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.
In 2020, NHS England announced that salaried and locum GPs would be recruited into new flexible staffing ‘pools’ backed by £120,000 of funding in each region.
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.
READERS' COMMENTS [4]
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Yep. I’m a locus. I’ll work for a PCN, a surgery or an agency but I will not work for NHSE. I’ve worked full time over the last 7 months in local surgeries because demand has been high. Demand has dropped so I’ll be doing shifts for an agency when not needed elsewhere. That is via a digital provider; not sure which but it’ll be push doctor, or equivalent. If the funding was given to the surgeries directly they could get me for extra shifts. When I work direct I don’t charge any more than I got for my salaried posts per session equivalent. So me working through the agency and digital provider is just costing the tax payer loads more, I get a bit extra but I would prefer to work direct for local surgeries or local out of hours when they have the work.
This government and their team at NHSE just can’t bear to give us the funding direct tp primary care and surgeries and let the surgeries make best use of it.
They love command control targeted funding Big private companies and don’t much like or understand smaller scale general practice
If you haven’t realised yet – they want to create problems, not solutions – they then fund the contracts to friends and label it “innovation” and “digitalisation” to create private solutions and equity and competition. No problem. Let’s all be clear. Medicine and anxiety = money and profit along the chain. And you do the clean up of anything remotely negligent with the state against you. Good equation.
Finola ONeill
well done girl ! like yourself i’m a locum. very happy to bale out colleagues. a couple of weeks ago i did a whole day for nothing – so a colleage could go and see his dying elderly mother. not a problem – i had a big “thankyou” from him, and i know if i want a favour i can call on him.
not the case if you are working directly for the beancounters – no thankyous, no bottles of sherbert at xmas time – don’t even get paid accurately, or on time !
and by the way – if they apply IR35, which the (mis)managed practices do, i load the bill by 30%. a couple have queried this, but i simply withdraw my offer of locum work until they improve their manners !!
they don’t like this at all – but “TSB” (that’s short for Tough S**t Baby) !!
i suggest they say “please and thankyou” – instead of issuing diktats and trying to boss us about !
they might find we are more cooperative and helpful !