NHS England’s top GP apologises after 'offensive' face-to-face appointments letter

NHS England medical director for primary care Dr Nikki Kanani has apologised for ‘any hurt’ caused by a letter reminding GPs of their responsibility to offer face-to-face appointments, after a furious backlash from GPs.

NHS England primary care medical director Dr Nikki Kanani
NHS England primary care medical director Dr Nikki Kanani

On 14 September NHS England urged GPs to remind patients that face-to-face appointments remain available during the pandemic after it found some people were ‘experiencing difficulty’ accessing family doctors.

The letter, which announced the rollout of a communications toolkit to support GPs, also warned GPs that failure to offer appropriate care may constitute a breach of contract.

But GP leaders reacted angrily to the message, insisting that it was ‘erroneous and offensive’ to suggest that GPs were failing to do their jobs properly. GPs accused NHS England of creating a ‘media onslaught’ against the profession - as the RCGP pointed out that practices were providing 300,000 face-to-face appointments a day.

COVID response

Dr Kanani has now taken to Twitter to apologise for ‘conclusions drawn by the media’ from the letter as she insisted GPs had done ‘incredible work’ during the pandemic.

She wrote: ‘I needed to take some time yesterday following some personal attacks but wanted to be clear: I am SO proud of the way general practice responded to the pandemic, safely assessing, speaking to and seeing patients as clinically needed. Any conclusions drawn by the media about my colleagues are not mine, and I apologise for any hurt caused.

‘As you know the changes in our ways of working have made it even more important that we are clear with patients about how best to use our services, and that WE ARE OPEN.’

‘The pandemic continues to be very difficult for both our patients and practices and I’m grateful for the incredible work done by primary care throughout.'

Health risk

The NHS England letter sparked widespread anger among GPs, and outrage at the suggestions that colleagues have been shirking contractual responsibilities.

Chief executive of Cambridgeshire LMC Dr Katie Bramall-Stainer said: ‘Cambs LMC strongly protests against NHS England using a letter to paint an utterly false impression of the vast majority of GPs, who have taken their professional responsibilities to their patients extremely seriously, at some considerable personal cost and risk to the GPs themselves.

‘Surgeries across Cambridgeshire and Peterborough should be commended for adapting so quickly and seamlessly to what was – and remains - a massive shift in their usual working pattern.

‘The government needs to do much more to recognise and support practices in doing this, especially since local hospitals have advised they are not presently able to operate at their usual capacity.’

Insult to GPs

Leicester, Leicestershire and Rutland Local Medical Committee chair Dr Nainesh Chotai said: ‘Implying that GPs have not been doing their job properly is erroneous and offensive. It is an insult to GPs and their teams who have worked continuously throughout the pandemic, to deliver the vast majority of patient care in the NHS.

‘Routine GP appointments are back to near normal levels for this time of year, despite the increased stress of working in pandemic conditions, and GPs should be thanked for doing this not castigated. At the same time, due to chronic underinvestment and increasing bureaucracy, the number of GPs available to provide the service continues to fall year after year.

‘We would like to reassure our patients that GPs will continue to work hard to provide a full service which will include face to face appointments where clinically appropriate.’

GPonline reported earlier this year that by July, face-to-face appointments being delivered in primary care were up 70% compared with the early stages of lockdown in the UK.

Face-to-face consultations have continued to grow as a proportion of overall GP workload in recent weeks - with overall workload now at a level in excess of last year, and still potentially underestimated in surveillance data.

Demoralising message

Derby and Derbyshire LMC chief executive Dr Kath Markus said the letter had stirred up a ‘demoralising media onslaught’ as she recognised the ‘wholescale changes’ adopted by GPs.

She said: ‘We wholly reject both the implication from NHS England that [GPs] are not seeing patients and the subsequent media "GP bashing". We are appalled that this letter was reported in the media before it was sent to GPs which services to undermine doctor-patient relationships and trust.

‘As your colleagues and your representative organisation, we ask that you try and ignore this further attack on your morale; we know you will continue to provide the high-quality care you always have.’

Both the RCGP and BMA have condemned the NHSE letter, saying that it was 'an affront' to GPs to suggest face-to-face appointments had been put on hold.

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