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NHS England orders practice to stop sending leaflet detailing GP workload pressures

A GP practice has been ordered by NHS England to stop sending copies of an email to patients advising them to visit alternative NHS providers in a bid to alleviate the ‘great pressure’ faced by general practice.

Kingskerswell and Ipplepen Medical Practice in Devon had sent the emails to patients detailing NHS-funded services that can be accessed without the need for referrals, such as physiotherapists, pharmacists and a depression service.

But NHS England ordered them not to send any more copies of the email, stating it was ‘very concerned about the impact on patients’.

However, local leaders reacted angrily, stating that NHS England ‘grossly overreacted’ and that the email was ‘good practice’.

The practice emailed leaflets to patients giving examples of nine other providers that they could see for if they had back pains, certain mental health problems, cuts grazes or wounds.

Part of the email described how surgeries are under ‘great pressure’ because of an ageing population with complex and chronic illnesses, so that demand for appointments ‘often outstrips capacity.’

The leaflet also describes a national recruitment crisis for GPs and declining Government funding.

It said: ‘GP surgeries are under great pressure with the population ageing and an increasing incidence of complex and chronic illnesses such as diabetes and dementia. Demand for GP appointments often outstrips capacity.

‘There is also a national GP recruitment crisis which is unlikely to be resolved quickly and the portion of NHS funding allocated tor GP practices has been declining for many years. It seems an opportune time therefore to inform our patients about the range of local NHS specialist services which they can access directly without the need for a GP appointment or referral.’

Practice manager Robert Hooper told Pulse: ‘It appears that apart from the leaflet there is sensitivity about the practice emailing the contents of the leaflet to patients, and particularly the introduction.’

He added: ‘Our information leaflet is a well-intended communication to our patients about the range of alternatives specialist direct access NHS services which have been commissioned, contracted and paid for by the Torbay and Southern Devon CCG on their behalf. 

The important message is that these services do not need a GP referral so can be accessed quickly by our patients rather than patients taking up GP appointments simply to be referred on.

Mr Hooper said that the practice had received ‘a lot of very positive comment from patients saying the leaflet is helpful and informative’.

Devon LMC medical secretary Dr Mark Sanford-Wood said that NHS England had ‘grossly overreacted’.

He said: ‘I know the partners are extremely upset by this. There is a wrong assumption here that the GPs are lazy and are trying to offload their work. But this is a very good practice. All they are doing is signposting patients to other services, which is entirely professional, proper and appropriate.’

RCGP chair Dr Maureen Baker said: ‘Patients should be able to make a GP appointment when they want one and the need to send this email is indicative of the intense pressure facing general practice.

‘It is important that patients are fully aware of the array of NHS services that are available to them in their local area, and this email provides some very useful information. Pharmacists, for example are ideally place to give advice for many common ailments without having to make a GP appointment. However, it does seem an awful lot to be suggesting people go to other place with such a wide range of conditions.’

NHS England national director for commissioning operations Dr Barbara Hakin said: ‘These leaflets have now been withdrawn. NHS England is urgently working with the practices as we are very concerned about the impact on patients.’

Members of the practice will meet NHS England Devon, Cornwall and Isles of Scilly Area Team head of primary care Julia Cory to review the leaflet wording on Friday.

Readers' comments (60)

  • ‘very concerned about the impact on patients’.

    What BS, and look at the guardian headlines 'denying treatment'!
    If the feedback is good, then the impact is good, so what grounds does NHSE have to oppose this?!

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  • The only issue that led to NHSE involvement was the part about pressure on services and GP recruitment and reduced funding. We all know this. It's spun as about patient care and that's how the media have been fed the story. Without that part it would have hailed as an excellent example of signposting. I feel very sorry for the practice involved

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  • RCGP chair Dr Maureen Baker said: ‘Patients should be able to make a GP appointment when they want one and the need to send this email is indicative of the intense pressure facing general practice.

    When our leaders suggest everyone should get an appointment when they want one, instead of need one, then the doors must be nailed open and my feet to the consutling room floor.
    Stupid.
    If I sent away anyonre who could be dealt with elsewhere my job would become a touch more bearable but we are open to abuse and refuse at our peril with Healthwatch,Monitor, GMC, CQC, FFT, MSF and mystery shoppers all watching!

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  • ?Are we self employed or not?
    How can we be "ordered"

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  • I can't see what the difference is between this leaflet and NHSE- endorsed schemes encouraging people to see their pharmacist, MIU etc...

    Except for that this leaflet explains the reasons why the problems occur, and implies that it may partly be NHSE's fault.

    Cynical of them, then, to demand that it is not used. Its okay when its their idea, but if its someone else's initiative, and it paints them in a honest light...

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  • I think patient education is key to fair and appropriate use of GP time. Shouldn't we all be sending this information out, or better still get NHSE to send out clear, unambiguous information to the public so that they are better informed and less confused about how and where to access the services they need. Please let us see this communication.

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  • So much for openness and transparency.
    Congratulations to the practice on trying to manage the crisis we are in .
    Me thinks NHS England doth protest too much !!!!

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  • A Spartacus moment...

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  • As CBT therapist it would be easier and more efficient if people Self refer to the IAPT programme! not much point them going to a GP for the GP to phone us. Waist of GPs and patients time.In kent we get lots of self referrals...works well. We notify the GP so they are aware and keep them informed of progress or risk issues....simple.D0nt know why NHS England so hot under the collar...encourages efficient use of resources by GPs ..they should be proud!

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  • We shouldn't stop doing it, but ALL start sending this advice out. In fact it should be a RCGP campaign

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