Patient choice should determine whether GP appointments are face-to-face, says Javid

GPs should respect patients’ choice to be seen face-to-face irrespective of clinical need, the health and social care secretary has suggested.

Health and social care secretary Sajid Javid (Photo: Wiktor Szymanowicz/Barcroft Media/Getty Images)
Health and social care secretary Sajid Javid (Photo: Wiktor Szymanowicz/Barcroft Media/Getty Images)

Giving evidence to MPs on 2 November, Sajid Javid argued that where GPs encounter a patient who wants to be seen in-person they should do the ‘right thing’ and offer them a face-to-face consultation.

The health secretary’s stance risks further angering GPs at a time when the profession is delivering more appointments than ever - and appears at odds with the GMS contract, which states that appointments should be 'delivered in the manner determined by the contractor’s practice in discussion with the patient'.

Mr Javid’s comments come just weeks after the BMA accused him of being ‘out of touch’ with reality after he told MPs it was 'high time' GPs offered in-person appointments to anyone who wants one - claiming life was 'almost back to completely normal'.

Face-to-face appointments

The health and social care secretary told the House of Commons health and social care select committee that he did not believe there was a ‘right or wrong percentage’ of face-to-face appointments, and denied plans to publish 'league tables' showing how many in-person appointments practices deliver.

However, he confirmed that the government was likely to publish data on face-to-face appointments levels conducted by individual GP practices - data that could be used to create league tables.

Responding to questions about the backlog of care in the NHS, Mr Javid said it was important patients had the choice to see their GP in-person. He said: ‘Where patients have a desire to be seen face-to-face, and this has been an issue recently, I think that choice should be respected.

‘I don't think there's a right or wrong percentage - in my mind there is no target... For me, it's never been about a number, it's about doing the right thing [and] it's about choice for the patient. Where you have a patient that wants to be seen face-to-face, perhaps the initial consultation might have been remote but they feel that they should be seen face-to-face, this is really important for primary care.

‘The purpose of the recent winter access package for COVID was working with GPs and listening to what they have to say, and to come forward with funding or other interventions that will help them do what they love doing, which is seeing their patients - that was the purpose of the package.'

GP 'support' package

Mr Javid, who was speaking at his first health and social care select committee meeting, added that the government had no plans to publish league tables of GP practices. However, he said that the DHSC would press ahead with plans to publish face-to-face appointment levels ‘at practice level’.

‘[In the last GP contract] it included the need for more transparency that GPs rightly accepted, and being able to publish data at a practice level rather than a regional or CCG level, and that is something that we plan to go ahead with,' he said.

As part of the government's ‘support’ package for GPs this winter, it asked integrated care systems (ICSs) to identify the 20% of GP practices in their area offering the lowest proportion of face-to-face appointments by 28 October, with these practices then facing immediate intervention.

However, it was reported that NHS England could shelve this initiative after making ‘significant concessions’ on its shared plans following talks with the BMA. It could also scrap plans to impose targets on face-to-face appointments.

Staff shortages

GPonline revealed earlier this week that ICS leaders were already plannig to ignore orders to list surgeries delivering ‘low’ levels of in-person appointments as they were worried about the effect it could have on an ‘already frantic’ primary care workforce.

Last month NHS England primary care medical director Dr Nikki Kanani said the face-to-face care debate had become 'too polarised', warning that it could drive a wedge between practices and communities.

RCGP chair Professor Martin Marshall previously warned that calls for general practice to offer face-to-face appointments to all patients who want them are 'unachievable' given GP shortages and rising demand. Despite pressure on GPs to deliver more face-to-face appointments, official statistics show that in-person contacts accounted for a higher proportion than at any time since March 2020.

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