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Face-to-face expectation does not change with Plan B, GPs told


By Caitlin Tilley
9 December 2021

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Plan B does not change the Government’s expectations on GPs to increase face-to-face access in line with Winter Access Fund plans, the Department of Health and Social Care has confirmed to Healthcare Leader‘s sister title Pulse.

Prime Minister Boris Johnson yesterday asked people in England to change their behaviour to reduce the spread of the Omicron variant of Covid-19 – including working from home where they can, and wearing face masks in more public places.

Pulse asked the DHSC and NHS England:

  • Where does this leave the Government’s current push on face-to-face GP appointments?
  • Are GPs to read the need for tightening restrictions to mean a reversion to remote appointments being the default?
  • Specifically, even if the patient expresses a wish for a face-to-face appointment and the GP feels it is not clinically necessary, who trumps who?
  • And if remote is default again, where does that leave the winter access plan, especially the monitoring side of it?

To which a DHSC spokesperson responded that there was no change, while NHS England did not respond at all.

The Winter Access Fund plan had asked GP practices to increase levels of face-to-face appointments, and NHS England has confirmed that those with the lowest numbers may not receive any of the winter funding.

The plan said that practices should work out the ‘optimal blend’ of face-to-face appointments, alongside remote consultations, ‘wherever these are clinically warranted, taking account of patient preferences’.

Dr Grant Ingrams, a GP from Leicester, said: ‘It’s barmy. We’re trying to do our best to run a service without the resources, which have been run down so much so that we can’t recruit doctors because they don’t want to do the job. 

‘And we are still managing to provide a constant service during a crisis pandemic, and to deliver the majority of the vaccines. And because of that, we are being beaten by the Government. It just doesn’t make sense.’ 

Dr Ingrams also called for ‘stressful’ CQC unannounced inspections focused on access, which began last week, to be stopped in light of plan B.

And he added: ‘I hope it means the Government will trust the profession to do what is in the patient’s best interest and that they will be positively saying to the press to do the same.’

Meanwhile, Yorkshire GP Dr Abbie Brooks called for Winter Access Fund money to be made ‘available to everyone to make sure that they’re able to offer the services they need over the winter period, without having to jump through hoops’.

She said: ‘I think we should be trusted to see people in person when necessary, and take the stress off of some practices.

‘All this monitoring is just really unhelpful, morale is already low. Everyone is trying their absolute hardest. And it feels like we’re having to prove ourselves every step of the way, while being asked to do extra work and extra sessions.’

All the while, ‘they want us to prioritise boosters, and work extra hours to do that’, which ‘is going to be a challenge as well’, she added.

The CQC has paused routine inspections with no set end date, but is continuing to follow up ‘all concerns’ raised about access.

The RCGP was asked to update guidance on face-to-face GP consultations by the end of last month, but Pulse revealed yesterday that is still waiting for NHS England to ‘provide feedback’ on existing resources.

In April this year, NHS England said that GPs should continue to triage patients remotely amid no plans for when the approach would end.

But in May it released guidance which said patients must be offered face-to-face appointments if that is their preference and receptions must be open for walk-ins.

The BMA yesterday welcomed the plan B announcement, with council chair Chaand Nagpaul commenting that the decision was ‘the right one’.

He said: ‘We’ve had increasingly high incidences of Covid-19 for some time now – more than 339,861 cases across the UK in the last seven days alone – and healthcare workers are rightly worried about the impact the Omicron variant could have on the ability for the NHS to function if cases continue to rise at the rapid rates already seen.’

This story first appeared on our sister title, Pulse.

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