In comments that echo earlier statements from NHS England that provoked an angry response from GPs, Sir Simon Stevens said there was a need to acknowledge that 'in some practices, and for some patients, they have not had a clear communication from the practice as to how they access services, and they do experience that as a barrier to access'.
GP leaders reacted angrily in September after an NHS England letter - briefed to the national press before it was sent to GPs - warned practices they could be in breach of contract if they failed to offer face-to-face appointments when appropriate. The warning came at a time when practices in England were delivering 300,000 face-to-face contacts per day - despite shifting to a total triage system in line with official advice.
GP leaders have warned negative press headlines triggered by the September letter led to a wave of abuse and complaints for practices - a problem that has continued well over a month later. Offensive graffiti was also sprayed on a practice in Bristol last month, which GPs who work at the surgery said was the result of the negative coverage.
Speaking at an NHS Confederation webinar on primary care networks (PCNs) on 11 November, Sir Simon said the networks would be crucial to ‘encouraging and supporting’ practices to improve access, now and in the future.
He recognised that rapid adoption of new ways of working during the pandemic across general practice had been 'remarkably successful and popular' - but warned that he had come across a small number of people who said access at their surgery had become 'far worse' during the pandemic.
Asked what NHS England could do to support GPs who were 'being told they were shut' and offering poor access despite delivering 2m in-person appointments per week, Sir Simon said: ‘I agree [that] the move to these other options for consultation have proved remarkably successful and popular in a very short period of time.
‘But equally, if we are speaking, frankly, and honestly between ourselves, I think we also have to acknowledge that in some practices, and for some patients, they have not had a clear communication from the practice as to how they access services, and they do experience that as a barrier to access.
Communication with patients
‘I don't think there's any contradiction between saying, we want to have this mixed model for what primary care consultations look like. But on the other hand, we've also got to be really thoughtful about how practices communicate with their patients.’
The comments came as LMCs prepare to debate a motion accusing health leaders of 'abhorrent and insulting' communications with the profession, press and public over access to general practice.
RCGP leaders have recently produced resources to help practices inform patients that they are open throughout the national lockdown in England - and NHS England has also issued advice.
Sir Simon also resisted calls for specific funding for PCNs to recruit managers, saying varied needs across communities would not benefit from a prescriptive approach.
The NHS chief was also asked during the session whether funding could be made available for PCNs to recruit practice managers. GPs leading PCNs have previously highlighted a lack of funding to recruit to this position to free up the time of clinical directors.
He said: ‘I think that is probably best left for PCNs and their CCGs to make a decision about. The risk is is that if we try and do that in a one size fits all way nationally, and we remove the flexibility, that we get it wrong; there are going to be different requirements in different parts of the country.’