Under the controversial access plan and support package for general practice unveiled last month by the government and NHS England, ICSs were ordered 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, the NHS Confederation's ICS Network has told GPonline that health service leaders are planning to reject these instructions - with many concerned about the effects of ‘naming and shaming’ GP practices when they are already under intense pressure.
The refusal to comply comes after it emerged last week that NHS England bosses had made ‘significant concessions’ over the GP access plans - although the union has confirmed it will proceed with an indicative ballot of practices over possible industrial action in England.
GP access plans
The firm stance of regional NHS managers against the access plans suggests NHS England may have come under internal pressure to back down over measures in the access plan and support package - proposals that were unanimously rejected by the BMA GP committee.
An ICS Network spokesperson said: ‘We have heard concerns from ICSs about the notion of "naming and shaming" GP practices. Many are planning not to do so, arguing that the only outcome of doing so would be to increase pressure on already frantic primary care staff.’
The BMA has confirmed it will press ahead with an indicative ballot of GPs over forms of action that will include a refusal to comply with 'bureaucratic and time-wasting parts of their contract that takes them away from looking after their patients'.
GPs will be asked whether they would be prepared to 'disrupt appointment data collection which may be used for naming and shaming GP practices', refuse to provide COVID vaccination exemption certifications, disengage from the PCN DES, and refuse to submit data in line with pay transparency rules that will see GPs and practice staff earning more than £150,000 in NHS income publicly named.
The furious response from general practice to the access plans comes as official appointments data showed that practices were providing more appointments than at any time since well before the pandemic began, and that face-to-face appointments have now risen to more than three in five of all contacts.
BMA leaders have said that the access plans 'would increase workload and bureaucracy on GPs while threatening to name and shame and penalise practices that need the most help'. Analysis carried out by the association found that 19 of the 29 measures - billed as a 'support package' - fail to offer additional support to general practice.
RCGP chair Professor Martin Marshall has also highlighted concerns with plans. He said the government’s preoccupation with access ‘ignores the other challenge [the profession] faces in providing high-quality, personalised care’ - and stressed that there was nothing in the measures to address ‘long-standing’ workforce pressures.
Professor Marshall has repeatedly warned that general practice must be the 'foundation of any successful ICS', arguing it is the only way to ensure that GPs, their teams and the wider NHS are best enabled to deliver patient care.