No ‘set number’ for GP face-to-face appointments, says NHS England chief

There is no “set number” for how many face-to-face appointments GPs should provide, the head of NHS England has told MPs.

Amanda Pritchard said that many patients liked face-to-face appointments but that others found phoning a GP or going online more convenient.

Data shows that 58% of patients were seen face-to-face in August in England, compared with 54% in January and more than 80% before the pandemic.

Health Secretary Sajid Javid set out plans last week for more cash for GPs, but also ways in which they can be named and shamed in league tables depending on how many patients they see in-person.

It comes as a snap poll for the British Medical Association (BMA) found doctors “overwhelmingly” rejecting the Government’s plan, with 93% of 3,500 GPs saying it was an unacceptable response to the crisis.

Speaking to MPs on the cross-party Commons health committee, Ms Pritchard said: “I’m really conscious that the vast, vast majority of colleagues in general practice have worked, and continue to work, absolutely tirelessly.

“In fact, they’re the building block of the NHS and they continue to be.”

She said the package announced last week was about the “need to put some money behind supporting general practice”.

She added: “I think we have really tried to steer away from saying that there is a kind of a right number for face-to-face versus other types of access, because what’s clear is many people absolutely do prefer face-to-face access, GPs are required to provide it, it’s part of the contract, but for some populations, it’s going to be a particular number, for others it will be different.

“So what we’ve talked about in the document is respecting patient preference.

“Because what I hear is many, many people say it is hugely convenient being able to phone a GP or do a digital consultation, ‘it saves me lots of time unnecessarily travelling to a GP practice’. But it’s absolutely right that that isn’t going to work for everybody and it’s not going to work for every circumstance, and therefore respecting patient preference is the bit that we have said is really important here.

“So, for those practices… where the percentage of face-to-face care is very low, that does feel out of step with what we’re hearing across the rest of the country, and we need to give them particular support.”

Watch: COVID cases rise among English kids amid slow rollout

NHS England’s medical director, Professor Stephen Powis, said there was no doubt GPs were busy at the moment and A&E departments were busy for a “variety of reasons”.

Asked if lack of face-to-face contact with GPs was directly causing more patients to go to A&E, Prof Powis said: “I think our answer to that question is that we will double down as we did before in ensuring that we help patients to access care in the most appropriate setting for the particular condition that they are phoning for, or presenting with.”

He added: ” I think there is no doubt that there are some patients who are attending A&E still who would be better off being seen in another setting – that was the case pre-pandemic as well.

“For exactly those reasons, the use of services such as 111, the use of digital online 111, is all designed to ensure that people don’t make a trip to the service when actually they could be dealt with quicker and more efficiently in another (area of the health) service.”

It comes as the BMA said the latest GP workforce figures show that England has lost around 1,800 full-time equivalent, fully qualified GPs since 2015, despite the Government promising 6,000 more.

It said Mr Javid “could be to blame for this number plummeting further” due to his plans.

A separate poll of more than 6,000 GPs in England, conducted in the week before the Government’s announcement, found that two-thirds (66%) were prepared to reduce their hours to protect themselves from the staffing crisis, while more than half (54%) said they would consider leaving the NHS altogether if the Government did not provide them with the support they needed.

Dr Richard Vautrey, chairman of the BMA’s General Practitioners Committee, said: “This shows the profession has out and out rejected this shambles of a plan from the Government and NHS England.

“If the Health Secretary thinks it is enough to provide a lifeline to surgeries this winter, let alone save general practice in the long term, this response shows how wrong he is.

“The BMA provided the Health Secretary with a clear plan to help address the crisis in the short term, that could improve patient access and guarantee safe, high-quality care, while also putting forward longer-term solutions.

“He chose to ignore that and instead we have a shambolic plan that has failed before it has begun. These survey results show how angry and despondent GPs are.

“Patient care will suffer because imposing these measures could very well result in doctors having to spend even more time on paperwork and admin.

“But it may also result in GPs leaving the profession altogether. We have already lost the equivalent of more than 1,800 full-time, fully qualified GPs in the last six years, and with a majority of family doctors now saying they could be forced to reduce their hours or leave the NHS altogether because of a lack of support, the situation could get far, far worse.

“This will be on the Health Secretary’s watch. He will be to blame.”

The BMA said its England GP committee will meet later this week to discuss next steps.

During her appearance before MPs, Ms Pritchard also said the NHS had not been overwhelmed due to Covid. This caused a backlash on Twitter from some medics and patients.

She told MPs she was proud of the NHS and the “way that critical care services were stood up and expanded, the speed of new treatments like dexamethasone, the rollout of the vaccine programme – all of which meant the NHS was not overwhelmed.

“And we did see sadly that not every country was in that position.”

Prof Powis also said he thought single rooms in the NHS should become the “default” because they would improve infection control and the flow of patients through hospitals.

Watch: Business secretary says Government resisting calls for coronavirus Plan B restrictions