The urgent GP issues in the new health secretary's in-tray
Nicola Merrifield examines the GP issues Matt Hancock will need to address
GP leaders have welcomed the appointment of new health and social care secretary Matt Hancock, but have stressed the need for ‘properly resourced health services’ in what BMA chair Dr Chaand Nagpaul calls a ‘crucial time’ for the NHS.
Mr Hancock, who leaves his role as digital, culture, media and sport secretary, was yesterday announced as the replacement for Jeremy Hunt, who becomes the foreign secretary following the resignation of Boris Johnson.
Pulse looks at the most urgent GP issues in his in-tray
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Digital technology is being touted as a key focus for the NHS, which still often relies on paper records and outdated systems. According to Mr Hunt’s special adviser, Ed Jones, Mr Hancock is ‘massive on digital,’ and his appointment marked a ‘bad day for NHS fax machines’.
Mr Hancock was the minister for digital services, before taking over as secretary of state for digital, culture, media and sport. He used to work for the family business, which developed the software that allows website users to input their postcode and bring up their full address.
He also developed his own app - named ‘Matt Hancock’ - that allows his constituents and those further afield to keep up to date with his activities.
His appointment comes soon after Mr Hunt revealed the launch of a new app by the end of the year that will allow patients to book a GP appointment, check their patient record, and receive support for managing their long conditions.
Indeed, Mr Hunt specifically mentioned this app in his welcome message to Mr Hancock:
Couldn’t ask for a better successor than @matthancock to take forward long term NHS plan with his brilliant understanding of the power of technology. The new NHS app will be in safe hands!— Jeremy Hunt (@Jeremy_Hunt) July 9, 2018
However, not everyone is happy about the march towards digital services. BMA GP Committee chair Dr Richard Vautrey has warned that technology will not address the problems caused by a lack of trained GPs.
Meanwhile, this year’s GP contract requires all practices to stop sending paper referrals and instead switch to an electronic system from October.
But in places, efforts to switch over to the new system have been thwarted by a lack of preparedness – such as in Kent where an IT failure at a local hospital trust in May meant GPs were asked to put urgent referrals on hold for 24 hours.
The incident led to GP leaders warning local hospital trusts they would not support the move to electronic referrals until problems had been ironed out, due to concerns over patient safety.
‘vacancy vacancies recruitment’
The ‘crucial’ time at which Mr Hancock takes up his new brief will require him to turn around the general practice recruitment crisis that recently led Mr Hunt to admit he was ‘struggling’ to bring 5,000 more GPs into the workforce by 2020.
This was after official figures from NHS Digital revealed there were 1,000 fewer GPs working in the NHS in England than there were in September 2015, when Mr Hunt first pledged to ensure at least 5,000 more GPs would join within five years.
Pulse has revealed that vacancy rates are higher than ever, with one in six GP positions currently vacant.
There have been efforts to increase the number of GPs from overseas - however, to date only 85 are ready to begin work, out of a target of 2,000+.
Mr Hancock has little experience of health issues and he would be advised to address GP recruitment as a matter of a priority.
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Seven-day GP services
The new health and social care secretary also takes over the brief for the introduction of seven-day and evening routine GP appointments - which was the flagship policy of his predecessor.
Funding for extended access to routine GP appointments is set to rise - from the current £3.34 per patient to £6 per patient in 2019/20.
Yet there has been criticism of the plans, with the Public Accounts Committee warning in 2017 that the proposals ‘could prove expensive and duplicate existing out-of-hours services’.
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Source: Julian Claxton
Transformation of NHS services
Mr Hancock’s responsibilities will also be underpinned by the NHS’s plan to see health and social care services integrated at a local level through ’accountable care organisations’.
The ACO contract, which has still yet to be fully consulted on by NHS England, will require CCGs, hospital trusts and local authorities to work together to provide services for local populations.
But concerns have been raised by the BMA that the new contract could lead to privatisation of NHS services.
In addition, NHS England guidance for one type of ACO - multispecialty community providers – released last year revealed GP practices may be forced to give up patients if they back out of the new contract.
Mr Hancock has yet to reveal his priorities in his new role, but following confirmation of his move to the Department for Health and Social Care, he posted on Twitter yesterday: ‘Really looking forward to joining @DHSCgovuk at such an important time for our great NHS. I can’t wait to get started’