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GP contract negotiations will focus on ensuring 'good patient access', says NHS England

GPs face pressure over their opening hours as contract negotiations this year will focus on ensuring patients have ‘good access’ to GPs as a way of reducing the pressure on urgent care services, the deputy chief executive of NHS England has revealed.

Dame Barbara Hakin, who is also chief operating officer, said NHS England was ‘measuring’ patient access, which she said was ‘certainly an issue’ and would be discussed with the GPC in this year’s contract negotiations.

Dame Barbara made the revelation after being quizzed by the House of Commons Health Committee on Tuesday over how NHS England plans to reduce the number of patients turning up at A&E because they cannot get a GP appointment.

She also confirmed the issue would also feature in NHS England’s wider primary care strategy review, which is due to take place later this year.

Pulse revealed last month that resuming some form of out-of-hours responsibility wold form part of the negotiations for the 2014/15 GP contract, but this the first time extending access in-hours has been raised as something they would negotitate with the GPC.

Over the course of two and a half hours, Dame Barbara was put on the spot along with health minister Earl Howe, medical director Sir Bruce Keogh and NHS England’s emergency and urgent care review chair Professor Keith Willett over what NHS England is doing to solve the current crisis in urgent and emergency care.

Dame Barbara told MPs following a question regarding whether GP access was an issue: ‘Certainly this is an issue… when they are not able to get a routine appointment with their GP.

‘We have got a number of things in the GP contract to try and improve and extend urgent access for patients. We do measure this, and we will this year will be having another round of negotiations with the GPC, including ensuring that they have good access.’

She added: ‘We are as well as the urgent care strategy looking at the primary care strategy, which is looking at what the future of primary care will look like and general practice in particular.’

Referring to the GP Patient Survey - which showed that 1% of patients were unable to get a convenient GP appointment and that 9% of those patients ended up going to A&E or an urgent care centre instead - Professor Willett said solving this problem would be key to solving the wider issues with pressures on the system.

He said: ‘That is the sort of thing that may change the pressure we see on ambulance services, then hospital beds, then social care services.’

This follows health secretary Jeremy Hunt’s comments that a review into managing the health of vulnerable elderly people would look at GP access.

Dr Chaand Nagpaul, a GPC negotiator, told Pulse: ‘One of the first things we warned is that GP access will worsen as a result of the imposed changes [from the 2013/14 GP contract]. They will result in a significant number of appointments generated through GPs trying to recoup lost money through QOF targets, therefore reducing routine access to the GP. We would want a reversal of that.

The Health Committee is expected to report on its inquiry into urgent and emergency care after the summer.

Readers' comments (28)

  • 1% of people cannot get a convenient appointment. Sooo, that means 99% can. Oh well best change the system that ain,t broken then.
    Good luck with that.Hope it doesn,t mean that those mony grabbing GPs will leave the NHS and emigrate , retire or go private like that nice private Dr in my daily paper .

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  • I know I'm off (soon).
    Good luck everybody.

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  • They must be mad. There are many GPs just waiting for a reason to leave.

    The exodus may be unstoppable, with practices falling like dominoes.

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  • I believe we have already nailed this topic to destruction.

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  • At what point do leaders believe that changing the system will change the behaviour of the few? The evidence has been that the vast majority of those presenting at A&E present during normal hours. How will out-of-hours services change this behaviour?

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  • Bye and thanks for all the fish

    I do hope some emphasis is given to having a personal list. All the evidence points to this increasing patient satisfaction, good continuity of care, reducing A&E attendances, reduced admissions and there is no such barrier as "no appointments available". You see who needs to be seen as they are your personal responsibility (in hours) not OOH as the downside is this type of service can't be provided 24/7.

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  • There are two problems with having a strict personal list.
    First, the number of people a doctor is personally responsible for has to be capped in order to be manageable.
    Second, this cap requires a patient to be allocated to a particular doctor and the practice to insist on them seeing that doctor, removing "patient choice".

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  • Personal lists were attractive in the times of full time partners. They seem less workable when we have a completely different workforce mix. It also reduces patient choice - these days many of 'my' patients will see the young female partners for gynae exams rather than me - very sensible in my view.

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  • we have personal lists and works in teams to cover each others patients when we are not here, it works really well and I value knowing my patients and they value their Dr knowing them!

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  • All together now, repeat after me:THERE AREN'T ENOUGH GPs, THERE AREN'T ENOUGH GPs, THERE AREN'T ENOUGH GPs.

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