This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

CAMHS won't see you now

Labour pledges £100m to reintroduce 48-hour target to see GP

Labour leader Ed Miliband has pledged to end the ‘scandal’ of patients waiting more than a week for a GP appointment and reintroduce a right for patients to see a GP within 48 hours.

Mr Miliband announced that a Labour government would reintroduce the target scrapped in June 2010 for patients to have a guaranteed appointment at their GP surgery within 48 hours.

He also said that patients would gain a right to be seen by a GP on the same day if they need to be seen quickly and be able to book appointments more than 48 hours ahead ‘with the GP of their choice’.

The Labour leader pledged to invest an extra £100m a year in GP practices to pay for an additional 3m GP appointments every year.

He said this additional funding will come from repealing the requirements to use competition in the NHS and cutting back on what he called ‘quangos’, such as Monitor, the Trust Development Authority and Commissioning Support Units.

He said: ‘I can announce the next Labour government will put in place a new set of standards: a same-day consultation with your GP surgery with a guarantee of a GP appointment if you need it that day, a GP appointment guaranteed for all within 48 hours, and the right to book further ahead with the GP of your choice if your priority is to plan ahead or to see your preferred doctor.

‘This will be better for patients, because they have better access to their GP surgery; better for the NHS, because it will save money currently spent in A&E; and better for Britain, because it is the kind of health service we need.’

He added: ‘A quarter of the public now say they can’t get an appointment in the same week. It’s a scandal that people are waiting that long, it is not how our NHS, the pride of Britain, should work.’

He also promised to make the NHS a more integrated service. He said: ‘Our plan for the long-term of the NHS starts by making sure that physical health, mental health and social care – services which have stood apart for too long - work together. Just think of the difference it could make. If a simple grab rail is placed in someone’s hall at home, that can stop a fall that could lead to that person breaking a bone, keeping them out of hospital, saving them the pain and the suffering, and saving the NHS thousands of pounds.’

RCGP chair Dr Maureen Baker said that she welcomed the announcement of more funding for general practice.

But she added: ‘While we welcome Mr Miliband’s announcement it must not be another “sticking plaster” solution but part of a broader, long-term, shift in investment. Ultimately, general practice needs 11% of the NHS budget by 2017 in order to cut waiting times and guarantee safe care for our patients.

‘We particularly welcome Mr Milliband’s pledge to scrap the marketization of the NHS, something our members, across the country, have long said is unworkable and undermining their ability to provide joined-up patient care.

‘The college looks forward to working with politicians from all political parties to discuss how general practice can be funded to provide better and speedier access for patients, in order to take pressure off our hospitals and allow patients to be treated in their communities.’

GPC chair Dr Chaand Nagpaul said the targets were ‘misguided’ and ignored the real crisis going on in general practice.

Dr Nagpaul said: ‘I would very much want to have a discussion with the shadow health secretary Andy Burnham in particular, as I think these suggestions are misguided and are failing to address the fundamental problem which is the crisis in general practice.

‘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.’

He added: ‘What is really important is to address the fundamental lack of investment - £100 million is 0.1% of the NHS budget, it’s a tiny sum in the totality of what general practice is expected to deliver.

‘We need to look at the workforce, manage demand and ensure GPs can deliver the most appropriate care within the constraints they have – not stoke up demand that is not achieveable, leads to perverse behaviours and often ends up denying care to those that most need it.’

Meanwhile, commenting on Labour’s plans to overhaul the NHS competition regime, NHS Clinical Commissioners co-chair Dr Steve Kell said: ‘Labour raise[s] some interesting points about competition and we know from our members the unnecessary burden and cost that it can place on the system if it is not used or understood properly.’

‘Clinical commissioners are faced with the decision to tender local services every day, and have found there are a number of practical difficulties with the current system when trying to secure the best outcome for patients. It is sometimes unclear to commissioners whether they are simply free to commission from a market, or whether they have to commission in order to make a market operate.’


Related images

  • Ed Miliband - online

Readers' comments (86)

  • My GP practice has already done this for years. Don't see what the problem is, except (yet again!) GPs feel the need to tell us what they can't do and don't want when faced with patient need.
    For those who don't like us mere mortals presenting with crappy strep throats and the sniffles, pay a practice nurse to deal with this traffic for you, preferably a nurse prescriber, someone who does not mind the company of sick people. My practice does just that. Then pay for a Health Promotion Specialist to manage things like smoking/drinking/obese patients, someone who does not discriminate against those too stupid to look after their health without some assistance. Once again, my practice does just that.
    When you have drilled down to the genuinely sick among us (and I'm surprised that some of the folk posting on here can see patients around the coronae of their immense egos!), try listening to us or looking up from the paperwork/computer screen just long enough to make the patient feel you may be listening. MY PRACTICE DOES ALL OF THESE THINGS! What is the problem for everyone else???

    Unsuitable or offensive? Report this comment

  • To Dear 12:07 NHS manager

    most practices have triage system in place for urgent appointments/home visit requests. Signing up to guaranteed appt within 48hrs with preferred GP isnt possible: let me explain as you may not be aware of the reasons:
    1. some GPs work part-time
    2. some GPs have special interests eg dermatology, mental health, COPD ,diabetes etc and hence their clinics tends to get filled in more quickly with the chronic illness pts.
    3. most pts who need appt within 48hrs have minor illnesses and they are better served by minor illness nurses: most big practices do have them saving valuable GP time to deal with more complicated pts ( in fact I at times pray to get a pt with sore throat/earache so that I catch up in my clinics).
    4. there arent enough GPs to give this demand
    5. the current supply of GP appointments will be held back to meets idiotic targets supported by politicians and NHS managers. We shouldnt just say its doable but ask the question is it right to promise preferred GP appt within 48hrs when alternatives like the minr illness nurses / practice nurses and HCAs can deal with minor ailments, review of chronic illness and HCA can do BP checks/health checks etc.
    I think I need to stop before I refer myself to crisis team

    Unsuitable or offensive? Report this comment

  • Bonnie, get the chip off your shoulder and do a medical degree if the solution is so easy. Now where did I put my handbag? ( - anonymised but another lazy egotistical patient hating GP)

    Unsuitable or offensive? Report this comment

  • Dear Bonnie @12.17,
    I don't mind the strep throats - but I do object to the patient that has coughed once 'you can never be too careful, can you doctor', every child that wakes with the tiniest amount of eye discharge 'school won't allow him in until he has been checked by the doctor' and all minor ailments which do not need to see any health professional let alone an emergency GP appointment. Patients have been led to expect same day, even same hour or 'when it suits them' service when there is no good medical reason or need.
    I am usually in work - physically at the surgery - for 12 hours a day and routienly leave after 8pm when the last patient has been seen by 6pm. There is so much crap to deal with which the public never sees.
    I am happy you are a patient at such a wonderful practice but unless you are a GP at the sharp end, you have no real idea about what work is involved.
    The more patients are offered by successive governments, the more demand will rise.
    How come waiting times in A+E mean the poor doctors (who work a maximum 48 hours per week) are overworked yet the GP (unlimited hours) are lazy and twiddling their thumbs?

    Unsuitable or offensive? Report this comment

  • some others who use it as convience and 'you cant be too careful culture' with minor ailments; eg my son fell at school at 9am, bumped his head. At 4pm when collecting him the teachers tells me and also advised get him checked by GP. between 9am to 4pm:he has been running around, eating and drinking fine, attended classes etc.
    CAB/DWP: go to GP to get letter to support your claims for benefits: why do they give verbal advise. Do I tell my pts verbally: go to urology for your waterworks problem!

    Unsuitable or offensive? Report this comment

  • This comment has been moderated.

  • Bonnie- `In your perfect surgery - It would also be interesting to know how much funding they get per patient as a whole and whether they are PMS or GMS. Most surgeries get by on £70 tops (£100 all included QoF DES NES etc) but some surgeries had top ups via PMS growth money, MPIGs of £100 per pt. Obviously if we had double the funding we could give you a first class service! You cannot compare GP surgeries that easily - there are age demographics, commuter pressures, deprivation and size of the patient population. Most single handeds with 15k patients provide a commuter service with rotating drs, a real lack of continuity of care - but thats the way we are headed. I believe the perfect model would be 3 partners for 6-7k patient - that can marry the personal touch of single handed and the government's psychosis that we are all shipmans and cannot work alone.

    Unsuitable or offensive? Report this comment

  • my comment got squeezed! i was to say most single handed with <2k patients can provide 48hr appointments very easily as they have reduced demand (although proportional) but can provide a personal service. Larger multi partner group practices with 15k patients really are good for the WIC type patients but continuity is much more of a struggle...

    Unsuitable or offensive? Report this comment

  • Took Early Retirement

    Vote early and vote often I say!

    I wonder if Bonnie is registered at a nice Rural, Dispensing, PMS practice with £130 per pat per year? Can we be told please?

    Unsuitable or offensive? Report this comment

  • Hi all, thanks for taking the time to really hear what I was saying, rather than launch into a defensive rant.
    I understand that there are problems with the way that primary care is structured and funded, as I work for NHS England in Operations & Delivery.
    However, the rush to restructure (always remembering that the Labour Party gave us the TCS agenda, the Coalition only finished in undue haste a job started before their tenure), has left community services depleted by the acute trusts who administer them to bolster A&E and other acute functions, leaving the GPs to pick up 90% of the first contact business with less than 10% of the overall NHS budget.
    So, I DO get it. I just can't believe some of the bitter, twisted, angry stuff that passes for comment on here, when there are GPs working like the devil to provide for their patients who go unsung.
    GPs are not the only part of the NHS suffering under the vaunted restructure. Stop complaining and start making a change. You have the political power to do so, if it could be agreed as to what you need and how that should be provided.
    For those of us who are not GPs but are trying hard to make this new system work, I can say that the bellyaching is just grating.

    Unsuitable or offensive? Report this comment

  • "I wonder if Bonnie is registered at a nice Rural, Dispensing, PMS practice with £130 per pat per year? Can we be told please?"
    As it happens, I am registered at just such a practice. My mother is registered with a practice nearby, in a borough which ranks 17th in England for deprivation and negative health outcomes but she can also see a GP within 48 hrs, enjoys a full OOH service and is able to take minor ailments to a practice nurse.
    So, your point was?

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say