ignore the significant work that general practice has been doing throughout the pandemic, whilst simultaneously being the major artery of the COVID-19 vaccination programme.'

The BMA's GP committee delivered a vote of no confidence in NHS England's leadership earlier this week and has suspended meetings with its officials over the face-to-face appointments demands.

The committee's response to the final SOP underscores the deep divisions between GP leaders and NHS England over demands on how practices should operate.

NHS England dispute

NHS England's primary care medical director Dr Nikki Kanani has faced calls to resign - with a petition by the GP Survival group - which has since been 'paused' - securing more than 1,100 signatures.

Responding on Twitter Dr Kanani promised to 'keep doing what I do, because everything I do is for the benefit of patients and our profession'.

In a blog published alongside the updated SOP she wrote: 'The message that primary care continues to be open is an important one, because we know that many people over the course of the pandemic have put off seeking medical attention, including for symptoms which could be cancer or other serious conditions. But this message can only be effective if it is matched by people’s experience.'

An NHS England spokesperson said this week: 'GPs have worked hard throughout the pandemic and are now pulling out all the stops to roll out the biggest and fastest vaccination programme in NHS history - providing vital protection to millions of people. NHS guidance, which makes sure that patients can access face-to-face appointments has been widely welcomed by patient groups and local health groups will now work with practices to make sure patients get services they need.'

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