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Independents' Day

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)

  • Ok so we see patients within 48 hours problem…but it will be at the expense of routine appointments - of cause it will

    Maybe we should forget looking after the chronically sick, diabetics, chronic respiratory disease, chronic mental health, child protection issues, elderly care, getting to know our patients, identifying cancer before its becomes a 48 hour crisis?…but hang on I thought thats what GPs were for??

    It might help A&E a bit…I doubt it though because the problem is a lack of capacity in the whole system - this doesn't address this at all.

    This proposal is simply a decision to sacrifice the care of the chronically sick for the benefit of people who want to be seen within 48 hours.

    Its a half assed attempt to address problems in A&E caused by a chronic lack of capacity in the system as a whole exacerbated by exploding demand.

    It reveals a complete lack of understanding by Mr Milliband.

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  • Perhaps Mr Miliband wonders what all of the Health Visitors, Specialist Nurse Consultants in diabetes/cardiology/respiratory care, Assistant Nurse Practitioners and District Nurses, Mental Health teams, Drug and Substance Abuse teams, Smoking Cessation Advisors to be found in Community Healthcare Trusts are being paid for if the GPs do all of that single handedly.
    The GP may well be the main point of contact and treatment for primary care but he/she is not the only one.

    Also, to the GP who advised me to get a med. degree: why? It's hardly made you a cheery, well-balanced individual, now, has it? Perhaps my ignorance is bliss.

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  • Anonymous | GP Partner | 13 May 2014 12:19pm

    I don't remember saying anything about "prefered GP" nor do I think it mentions it in the article! In fact the article clearly satates "the right to book further ahead with the GP of your choice".

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  • Dear B Mitchell: I am a GP in a practice with >12000pts and most are happy with what we provide. Its very difficult to satisfy every patient. Remember my family and I are also patients in a smaller practice where its easier to see the same GP as there are only 3 of them.
    We do have minor illness nurses, practice nurses, HCAs and at times have healthcare professionals from other agencies running clinics from our site.

    what you have said is partially correct: why not promise being seen by other clinicians eg MIN, PN etc but what labour wants to promise is a guarantee that pt will be seen by GP within 48hrs likely the preferred GP. Please ask your GP and your mother's GP if they can provide this?
    I am not trying to be rude. I do care for my patients like most GPs do and hence end up finishing work at -8pm and at times have to go on saturday morning to complete my work. Most patients do not see what we have to do daily. Those who come to know abou our work patterns and care we provide are highly appreciative. We do not work to any time unlike A&E drs who will complete 6hr shift and they are off despite the waiting time in A&E. I do not leave my pts/work until we feel most of its done in the same day.
    We also have duty drs who at times finish seeing pts at 7pm. Rest of the GPs who are do routine shifts also end up helping the dut dr so that we all can go home at reasonable time. This is the unseen work which patients have learned to accept it as their rights.
    What the conservative gov is doing and what labour wants to promise will lead to many GPs becoming locums who will work to the clock, dictate terms, move from one surgery to another ever few months and enjoy breaks when they like it but at the expense of GP partnerships dissolving.
    Please take my advise and ask your GP if he/she will be supportive of the labour proposal?

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  • Nobody mentions the role of NHS 111 in sending the worried well in their droves to UCCs and A&Es.
    Assessment by algorithm causes more problems than it solves.
    That is why there is a need for more timely access to a GP.
    I agree with the Anon. NHS Manager above, there is no requirement for it to be your preferred choice of GP. A truly sick person will see any doctor who can help, so, built in triage!

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  • Bonnie Miitchell
    I don't understand your point ?
    If you understood General practice then you could see that a 48 hour target will come at the price of waiting to see your GP!
    £100m. Only funds 1 gp for about 60000 patients
    not enough to make it possible to see all patients in 48 hours and your own Gp when you want after 48 hours!
    If any gp can do then why is the ooh service not stemming the flow in to A and E?

    Continuity is the Key..
    But this costs .... Ever increasing demand
    And falling resources has made the situation
    Untenable ... When that happens. People "belly ache"
    Then finally they take action.

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  • I agree that patients should be seen within 48 hours when clinically necessary. However, that is not what Milliband is promising on our behalf. The "right" to see a GP within 48 hours risks more time being spent on self-limiting illnesses that don't need to be seen at all while reducing time available for those who might benefit from out attention. This approach will just increase demand at the expense of the less vociferous and skew clinical priorities.

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  • Took Early Retirement

    MY point was that your nice practice (no surprise to me) is paid about 30% more for each patient than my urban one, where we get c £100 and ONLY when we hit all the QoF points and do the DES's etc.

    Now, it would be interesting to know about your mother's practice too. Not in a Darzi Centre perchance? They get a lot more just to be open 8-8.

    In our practice we can't afford the extra staff that your nice one does. Let's have a level playing field, then you can start moaning about other practices' performance. I bet, being a nice rural practice that you don't have about 5-10% of appointments taken up with social issues, like appeals against benefit refusal, Blue badge applications, "I want to move house and the council say if I get a letter form you it will help.... etc"

    So, in fact, we usually in my deprived area practice have appointments available with DOCTORS (not NPs- even though I have very little against them) We also do a daily pm "emergency" surgery to which anyone can come, without question, who says they cannot wait for the next available appointment. I'd say about 60% of the attendance to this is genuine. The numbers vary from zero (very rare!) to 40 (also rare) I'd say the mode is about 20. But don't some people MOAN like hell that they might have to actually wait for up to an hour.

    Anyway, I've got fed up with it all- threads passim- and am taking premature retirement in 15 days.

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  • Re confusion over 48 hour access and choice of GP - has this story been edited since yesterday? I thought when it was "breaking news" then, it was stated that the requirement would be appointment within 48 hours with the GP of your choice.

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  • We area political football being kicked around . When will someone see sense ? I can't take it anymore .

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