NHS England plans to bolster GP capacity by funding remote consulting through its ‘Winter Access Fund’ could worsen problems in under-doctored areas, GP leaders have warned.
Winter Access Fund guidance issued by NHS England in October encouraged local commissioners to use the cash to pay for extra sessions from existing staff or by hiring locums to help clear the backlog of appointments and meet demand for face-to-face consultations.
The guidance said that the money could fund ‘full use of the digital locum pool framework’, with all parts of the country expected to have established a digital locum bank model or equivalent by December.
But Lincolnshire LMC medical director Dr Kieran Sharrock told Pulse that this only makes sense if it ‘doesn’t move funds away’ from local services.
He said: ‘My concern is by giving someone more money to do remote consulting for us, it’s going to mean they become under-doctored in the area and in the other practice where that GP works.
‘If someone decides that they won’t go and do a session in [their] out of hours and won’t go and do a session at [their] local GP practice because [they] can do this remote consulting thing, then that disadvantages the patients somewhere else.’
And Dr Sharrock, who was appointed to the BMA England GP Committee executive team last month, added that the plans are unlikely to solve capacity issues because there is no spare GP capacity anywhere.
He told Pulse: ‘I very much doubt that there is anywhere in the country that is over-doctored and under-worked. It’s a little bit like shuffling deck chairs around on the Titanic as it’s sinking.’
Pulse has learned that NHS Lincolnshire CCG has plans to use the access funding to buy private GP remote consulting capacity.
An anonymous Lincolnshire GP told Pulse that the CCG approached at least two practices in the area in November, offering to pay for bundles of remote consulting capacity from private providers such as Livi and Push Doctor.
According to the anonymous GP, at least two out of four CCG GP clinical leads were not consulted on the plans and practices, PCNs and GP federations had not been invited to tender capacity before the offer of private providers.
A spokesperson for the CCG told Pulse this is a pilot, but it remains unclear what the wider plans would entail.
Lincolnshire CCG chief operating officer Sarah-Jane Mills said: ‘Our GPs and their teams have and continue to do an outstanding job of providing care and treatment to their patients. The CCG continues to work closely with our colleagues across primary care to understand how we can support them to continue to provide care and treatment in the coming months as we anticipate a busy winter period.
‘We are exploring a range of initiatives including piloting whether additional remote consultations support local GPs with recruitment and estate constraints to provide the care they want to for their patients.’
GP sessional leaders previously warned that there aren’t enough locums to fulfil demand when the Winter Access Fund plans were revealed.
And last year, NHS England confirmed its intention to extend the use of GP staff banks beyond the Covid pandemic – but GP leaders warned that the model ‘won’t work’ because locums ‘don’t want to be corralled’ into staff banks.