BMA calls on health secretary to clarify face-to-face GP message

The BMA has called for an ‘urgent meeting’ with the health secretary to seek clarity regarding face-to-face GP appointment advice.

In a letter to Matt Hancock, the doctors’ union also called for renewed Covid funding for practices as well as an ‘end to directive letters’; and a suspension of QOF, PCN service specifications and routine CQC inspections.

It comes as NHS England last week said GP patients must now be offered face-to-face appointments if that is their preference and later confirmed that the only reason for refusal should be if the patient is deemed an infection risk.

But GPs responding to NHS England’s new guidance branded it ‘tone deaf’ and ‘badly judged’, while the BMA said the guidance was not contractually binding.

BMA GP Committee chair Dr Richard Vautrey has today written to Mr Hancock requesting an ‘urgent meeting’ over NHS England’s letter – which he said shows ‘a worrying disconnect with the reality facing general practice’.  

Dr Vautrey’s letter said that practices and GP out-of-hours services ‘do not feel supported by the Government or NHS England’.

It added: ‘Growing numbers of practices are reporting that their staff are being verbally, and at times physically threatened with abuse. We risk losing much needed and dedicated staff as a result. 

‘This is completely unacceptable and should be condemned by yourself, wider government and NHSEI in the strongest possible terms.’

Dr Vautrey called for ‘an end to directive letters, and instead practices and other GP services must be allowed to deliver patient care in the most appropriate manner, meeting the reasonable needs of their patients and based on their knowledge of their local communities’.

He added that the Government must provide ‘a clear statement from the CMO about when it is safe and appropriate to remove social distancing measures and when to use PPE for face-to-face consultations in GP premises’. 

The Government must also launch a ‘major public campaign, that explicitly supports general practice, and honestly informs patients about the challenges impacting primary care’, Dr Vautrey added.

The letter also called for:

• A suspension of QOF and other targets including PCN DES specifications;
• An end to routine CQC inspections and removal of other ‘unnecessary bureaucratic burden’;
• A commitment to fund premises development to ‘improve ventilation and space in waiting areas’;
• Practices to no longer be the ‘automatic default’ for hospital outpatient queries;
• An increase and extension to the £120m funding to support practices and PCN clinical director funding
• A removal of VAT for general practice; and
• Access to mental wellbeing services for the general practice workforce and more support for those impacted by Long Covid.

It added: ‘We want to be able to provide the best possible service we can, but we need the Government and NHSEI to bring an end to the criticism, and to properly support us in order to achieve this.’

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

It comes as GPs are calling for the resignation of NHS England’s medical director for primary care amid the furore created by its letter.

Asked about face-to-face GP appointments in a House of Commons debate yesterday, Mr Hancock pointed to NHS England’s letter saying it had ‘reiterated’ that ‘it is important to offer a face-to-face consultation for a patient who really wants one while also using technology where that is the most clinically appropriate thing to do’.

He added: ‘These decisions should be taken between doctor and patient together. There is no greater supporter than me of the use of technology in healthcare. I think it improves access no end.

‘People do need to be able to go to the surgery if they so choose and see the right person – the clinically appropriate person. That is the approach that we are taking while making sure that we can use a system that allows people to access the right services in the right settings as much as possible.’