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NHSE asking GP practices to justify ‘low’ levels of F2F appointments


face-to-face appointments


Exclusive NHS England is monitoring how many face-to-face appointments GP practices are offering and asking them to justify ‘low’ levels, Pulse has learned.

Practices in London have been approached by commissioners about data on their appointments, but Pulse understands this has also been happening in other parts of the country.

GPs have been given short deadlines to fill out a survey on their levels of face-to-face appointments, including justifying a ‘low proportion’, which Pulse understands has come to CCGs centrally from NHS England.

NHS England told Pulse that fewer than 150 practices have been approached as part of a scheme to support those delivering low levels of face-to-face appointments.

Previously, NHS England told Pulse that it would not enforce its new guidance on face-to-face appointments, although CCGs may.

The survey, seen by Pulse, asks whether the CCG believes ‘that the proportion of face-to-face appointments in this practice is clinically appropriate and that the practice’s patients’ needs are being met’.

It also asks whether the practice has ‘a physical reception area open and staffed, where patients can present, undergo triage and book appointments in person’ and whether ‘patients at the practice [have] raised issues or complaints relating to the availability of face to face appointments’.

The survey says: ‘Are there any data quality issues, specific to this practice, which may result in their recording an incorrect proportion of face to face appointments?’

It adds: ‘Are there any other reasons for the low proportion of face to face appointments at this practice?’

Practices were also asked whether there are ‘any specific plans in place (at a practice, PCN, CCG, ICS or regional level) to increase the proportion of face to face appointments in this practice in the near future’.

GPs were asked to provide information by the next morning, Pulse understands.

An NHS England spokesperson told Pulse: ‘We have reached out via CCGs to about 144 general practices which have recorded fewer than a fifth of their total appointments being conducted face to face in the first three months of this year.’

They added that there is no intention to look at the majority of practices in this way.

The BMA said ‘robust’ data on GP appointments is important but stressed that the timing of the demands ‘could not be any worse’.

Dr Farah Jameel, BMA GP Committee executive team member, told Pulse: ‘Practices have continued to see patients face-to-face throughout the pandemic. The proportion of in-person appointments recorded will obviously vary between practices– not least because no two practices are the same and because GPs are the best people to know their patient communities and provide care in the most appropriate way for them.

‘Practices will feel very much like they are once again being reprimanded and asked to “explain themselves” for responding directly to their patients’ needs and providing care in the best way they can, given the immense pressures they are experiencing.’

She added: ‘On the back of last week’s letter that left GPs incandescent with anger, the timing of these demands could not be any worse.’

Last week, an NHS England letter sent to practices said patients must now be offered face-to-face appointments if that is their preference.

Both LMCs and the BMA have advised practices that the letter has ‘no contractual force’ and should be regarded as guidance only.

It comes as the BMA’s GP Committee has voted to pause all meetings with NHS England until the disagreement around face-to-face appointments in practices is resolved, saying it has ‘no confidence’ in NHS England’s executive directors.

It follows calls among grassroots GPs for the resignation of NHS England’s medical director for primary care amid the furore created by its letter – with a petition to that effect racking up over a thousand signatures.

READERS' COMMENTS [15]

Robert James Andrew Mackenzie Koefman 21 May, 2021 1:44 pm

Not so long ago NHSE or Matt hancock was pushing us all to do more telephone triage etc.It is unsustainable to do both .

Mr Marvellous 21 May, 2021 1:44 pm

“a physical reception area open and staffed, where patients can present, undergo triage and book appointments in person”

So patients are to be triaged in reception. By the receptionists?

Oh dear NHS England.

David Jarvis 21 May, 2021 1:57 pm

Explanation COVID innit.

Patrufini Duffy 21 May, 2021 2:00 pm

Telephone: 0300 311 22 33
The NHSE contact number for “customers”. Let’s see how many you see face-to-face? See the one who split up with her boyfriend and the other who has tooth pain. Within 6 hours says 111.

Andrew Jackson 21 May, 2021 2:10 pm

this is getting very messy indeed

Michael Crow 21 May, 2021 2:37 pm

If GPs could actually stick together, the best way of dealing with this is for NOBODY to comply

Simon Ruffle 21 May, 2021 2:55 pm

Dear GPs
Come on with you all; open the doors, see everyone face to face. Give the public and NHSE what they want. They pay your wages.

Love Me xxx

PS. R rate is today between 0.9 and 1.1, so you’ll be blamed for anyone catching COVID too.

(Your contract tells you to do what is appropriate for the needs of the patients not their or NHSE wants. NHSE understanding primary care would be a start.)

Hello My name is 21 May, 2021 2:57 pm

I actually think this is the right approach. Some practices will be struggling to balance the demands upon them and may not have found a way to safely accommodate their patients FTF needs again. Practices should be looked at individually, offered support, be it financial or workload diversion (whatever it may be). Given the huge shift in consulting strategy and the likely consequences for patient care it’s reasonable for NHSE to monitor the situation and try to help. I assume it’s part of their job. Better than undermining letters via the national media. Let’s acknowledge when they are actually Doug the reasonable thing.

Concerned GP 21 May, 2021 3:39 pm

I don’t think NHSE are trying to help here but maybe I’m being cynical? Helpful behaviour does not consist of statements to the public after bowing to pressure from a hostile media and therefore giving the impression that GPs are not doing face to face reviews. Helpful behaviour does not consist of “ordering” practices to work a certain way and making huge generalisations which serve to damage the doctor-patient relationship. I doubt any of this monitoring of practices will lead to actual, meaningful support that practices need. I rather suspect that they will use any information to further beat us with their self righteous stick.

John Graham Munro 21 May, 2021 3:45 pm

An amusing distraction——–Did anyone see that G.P. television clown trying to explain Prince Harry’s bizarre therapy sessions?

nasir hannan 21 May, 2021 4:43 pm

Are practice contractually obligated to participate in the survey? Are they contractually obligated to respond within a time frame?

One for the lmc and if systemic then for gpc to advise.

David Church 21 May, 2021 9:43 pm

The really curios thing about this is that it is the Practices with low F2f contact numbers who are doing what they should be!
And Practices with high F2f who are NOT doing the job properly.
Just in case nobody has noticed, (and NHSE seems not to have), there is a pandemic in full swing of a fatal or chronically disabling virus – it is GPs job to keep the masses OUT of the crowded waiting rooms and reduce footfall in surgery buildings.
Indeed, it is a good indicator of close, healthy, caring and cooperative relationship with patients if both sides can have the confidence to manage care almost entirely without F2F contact! As a locum and ex-Principal, I know this only too well!
NHSE non-clinical buffoons do not understand the blatant perverse inversity of their chosen measure of ‘good care’. …..or else they are still after the aim of the PM to have bodies pile up to reduce the drain on public money of the retired and disabled.

Patrufini Duffy 21 May, 2021 9:54 pm

On the cosmic scale, Kanani, Waller et. al are truly insignificant. Don’t let their egos ruffle your own existence within the Milky Way.
But, NHSE should go to New Delhi or Mumbai. And tell their physicians, that you seemingly all aren’t doing anything, so open up. See what happens. Now you have their Indian strain dominant, you talk like clowns. You can’t even put a public health policy together.

James Weems 22 May, 2021 9:43 am

This is an absolute joke. The first three months of this year was during peak pandemic. I was seeing maybe 1/10 face to face at that time and things has picked up since. I think this level of intrusion and monitoring is abhorrent and needs rebuttal. Who in CCGs is going to question the clinical acumen and triage skills of GPs? It’s been a terrible week. Seeing this at the end of it is the last straw.

John Glasspool 22 May, 2021 8:01 pm

If you can retire early: go now. I did and have loved every minute of it.