New health secretary Therese Coffey does not yet have a plan for how to boost GP appointment access, her first interview has indicated.
New Prime Minister Liz Truss yesterday listed improving access to GP appointments as one of her three key priorities.
But, interviewed on BBC Radio 4’s Today programme this morning, her new health secretary and deputy Prime Minister seemed to have yet to research the topic.
Ms Coffey was asked if she has ‘a sense of what the real obstacle’ to GP access is.
‘Is it attitude, culture, bureaucracy, money, what do you think it is?,’ asked presenter Nick Robinson.
The health secretary replied: ‘Well, every GP around the country is effectively part of an independent practice that agrees to do NHS services.
‘And that’s why we’ll be trying to work through exactly how we can make sure that where we have some practices that are absolutely fantastic, people being able to get through, being able to book appointments, and just to try and work through the detail of how we can make changes there or help those practices, improve how they work with their patients.’
She added: ‘I’m very conscious the relationship between a doctor and a nurse and their patient is absolutely paramount. But we must do whatever we can to support that process. Because ultimately, I’m here to stand up for patients.’
When asked if standing up for patients meant more face-to-face GP appointments, Ms Coffey said: ‘I think we just need to work through that level of detail and recognise that ultimately, the relationship is between the doctor and the patient.’
However, she did confirm that patients would not be charged for GP appointments, with Mr Robinson referring to an old think-tank report that Ms Truss had once worked on.
‘I will not be charging people to go and see their GPs,’ she said.
In an apparent gaffe, Ms Coffey also named chiropractors as a key part of NHS primary care during the interview.
She said: ‘The majority of healthcare is actually delivered through primary care, through our doctors, through our dentists, through chiropractors, all those other supports that are there, not just through hospitals.’
However, chiropractic is considered a type of ‘complementary and alternative medicine, which means it’s not a conventional medical treatment’, and most people who have chiropractic treatment pay for it privately, according to the NHS.
‘Chiropractic is not widely available on the NHS,’ and ‘a GP is more likely to refer you to a physiotherapist,’ says the NHS website.
Her comments come as the BMA has asked the new Prime Minister to please work ‘with’ doctors rather than against them to ‘turn things around’ for the NHS.
And they come as Ms Truss again stressed that improving GP access will be an ‘immediate’ priority for the new health secretary.
Speaking in her first Prime Minister’s Questions session in the House of Commons today, Ms Truss said: ‘Our new health secretary, who is also the deputy prime minister, will be taking immediate action to make sure people are able to get appointments with their GP and proper NHS services’.
However, she made the comments in response to a question referencing the elective backlog, with Labour MP for Bethnal Green and Bow Rushanara Ali saying ‘the NHS is on its knees with 6.6 million people waiting for treatment’.
READERS' COMMENTS [15]
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What a dismal deflating start. We really are doomed.
I have a dim memory of her doppelgänger Kenneth Clark (who we hated at the time) and sure didn’t he turn out OK?
Not sure how they can fix this in the contract? (without patients paying to see GP).
Reward those delivering good access? Punish those whose access is bad?
But fixing the current tax and pensions which encourages GP’s and consultants to retire or reduce sessions is a good start, but not cheap…
If people are struggling to get an appointment, it is because we are already fully booked
So what is the magic plan?
Can she come round and decide which patients are going to have their appointments cancelled to free up slots?
It just doesn’t make sense, just another ‘sound bite’ – look Im on the patients side.
Cant really solve it without reducing demand
Just answer the phones (within 10 rings) when a patient rings would be a start towards better perceptions. Not everyone
communicates by computer. Phones deserve much more attention and funding to match of course. Some practices are
better at this than others; it does not seem respectful to patients when they cannot even get a basic hearing on the phone.
It is really simple. The answer is money.
More money = more staff = more appointments
If there is no more money, then patients will just have to get used to a reduced service. Perhaps the NHS could cut other “less important” activity to pay for more GP availability.
Unfortunately if it was simple ‘just answer the phones in 10 minutes’ the practices would do this. Many things prevent this from happening.
– the shear volume of calls that varies , you can’t predict how many people to have in reception to man the phones on an hour to hour basis
– patient ring and spend 20 minutes chatting about their life stories to reception and will not stop
– patients ring for unnecessary issues we cannot solve- ‘I’m at the airport can you send me my Covid pass, can you tell me my NI number etc
switch ARRS money to practice budgets?
Allow practices (and PCNs) who know their patients and populations,
to decide on what staff they need and that may be more GPs!
or receptionists to answer phones.
The current scheme reduces patient satisfaction…
and assumes that people want to work at getting healthy…
a large part of the demand is ourselves booking things like annual medication rules (because we have always done it) and review and treatment of new groups being targeted by primary prevention initiatives eg blood pressure lowering (another national push is in full swing)
Although these are very worthwhile to do they mean we can’t see enough of those who think or are ill
if the ARRS fund allowed us to employ staff who can handle medication titration and monitoring eg nurses, HCAs etc we might have more of a chance or we are allowed to ditch this stuff in favour of being more available.
There are some choices that can be made that help or hinder but carry some consequences
we can’t do everything without more of us whatever the rhetoric
How about just looking after with what you have? Is it that hard?
Maybe, if you want corporates in.
Maybe actually asking working GPS for help in deciding what needs to be done would help !
Two big steps:
1 – Remove any non-essential string which is attached to funding. So keep a fee for vaccinations, but QOF IIF AARS and most enhanced services can just have a red line through them – add the funding to the capitation fee.
2 – Do something about home visiting and care homes, probably make it a commissioned service and those patients are removed from the GP system.
3 – Add more funding to the GP system. Do it through the capitation fee. If you have done 1 properly it will be less, but if you have not done 1 properly you will need to add more money to the system. You will know when you have the right amount of money when good practices stop enforcing their borders and keeping patients who move out of area – you will need to have done 2 properly to allow this.
4 – Do something about buildings. You can’t have the good practices not wanting to compete for patients because they do not have enough space. Practices demonstrating an increase in patient numbers should automatically be given the right to invest in their building area with rent reimbursement guaranteed from the NHSE. Alternatively link property funding to patient numbers with a guarantee to cover the current leases for their duration.
Let’s face it, the free system is not sustainable. Unlimited demands.
When demand exceeds capacity, delays will always happen
Either increase capacity or reduce/cap demand
Mark Cathcart
exactly – “tap and plug”. either you turn the tap off, or you pull the plug out.
hardly rocket science !