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Government questions GPs’ work commitment

Doctors angry at Prime Minister intervention on patient access

Adrian O'Dowd

Monday, 16 January 2017

The government has questioned the commitment of all GPs to provide their patients with greater access to care while NHS hospitals are struggling to meet winter pressures, following comments made at the weekend.

A statement issued by the Prime Minister’s office at Number 10 Downing Street said it was concerned that not all GP practices were providing extended opening hours despite having been given extra funding to do so and that it was considering taking steps to tackle this.

The medical profession reacted angrily to the suggestions, saying that the government was attempting to shift the blame and scapegoat GPs instead of taking responsibility for the current strain on the NHS.

In a statement issued by Number 10, a Downing Street source said: “Most GPs do a fantastic job, and have their patients’ interests firmly at heart.

“However, it is increasingly clear that a large number of surgeries are not providing the access that patients need – and that patients are suffering as a result because they are then forced to go to A&E to seek care.”

The government’s pledge that all GP practices should offer an 8am to 8pm service, seven days a week by 2020 was backed by an extra £528 million per year in funding by 2020-21, said the source, with the intention of offering patients a better service and to prevent them from going to A&E inappropriately.

However, recent figures from the National Audit Office had shown that almost half (46%) of GP surgeries closed at some point during core hours despite three quarters of those practices receiving additional funding in 2015-16 to provide access outside of core hours.

To help reduce pressures on A&E, the Prime Minister had signalled her support for reforms, including GPs doing more to meet the extended hours commitment of 8am to 8pm, seven days a week unless they could prove that there is no demand for this.

In addition, ministers were considering asking every GP surgery to use a new appointments tool to submit data on the number and type of appointments offered, to help understand demand.

Doctors would have local flexibility, but extra funding would be contingent on demonstrating that they offered appointments when patients wanted them and that they advertised them to patients properly.

RCGP chair Professor Helen Stokes-Lampard, said: “It is not the case that GP surgery routine opening hours are contributing to the pressures our colleagues in A&E departments are currently facing.

“GPs and our teams are also struggling to cope with increasing patient demand without enough investment, and without nearly enough family doctors and practice staff to deal with it.”

Professor Stokes-Lampard said that in many cases, practices had already been forced to stop offering extended opening hours because of a lack of patient demand for them.

There were also good reasons why some practices closed temporarily during core opening hours, she added, such as GPs conducting telephone or online consultations, making home visits or carrying out staff training.

“Blaming GPs for the crisis facing our NHS is not going to help anyone, instead we need to start investing in our health service properly, so that there are adequate resources and clinical staff to deliver the care our patients need and deserve,” she said.

The BMA’s GP committee chair Dr Chaand Nagpaul said: “Many GP practices already offer evening and weekend appointments, and there are examples where extended opening has been abandoned due to lack of demand. Government funding for extended opening has also been halved in some areas.”

Much of the pressure on A&E had nothing to do with general practice, he argued, and was linked to seriously ill patients for whom seeing a GP would not prevent a hospital admission.

“This crisis, which was both predictable and avoidable, is the culmination of a decade of underfunding, and a recruitment crisis that has left one in three GP practices unable to fill vacancies,” he said.

“This is not the time to deflect blame or scapegoat overstretched GP services, when the fundamental cause of this crisis is that funding is not keeping up with demand.”

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