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GP 48-hour appointment standard could be contractual requirement under Labour

The proposed 48-hour GP appointment target could become contractual under a Labour-led Government, shadow health secretary Andy Burnham has said.

Speaking at a visit to a GP practice in Tower Hamlets in east London today, Mr Burnham said Labour would look at the ‘most effective way’ of ensuring GPs were upholding the standard, but that it would be either contractual, or form part of the QOF.

Mr Burnham said: ‘Well it would be through the QOF wouldn’t it, and through the GP contract. That’s the way that we did it before and it seemed to work.’

Asked to clarify whether it would form part of the QOF, or the core GP contract, Mr Burnham added: ‘We would look at the most effective way of doing it, but it would be one way or the other.’

Mr Burnham said that the proposed standard is ‘a variation’ on the 48-hour target that was in place under the last Labour Government, with a tweak to ensure ‘same-day consultation’. However, he clarified that this could also be done over the phone.

He said: ‘What we have brought back is a variation on the standard that we had when we were in government, with the addition this time of talking about the same-day consultation - maybe not face to face, it could be over the phone, but have that reassurance up front. I think something like that is crucial because otherwise, if we are not careful, the public might lose trust in general practice.’

‘People are saying this thing about “we’re ringing the surgery in the morning and nothing’s available”, and the worry about that is that if people feel that is going to be their experience, then they may just say “sod it, I’ll go to A&E”.’

‘We are very clear that the system we had when we left government was delivering. The vast majority of patients were seen within four hours, those who wanted to be, and what we’ve seen in the past four years is a complete reversal of that.’

He added that Labour will firm up the policy in July.

The professional bodies have said they are against the return of the standard.

Dr Chaand Nagpaul, chair of the GPC, told Pulse yesterday: ‘Issues around 48-hour targets and so on are just an irrelevance. The worst thing you can do when you’ve got a system under pressure, where demand outstrips capacity, is to create such targets that are likely to result in counterproductive, perverse behaviour - this is the last thing we need.’

Mr Burnham, along with other members of the Labour shadow health team, was visiting the Jubilee Street practice in Tower Hamlets, which could face having to close down as a result of GP funding swings.

Yesterday, Labour Party leader Ed Miliband announced that the party, if successful in next year’s election, would fund GPs to provide the new standard via £100 million that would partly be recovered from removing requirements to put NHS services out to tender.

Mr Burnham also told Pulse that the MPIG changes were ‘pulling the rug’ from practices.

He said: ‘What we have seen in more recent years is some imposed changes to the contract, imposed changes to QOF which has taken money out of practices, and now this plan to phase out the MPIG which is pulling the rug from under a number of very valuable practices. Now this is the wrong way of going about giving primary care the stability it needs. It has been destabilised by this Government and I am saying very clearly today that the next Labour Government will make [stability for primary care] a priority.’

The shadow health secretary added that Labour will ‘remove the obligation’ on Monitor to promote competition, and expressed that GP funding had become a casualty of the NHS reforms.


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Readers' comments (24)

  • Unfortunately this ridiculous political target means that General Practice is screwed whichever of the main two parties gets in.

    I feel sorry for the patients.

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  • I don't know how much this would cost to implement but I can't imagine that slightly under £2 per head of population is likely to be grossly inadequate. What is he planning to do about getting rid of unrealistic demand and/or abuse? Why do all politicians think that because patients want to see us of A&E that they NEED to. many of them don't need either

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  • 2 weeks without OOH should be sufficient shot across the bows .

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  • It gets worse ! When you have one doctor looking after 1900 patients, the average list size, how can that ONE doctor be obligated to see an infinte number of them in a finite time ?

    The last time I looked there were still only 24 hours in a day. It is not physically possible unless someone comes up with a way of cloning GPs.

    Working 8 hours a day, 5 days a week, 52 weeks a year each patient has only 66 minutes a year for all their needs. This is assuming the GP does not have lunch or take holidays. There is no spare capacity.

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  • Great.I can guarantee for the election after the next whichever party is in opposition wil be saying " continuity of care/same gp within 48h"
    Does anyone in General Practice actually talk to anyone in goverment( and I mean people who actually do the day Job)?

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  • What sounds better? An extra 3 million appointments, or an extra 0.75% appointments (they are about the same). This is the equivalent of me seeing one extra patient a week. In terms of patient access it is basically p*ssing in the wind, and until we stop talking about sums of multiples of millions and start talking about multiples of billions - it will remain so.

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  • What sounds better is saying:

    "Your GP is contractually obliged to see you within 48 hours. "

    Trouble is it is an impossibility, unless the patient is content with seeing me surrounded by my other patients.

    Politicians obviously exist in a different time space continuum to the rest of us.

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  • Recipe for even more chaos. Thankfully I will be out of this game by the next pandemic.

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  • 7:23 what a brilliant concept. The IAPT and mental health people have been doing it for ages.
    Group versus individual appointments.
    Come and discuss your misery,bad workplace, unhappy marriage/relationship/life. (I am not allowed to talk about non-illnesses in a public forum but GPs will fill in the blanks)
    Tell us about the snot cough and pyrexia of a common cold.
    All in the comfortable surroundings of fellow sufferers.
    One GP, 20 patients, 20 minutes. Hits all the targets.
    MPs have no idea of continuity of care, personalised medicine or management of uncertainty. So we could give them what they want. it is not what patients want but they have to vote for someone.

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  • Why is access such an issue ? Patients with pressing need are seen urgently . Instant appointments for worried well people is possible for patients willing to pay for private care , It is not available on the NHS because it is not funded to this level. Politicians are unable to distinguish between want and need but are anxious to give people what they want to garner votes . They see primary care as an easy target because it is an essentially open contract in which the work force will not protect itself. It is time to show them that we will not be trampled on . The idea for an OOH boycott would work if it could be co-ordinated.

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