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Health Secretary announces ‘new deal’ for GPs

GP leaders question 7 day service pledge

Jo Carlowe

Friday, 19 June 2015

The Health Secretary has today promised GPs extra investment provided they sign-up to seven-day opening.

In a speech broadcast this morning, Jeremy Hunt, set out his ‘new deal for GPs’. 

The package includes 10,000 extra primary care staff, including 5,000 GPs and a national marketing campaign to encourage medical students to choose general practice.

New flexibilities are also promised for GPs wanting to work part-time, as well as support for those wishing to return to the profession. 

In addition, the health secretary announced a £10m turn-around programme to support struggling practices, led by NHS England and NHS Clinical Commissioners.

However, Mr Hunt called for co-operation from the profession in return. 

Speaking from the Nelson Medical Practice in South West London, he said: “So plenty of commitments from me. But now perhaps the more tricky part: your side of the bargain.

“I am prepared to commit money to this plan – more GPs, more community nurses, more money for infrastructure, help to reduce burnout. The Five Year Forward View requires more investment in primary care so this is the biggest opportunity for new investment in General Practice in a generation. But in return I will need your help to deliver a profound change the quality of care we offer patients.” 

He called on GPs to break down the barriers with social care providers and asked GPs to "play their part" in moving towards "multi-disciplinary work" and seven day access. 

In response, GP leaders have welcomed the health secretary’s acknowledgement of the need for increased investment in primary care. However, they questioned the viability of a seven-day service for routine care.

Commenting, Dr Chaand Nagpaul chair of the British Medical Association’s GP Committee said: “At a time when even the government recognises that general practice is under resourced and practices struggling with GP vacancies, with some even closing, it is not logistically possible for GP surgeries to be open nationally seven days, without stretching GPs so thinly so as to damage quality. Further it is crucial that taxpayers money is not diverted from frail elderly patients in greatest need given that pilots of seven-day routine working are increasingly demonstrating a low uptake of routine weekend appointments. The government should focus on supporting practices to provide accessible services during the day and further develop the current 24/7 urgent GP service, so that patients can be confident of getting access to a quality GP service day and night.”

And Dr Nagpaul, who described general practice as a ‘hamster wheel’, said the priority should be to address the "overwhelming workload pressure GPs face, in order to re-establish general practice as a career that is rewarding and appealing". “Only this will improve GP recruitment and retention,” he said.

Dr Maureen Baker, chair of the Royal College of General Practitioners (RCGP) welcomed the new deal but called for more details on how the scheme would be costed. 

“The Secretary of State makes many commitments which, if they come to fruition, will put general practice on a more stable and secure footing for the future and ensure that family doctors can keep pace with rocketing patient demand and increasingly complex caseloads. What we need now is a clear and costed plan for turning this into a reality – and a timescale for how quickly this can be delivered.”

And like the BMA, the RCGP has questioned the feasibility of a seven day service.

“We believe that the emphasis should be on strengthening and better resourcing for existing GP out of hours services, staffed in the main by local GPs – and on ensuring that patients and the public are aware of the services that are available to them so that they can have better access to the skills of a GP 24/7 when they need them,” said Dr Baker.

Speaking to Onmedica, Dr Richard Vautrey, deputy chair of the GP Committee, warned: "The Secretary of State clearly recognises the growing workload pressures GPs and practices are trying to cope with but suggesting that we try to stretch and already overstretched service more thinly could make matters worse for both patients and GPs.”

He added: "We welcome his emphasis on encouraging medical students and junior doctors to choose a career in general practice, but turning the rhetoric in to reality is what matters, and until we address the workload pressures in general practice and the low morale of GPs we won't see a big change in GP recruitment. At the same time our BMA GPC survey suggested a third of doctors were planning retirement, which would mean 10,000 GPs leaving who would need to be replaced before any additional expansion could be possible. With not enough GPs to keep the current service running, some practices closing and a £30bn NHS funding gap, it would be foolhardy to waste valuable funds and professionals trying to deliver a routine weekend service. Instead we should use what resources we have to ensure a comprehensive and sustainable 24/7 urgent care service.”

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