Single-handers in deprived areas most worried about NHS plan, says RCGP

The new GP ‘rescue’ package will hit Asian single-handers that are practising in deprived areas among the hardest, said RCGP chair Professor Martin Marshall at the College’s annual conference today.

Professor Marshall said that single-handed colleagues in east London, where he practises, are among the most in need of funding but are most likely to lose out due to the plan.

The £250m funding is dependent on ICSs tackling ‘variation’ in access to GP care, and NHS England said practices that are performing worst in terms of delivering face-to-face appointments may be forced to partner with other practices or face contractual action from commissioners.

But Professor Marshall said: ‘Extra money isn’t, or might not be, available to the bottom 20% of performers. That seems really bizarre, when it’s the bottom 20% of performers, in terms of face to face, that really need the money.

‘As a GP working in East London, quite a few of my colleagues [who] are older, Asian doctors working in small practices, are genuinely and understandably worried about Covid, and they’re the kind of people who won’t get the support but who most desperately need the support.’

The measures come as part of a £250m ‘package of support’ for general practice announced yesterday, aiming to ‘increase the proportion of appointments delivered face to face’.

The document does not give a target for the proportion of appointments that should be face to face, but says all practices must review if they have got the ‘balance for patients right’ by the end of the month.

Professor Marshall said he thinks the current level of 60% of consultations being face-to-face is ‘about right’. 

He said: ‘Prior to the pandemic, 80% of consultations were face-to-face. Now it’s around about 60%. We learned a lot during the pandemic about what we could do remotely, so actually that shift is probably about right, and I suspect that both the public and conditions will get used to that.’

Professor Marshall said the announcement of the GP package shows health secretary Sajid Javid has ‘got a lot to learn’, adding: ‘I think, particularly after the last 24 hours, he knows that he’s got to learn that fairly quickly.’

Responding to a question about the college’s relationship with Mr Javid, Mr Marshall said: ‘He accepts himself that he knows very little about health, and just about nothing about general practice. He’s only been in office for three or four months.’

It comes as Mr Javid pulled out of appearing at the conference yesterday, but said in a piece published in the Daily Mail that ‘patients must be able to see their doctor the way they want’.

Speaking at the conference, NHS England’s medical director for primary care Dr Nikki Kanani said the NHS ‘is built on a principle of need’. 

When asked if a face-to-face appointment is an automatic right for anyone who requests it, she said: ‘This is not just about a face to face with a GP, we have many other colleagues that are better able to offer care to our patients than we are, and that actually must be recognised and celebrated, and we need to keep talking about that and see do all of us across the profession.’

However, the document setting out the support package says that in order to access the winter funding, practices must ‘increase the proportion of face-to-face appointments with GPs’.