NHS chief denies ignoring GP calls for support amid workload crisis

NHS England's chief executive has denied ignoring advice from GPs on how to ease pressure on practices, in the wake of widespread condemnation of the access plan and support package published last month.

NHS (Photo: Scott Barbour/Getty Images)
NHS (Photo: Scott Barbour/Getty Images)

Speaking at an NHS Confederation conference on primary care - held online - Amanda Pritchard said NHS leaders would ‘not ignore what GPs and their teams are telling us would make a difference’ to primary care services.

However, the NHS England boss' comments came just weeks after the access and support package for general practice was condemned by the profession. The BMA called the package 'frighteningly ignorant' of the needs of general practice - while the RCGP said it offered 'nothing to address the long-standing workforce pressures facing general practice'.

NHS England primary care medical director Dr Nikki Kanani, speaking alongside Ms Pritchard, said the access plans were not about ‘naming and shaming GPs’, but providing 'good support' for patients.

GP access

Their comments came after GPonline revealed last week that integrated care system (ICS) leaders were planning to ignore orders to compile lists of GP practices delivering ‘low’ levels of face-to-face appointments - warning it would increase pressure on practice teams.

Ms Pritchard, speaking in front of primary care staff for the first time, said issues around access to GP surgeries were ‘really complex and challenging', adding GPs had come ‘under a great deal of scrutiny’ from some media outlets.

She said NHS leaders were working to improve the ‘front door’ of the NHS. ‘We know that most practices provide accessible, high quality care - and this is clearly evidenced in the GP patient survey, which does show the majority of patients have a good experience overall,' she said.

‘But, we also know - and this is no different to any other part of the health service - that there is variation, and we do know that access isn’t as good as it should be; not as good as patients want it to be, but also not as good as GPs or their teams want it to be.

Primary care bureaucracy

‘While we can’t ignore the concerns of patients and patient groups who struggle to get the care they need, we must not ignore - and I will not ignore - what GPs and their teams are telling us would make a difference,' she added.

GP leaders have argued in recent weeks that their ideas around reducing current workload pressures are not being considered by NHS England's leadership. BMA GP committee chair Dr Vautrey said association had repeatedly told ministers that patient care and access would be at risk unless red tape for practices was cut back.

Last month RCGP chair Professor Martin Marshall outlined immediate steps that the government could take to ease pressure in general practice, including scaling back the QOF and requirements for CQC regulation. He also said hospital staff discharging patients could take on responsibility for some fit notes.

Hospital doctors will be encouraged to issue some fit notes from this spring, but the government's access plans note practices wih low levels of face-to-face appointments could be subjected to unannounced inspections, while NHSE has commissioned an additional QOF improvement module.

F2F consultations

Dr Kanani said the the access plans were not there to ‘name and shame’ GPs. Her comments echoed the message from health and social care secretary Sajid Javid to MPs earlier this week.

Mr Javid told the House of Commons health and social care committee that the government did not intend to name and shame GPs over access to face-to-face appointments - although he confirmed that officials would press ahead with plans to publish data on face-to-face appointment levels ‘at practice level’.

Dr Kanani told the conference: 'The package of support we outlined last month involves working at ICS level, thinking about how systems can be empowered to support practices as individuals and as PCNs. What was really frustrating was this narrative about naming and shaming, that’s not what this is about. This plan is about getting good access for patients, but good support for general practice as well.’

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