Health minister denies online GP consultation changes causing ‘doomsday scenarios’

‘Doomsday scenarios’ over online consultation changes predicted by GP ‘refuseniks’ have not yet come to pass, according to the primary care minister. 

Giving a keynote address at the RCGP conference yesterday evening, Stephen Kinnock took aim at the ‘rump of refuseniks and their cheerleaders in the BMA who are intent on whipping up this issue’ around online consultation changes.  

Mr Kinnock said: ‘The BMA claims that GPs are terrified really, and they say that patients are at risk from an avalanche of online requests that will lead to hospital style waiting lists. But neither of these doomsday scenarios have so far materialised.’ 

‘We negotiated and agreed a contract package in February that included the requirement to have online access available throughout core hours.

‘We agreed to delay the implementation by six months to give practices time to prepare, we established clear safeguards that mean GPs can divert those with urgent needs to the telephone, and we insisted that surgeries must remain fully accessible by phone and walk-in.

‘So we are profoundly puzzled as to why this has suddenly blown up as an issue’, he said.

He urged practices struggling with the changes to take advantage of ‘tailored support measures’ including ‘funding for software, peer to peer support, webinars and hands on help with workflows’ through the General Practice Improvement Programme. 

The primary care minister referenced an anonymous GP in the Telegraph, who had compared the changes to ‘modern-day slavery’, as proof that opponents of the changes are ‘going too far’ in their criticisms. 

But some GPs have shared their experiences of difficulties caused by the contract changes.

One anonymous GP told Pulse the changes have led to an increase in ‘low level abuse’ by patients. 

They said: ‘Lots of comments about you have to see me, “you are breaking the law”, when not given appointments. People walking in saying, “you’ve given me an appointment in three weeks, I want to be seen now, I’m sitting down and not leaving”.  

‘The stress level has really ramped up in reception as the wait for routine appointments is so long. It’s really demoralising, even I ended up in tears doing triage yesterday as completely overwhelming.’ 

Another GP based in Gloucestershire said: ‘The partner who was on call Friday said the pressure to triage the late eConsults and ensure the patient was aware of the outcome was extremely hard going.

‘We’ve always triaged everything that comes in up to 6:30pm, including those reception have care-navigated to the next day, but it’s the new requirement to provide and communicate the outcome the same day that’s breaking the camel’s back.’

Since 1 October, GPs are contractually required to keep online systems open for patient requests between 8am and 6.30pm for routine enquiries regardless of capacity, and ICBs have been told by NHS England that they should ensure the changes are implemented.

The BMA’s GP committee England (GPCE) formally entered a dispute with the Government over the issue on the same day, arguing it signed up to the policy only on the condition that ‘appropriate safeguards’ would be put in place, so that urgent requests cannot be sent online and potentially missed.

The primary care minister has been criticised after he urged patients to ‘take action’ should GP practices not fulfil their contractual obligations around online access. Pulse revealed last week that several GP practices have already been threatened with contract breach notices.

Responding to Mr Kinnock’s comments, Dr Katie Bramall, BMA GPC England chair told Pulse the BMA’s dispute is a reaction to ‘false promises of infinite capacity’ from a Government it says appears ‘intent on destroying general practice’. 

She said: ‘The BMA and GP practices nationwide already support online consult tools. Practices responded to over five million online patient queries in August alone.  

So, it is profoundly disappointing to hear a Labour minister twist the truth concerning genuine patient safety warnings from the BMA, warnings echoed by the DHSC’s own Health Services Safety Investigation Board which he dismisses as ‘doomsday scenarios’.  

‘In the Spring, the Department of Health agreed to work with us to manage these – but have now instead decided to leave practices hung out to dry. 

‘As GPs, we are raising legitimate concerns following the irresponsible and false promises of infinite capacity to manage millions more online queries with no extra staff.  

‘The Government that promised to bring back the family doctor looks like it is intent on destroying general practice – political point scoring should never be deployed to hide legitimate patient safety concerns. We implore the Government to work with GPC England to protect patients and practices.’ 

Dr Bramall said the dispute is to ensure the Government protects practices and accepts that diverting online contacts through telephone lines is a key safeguard against missing urgent queries later in the day. 

Elsewhere in the speech, Mr Kinnock repeated the Government’s announcement of a six-month review of the Carr-Hill funding formula. He said changes to the formula will ensure ‘no patient is left without care’. 

And on neighbourhood health services, he said the planned changes are ‘emphatically not’ about ending the GP partnership model but were instead about ‘creating an option to work over larger geographies’. 

Health secretary Wes Streeting previously told Pulse the Government would not replace GP partnerships ‘that are working well’.