GPs will be named and shamed if they fail to deliver enough face-to-face appointments

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GPs will be named and shamed if they fail to deliver enough face-to-face appointments under a revolutionary plan to improve patient care.

Sajid Javid’s nine-point plan, launched last night, will also see family doctors offered an extra £250million to improve access to healthcare.

The Health Secretary today defended the proposals, which will give patients the right to demand face-to-face appointments. GPs will be told they should only refuse the requests if there are good clinical reasons.

He said: ‘This whole package today is about support. This is all about helping GPs so that they can do what they do best, which is seeing their patients.’

But unions today warned that the plans would trigger a wave of retirements. Doctors can retire with annual pensions worth £100,000 or more.

A GP from Shropshire blasted the plans as ‘insulting’, and urged Mr Javid to visit her surgery to show her where efficiencies could be made.

Responding to the request, the Health Secretary said he spends a lot of time in surgeries and would ‘certainly look’ at visiting hers. He thanked all GPs for their ‘phenomenal work’ throughout the pandemic.

He also admitted that he does not have a target for face-to-face appointments, and insisted there would be no league tables naming and shaming practices.

But Whitehall sources last night acknowledged that the data would allow for the creation of local and national league tables, with the worst performers named and shamed in the media.

The plans are a victory for the Mail’s Let’s See GPs Face to Face campaign. The Health Secretary, Boris Johnson and new NHS chief Amanda Pritchard all paid tribute to the Mail for highlighting the devastating decline in face-to-face appointments.  

In a round of interviews this morning Mr Javid defended his plans for improving access to GP surgeries.

He told Sky News: ‘I think it is going to help because it will provide more support, financial support, remove red tape, spread the workload and provide more direct support to practices that ask for more expert advice.’ 

Under the new proposals, patients will be given the right to demand a face-to-face appointment with their family doctor.

GPs will be told they should refuse a plea to have an in-person consultation only if there are good clinical reasons.

The NHS England ‘Plan for GPs and Patients’ will give practices £250 million of extra cash to take on more staff, ensuring patients can have an appointment on the day they request one. This could include extending opening hours.

But they will not be able to access the extra money if too many of their consultations are carried out over the telephone or online.

New ‘transparency’ rules will also publish data on the level of service offered by individual GP practices, including the level of access for patients seeking face-to-face appointments.

Whitehall sources acknowledged the data would allow the creation of local and national league tables, with the worst performers named and shamed in the media.

GP practices which fail to improve access for patients will face direct intervention from teams of NHS trouble-shooters.

To help doctors improve their service, red tape will be slashed to give GPs more time to see patients in person – and telephone systems will be upgraded to make it easier to book an appointment.

Meanwhile, pharmacists will get enhanced powers to treat a wide range of minor complaints to ease the pressure.

The Department of Health will reduce administrative burdens on GPs by reforming who can provide medical evidence and certificates such as fit notes and DVLA checks – freeing up time for more appointments.

And officials will today confirm that GP surgeries can scrap the two-metre social distancing rule imposed during the pandemic, which has dramatically reduced numbers in waiting rooms.

However, last night there were signs the plans would spark a row with doctors’ unions and some frontline GPs.

Dr Richard Vautrey, chairman of the British Medical Association’s GP Committee, said the proposals would make appointments harder to book and the Government was ‘out of touch’.

He said it was disappointing to see there was ‘no end in sight to the preoccupation with face-to-face appointments’ – and demanded an end to ‘target-driven, payment-by-results’.

Professor Martin Marshall, chairman of the Royal College of GPs, said there was ‘nothing here to address the long-standing workforce pressures facing general practice’.

But he cautiously welcomed plans to slash bureaucracy. ‘GPs go into medicine to care for patients, yet they spend a significant amount of their time on box-ticking and filling forms,’ he said.

‘This bureaucracy has an impact on workload in general practice, which has become increasingly ‘undoable’ and is leading to many GPs, and other members of the team, burning out or leaving the profession.

 Last night the Prime Minister praised the Mail for highlighting the collapse in face-to-face appointments over the past two years.

Mr Johnson said: ‘The Mail’s campaign on this issue has shown the importance of everyone having the choice and ability to see their GP face to face, and this plan will mean more appointments at more surgeries.’ Writing for the Mail, Mr Javid said he was determined to get the NHS ‘closer to pre-pandemic levels of face-to-face appointments’.

Mrs Pritchard thanked the Mail for acting as ‘a strong voice for patients’, adding that there would also be a new effort to tackle abuse against GPs.

The nine-point plan came as a YouGov poll found that two-thirds of people prefer a face-to-face appointment.

The Nine Commandments…and what they really mean

By Shaun Wooller for the Daily Mail 

The Daily Mail launched its campaign to improve access to GPs after being inundated with horrifying stories from readers who struggled to be seen in person.

The revolution it has brought about is an extraordinary achievement that will undoubtedly benefit patients and the NHS. Today’s new NHS England and Department of Health blueprint will help ensure all five points of the Mail’s original manifesto for change are delivered.

It will improve access to GPs, get patients and doctors back into face-to-face contact more often and boost safety.

Here are the nine key points of today’s announcement – and what they mean:

1 Patients’ right to face-to-face appointments

What they’re announcing: Health officials have made it clear that every GP practice must ask patients what form they would like their appointment to take.

What it means:

Doctors must respect preferences for face-to-face care unless there are good clinical reasons to the contrary – for example, if the patient has Covid.

This means surgeries can no longer fob people off with a remote consultation if they want to be in the same room as their medic.

People can still choose to have their appointment on the phone or by video if it is more convenient.

Conducting appointments in-person will allow doctors to spot symptoms they could not have detected remotely and improve the patient-doctor relationship.

Elderly and vulnerable patients who lacked the technology needed for remote consultations or struggled to use it will no longer feel excluded.

2 More money for more appointments

What they’re announcing: A £250million winter access fund will let practices offer more appointments so patients who need care can get it – on the same day, if needed.

What it means:

The money will pay for locums and other health professionals, such as physiotherapists and podiatrists, with a focus on increasing capacity.

Surgeries will be encouraged to extend opening hours or operate walk-in clinics, making it easier for patients to be seen quickly at a convenient time.

3 ‘Hit squads’ and cash penalties to keep GPs on track

What they’re announcing: GP practices that fail to improve access will face special measures and be denied a share of additional funding.

What it means:

Poor performers will see specialist ‘hit squad’ teams sent in to knock them into shape.

This should ensure patients have access to good quality care. Denying surgeries that fail to improve access a share of the new pot of cash will act as an incentive.

4 Better phone systems

What they’re announcing: The NHS will help practices upgrade telephone systems to make it easier for patients to book appointments and cut waits to speak to a receptionist.

What it means:

New technology will make it easier for staff to manage queues. This will reduce the frustration of trying to reach a surgery, with some people dialling hundreds of times. 

Patient groups report some elderly people have given up attempting to see their GP because of the stress of phoning.

5 Less paperwork and more help from pharmacists

What they’re announcing: The Government will free GPs from some red tape by reforming who can provide medical evidence and certificates, such as fit notes and DVLA checks. Pharmacists will become the first port of call for most minor illnesses.

What it means:

Lessening the burden of paperwork will make the job more attractive and help bring in more trainees, in a boost to the commitment to recruit 6,000 more GPs.

Getting highly-skilled nurses and pharmacists to perform some checks will free up GPs for more complex issues.

Pharmacists will be given greater powers to write prescriptions and treat patients for routine conditions.

6 Relaxation of guidelines on social distancing

What they’re announcing: The two-metre social distancing rule, which applies in surgeries, will be axed.

What it means:

GPs have argued that strict Covid rules prevent them from seeing more patients in person because their waiting rooms are too small to accommodate them.

7 Performance league tables

What they’re announcing: GP appointment data will be published at practice level by spring next year to enhance transparency and accountability.

What it means:

Naming and shaming individual GP practices that fail to offer enough face-to-face appointments or that have long waits to be seen will incentivise doctors to improve. 

Producing league tables will allow patients to compare their practice with others in their town and increase competition.

8 Easier patient feedback via text message

What they’re announcing: Making it simpler for patients to rate their practice’s performance.

What it means:

This will give doctors and NHS managers a clearer picture of what patients do and do not like about their surgery and make it easier to identify recurring problems, so they can be improved.

9 Zero tolerance campaign on abuse of NHS staff

What they’re announcing: A new campaign to reduce abuse and punish offenders.

What it means:

Unacceptable behaviour by frustrated patients drives much-needed doctors out of jobs and creates an environment that is not attractive to new recruits.

Ministers and the NHS hope a new campaign will prevent a disastrous exodus of staff and ensure more medical trainees want to work in general practice.

The Mail’s right. Patients must be able to see their doctor the way they want and now they can

By Sajid Javid for The Daily Mail

Like many Asian parents, my mum always wanted me to be a GP.

When I told her I’d been made Health and Social Care Secretary, she said: ‘Well, you didn’t quite make it to GP, but at least you’re working in healthcare!’

In truth, she was only half joking. There’s a reason why people such as my mum have such high regard for GPs: their powerful blend of expertise and empathy has made generations of communities happier and healthier.

So I want to say a huge thank you to GPs and their teams across the country for their commitment to patients during the most challenging of times.

I may not have become a GP, but I do want to make it easier for them to do their vital work.

Equally, I am committed to making sure patients can see their GP in the way they choose and have a better experience when they do. The Mail has run an important campaign on this issue.

Working closely with the NHS, we’ve made a plan for GPs and patients to do just that: it will mean more appointments in the ways people want.

While I’m determined to get us closer to pre-pandemic levels of face-to-face appointments, it is, of course, true that online and telephone consultations are more convenient for many people.

There’s no question that telephone and video calls will be a part of the future of general practice. But it cannot be the whole future.

With winter just around the corner, I know GPs are under real pressure: the demand for appointments is high and so is their workload.

So today, I’m announcing a fresh £250 million investment in general practice to boost capacity ahead of the winter, opening up more appointments.

With this money, we will expect GPs to provide clear plans for how they will improve access and deliver more face-to-face appointments, such as offering appointments on evenings and weekends.

By and large, people understand why it’s been a difficult time for our GPs: Covid pressures, concerns about infection and reduced space in waiting rooms have often made the process of getting an appointment more difficult.

While I understand the frustration, violence and abuse towards GPs and their teams will never be tolerated.

GPs and their teams need to feel safe at work, and the NHS is making £5 million available for practices to improve their security measures as part of our plan.

Another way we’re going to ensure more time is spent with patients is by spreading the workload.

I want every practice to use the NHS Community Pharmacy Consultation service, so our brilliant community pharmacists can do more in terms of prescribing.

I’m asking my department to work with the NHS and look at a ‘Pharmacy First’ scheme for England, so pharmacists can provide treatment for specific conditions such as sore throats, without patients having to go to their GP – building on pilot schemes in England and much as they already do in Scotland.

We also need to measure GPs against clearer standards. The vast majority of GPs are doing brilliant work, but where GPs are not, we have to fix it: it’s simply not fair for their patients to suffer in silence.

The challenges in general practice are far from over, but I have every confidence we can meet the difficulties ahead by working together to achieve our common goal – delivering for patients. 

Pharmacists to get more power: Chemists will prescribe extra drugs and treat wider range of illnesses under plan to free up GPs for face-to-face appointments

Pharmacists will become the first port of call for most minor illnesses under plans being considered by Sajid Javid to free up GPs to deal with more serious cases.

The Health Secretary’s battle plan for improving access to family doctors includes options to give local chemists enhanced powers to treat a wide range of minor complaints.

This is likely to include handing them the power to prescribe a number of medicines which are currently the sole preserve of doctors.

A health source said Mr Javid wanted to see a ‘substantially’ increased role for pharmacists, adding: ‘He is looking at expanding quickly the role that they play.

‘He is interested in whether they can do more in terms of prescribing.

‘It is all about sharing the workload and freeing up GPs to deal with more complex cases.’

The source said the Health Secretary was examining the ‘Pharmacy First’ scheme in Scotland that allows pharmacies to treat a wide range of common conditions from earache and sore throats to hay fever and cystitis.

Ministers hope the scheme will make it easier for patients with minor conditions to get treatment more quickly, as well as freeing up GPs.

Writing in the Mail today, Mr Javid said: ‘Another way we’re going to ensure more time is spent with patients is by spreading the workload.

‘I want every practice to use the NHS Community Pharmacy Consultation service, so our brilliant community pharmacists can do more in terms of prescribing.

‘I’m asking my department to work with the NHS and look at a ‘Pharmacy First’ scheme for England, so pharmacists can provide treatment for specific conditions like sore throats, without patients having to go to their GP, building on pilot schemes in England and much as they already do in Scotland.’

The move is likely to be welcomed by pharmacists, who have been pushing to play a bigger role in community healthcare.

Around 800 GP practices are currently signed up to the Community Pharmacist Consultation Service, which refers patients with a limited range of minor conditions to their local pharmacy.

The scheme, launched in 2019, has so far led to 64,000 referrals, freeing up valuable time for GPs.

But Scotland’s ‘Pharmacy First’ scheme goes much further.

Patients living north of the border are advised to attend a local pharmacy for advice and treatment on all minor illnesses and health concerns, ranging from backache and verrucas to eczema and allergies.

Patients can attend any pharmacy for advice, and in most cases they do not need to make an appointment.

Those requiring privacy can seek advice in dedicated consultation rooms.

Pharmacists have the power to issue advice and prescribe medicines, including antibiotics, if needed.

However, patients displaying unusual or serious symptoms will be referred to their GP or local hospital.

As with GPs, pharmacists will keep records of all treatments.

A health source said Mr Javid would consider whether to replicate the Scottish scheme in England wholesale or adapt it.