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NHSE primary care director sorry for ‘hurt’ caused by GP letter

NHS England’s medical director for primary care Dr Nikki Kanani has tweeted in response to a storm of criticism against a letter reminding GPs to offer face-to-face appointments, apologising for any ‘hurt’ caused.

The letter, signed by herself and NHS England primary care strategy and contracts director Ed Waller, was sent out yesterday to GP practices across England, reminding them to offer face-to-face appointments to patients where necessary and including a toolkit to help clarify patient communication to make it clear they can still be seen in person where necessary.

But it was also highlighted to newspapers in advance by NHS England’s press office – leading to widespread coverage including being the lead story in Monday’s  Telegraph,  which claimed GPs had been ‘warned’ they must offer face-to-face appointments.

GPs, including the RCGP, called the letter ‘insulting’ in the face of the massive effort by practices to adapt to the Covid-19 pandemic. Many highlighted how they have continued to see patients where necessary, despite problems with accessing PPE.

In a tweet this morning, Dr Kanani responded to the criticism by saying that she is ‘so proud’ of general practice, and apologising for any ‘hurt’ caused by the letter.

She concluded that she is ‘grateful’ for the ‘incredible work’ by GPs through the pandemic.

Meanwhile, some doctors spoke out in defence of Dr Kanani, against some reactions which had focused on her personally rather than the content of the letter.

Meanwhile, the fallout continued, with BMA council chair Dr Chaand Nagpaul referring to the letter and communications in today’s opening speech to the BMA’s annual representatives meeting.

He said: ‘It’s an affront to hardworking GPs in England to imply they’ve shirked their responsibility to offer face-to-face appointments, when NHS England itself clearly directed GPs in April to provide online, telephone and video consultations and avoid face-to-face appointments unless absolutely necessary. This also flies in the face of the secretary of state’s own pronouncement on the July of 30th that GP appointments should be remote by default.

‘GPs, like hospital doctors, have worked flat out providing millions of appointments, including face-to-face, throughout the pandemic. They’ve responsibly followed instructions to prevent the spread of a deadly virus by limiting unnecessary contact between vulnerable patients and those who may be infectious mixing in the confined space of a waiting room.’]

NHS England’s press office did not respond to a request for comment.



Please note, only GPs are permitted to add comments to articles

Anonymous 16 September, 2020 4:23 pm

The damage has been done, duplicity or incompetent take your pick

Reply moderated
Anonymous 16 September, 2020 4:55 pm

Phenomenal and unique sign of the times :
(1) At any other point of time in history, this row would simply represent either a storm in a teacup or a story of penance( remember who famously used this word?) GP usually ‘deserved’ . I totally take the argument that some patients suffered finding it really difficult to access our services during last 6 months . There were clearly circumstantial reasons , strongly related to Covid 19, behind these difficulties . But the fact some patients having such difficulties is never the same as ‘GP surgeries are closed ‘ . In fact , closure is equating to a breach of GP contract which is always punishable. But having an alternative arrangement due to circumstantial obstacles needs to be accommodated by the system and its hierarchy . In fact , it has the responsibility to help struggling practices ,especially during the peak of Covid 19 ,to communicate properly with patients so that they understand and know how to access the alternative arrangement. Each individual case should be supported after discerning the facts . I did not see that from the government and NHS England .
(2) Of course , patients then complained as well as spreading ‘rumours’ . The top down technocratic recommendation was providing us an one-size-fits-all ‘communication toolkit’ . This is much far from supporting GPs .
(3) NHSE also ‘reminded’ us that face to face consultation remains available when clinically appropriate. This is fine at any other time and circumstances although ,to me ,it is just telling me that my mother is a woman and my father is a man !
Problem is the current relationship between GPs and the government, hence NHSE , is bottom low . There is very little trust left between . The plight of all frontline clinical staff working with least amount of protection undercut loyalty and faith towards the system . What was left to drive them forward was purely primal professional code . I am not so sure that NHS England recognised that .
Ultimately , yes , this reminder is an ‘insult’ against this backdrop (it is rare that even pro-establishment body like the Royal College of GPs would use word like that ).

Nikita , during the first painful 3 months of the pandemic, my simple message to my colleagues(particularly PCN) in practices was :(1) Cut the red tape (2) Improvise with full flexibility (3) Last certainly not the least , listen carefully to the feelings of all frontline colleagues.
I don’t think NHS England showed any sign of these .
While I would never condone any personal attacks on you , politics is perhaps not something you are cut out for ( just like many doctors and nurses) . I think you are the one being ‘hurt’ in here .
After all , politics is merely a medium to expose the dark side of human nature . Every time you ‘signed’ something , you might have become the no-man of the no-man’s land.
Live long and prosper……….

Reply moderated
Anonymous 16 September, 2020 4:56 pm

Vinci Ho

Anonymous 16 September, 2020 4:58 pm

Empty words. It was sent to the right wing press before being sent to GPs. They must have known full well what would happen. I’m not a press officer, but a letter along the lines of “Thankyou for continuing to see patients face to face throughout this pandemic. Here is a toolkit which you may find useful to reassure your patients that you have been open and available to them throughout the pandemic and will continue to be”, would have set an entirely different tone. This was deliberate – noone is that incompetent.

Anonymous 16 September, 2020 7:48 pm

Sorry is not enough to resign would be good
walk the talk.

Anonymous 17 September, 2020 1:27 am

If the signatories to the letter from NHS England knew about the timing of the highlighting to the newspapers they should resign -because of the hurt caused
If the signatories didn’t know about the timing of the highlighting they should resign -in protest at the politicising of their letter .
They should have known that anything goes to keep the Covid testing fiasco out of the headlines …
A tweet to say sorry doesnt really cut it compared to Mondays headlines !
Very sad that the rounds of applause have now been replaced by two fingered salutes!

Anonymous 17 September, 2020 9:15 am

This is the world we live in.
She should resign.
She is out of her depth.

And since when was she ‘the UKs top GP’?

Then you wonder why folk are emigrating and dont want to be part of the ar’see geepee brigade.

Anonymous 18 September, 2020 3:45 am

Apologising for the hurt caused rather than apologising for putting general practice under the bus again for political expediency. I love it. It’s a good job GPs love being patronised.

Richard Greenway 30 September, 2020 2:15 pm

The NHSE letter was disgraceful in many ways. Relations between GPs and the pubic have been good throughout Covid, and we have been there for patients.

The letter created an unwarranted press storm indicating there was a problem -that we weren’t seeing patients, and set the profession up for direct criticism. This simply wasn’t a problem that needed solving. We have been seeing patients throughout, with inadequate PPE, no access to testing for staff or patients when we needed it, dealing with uncertainty – and this the thanks we get!

It undermined our professionalism -suggesting that patient had a “right” to be seen based on demand, whereas in reality the decision to have a f2f is based on clinical assessment (“need”).

These toolkits treat us and the public like fools. Patients know how to contact us by phone or through our websites -give them and us some credit.

Next time I get a letter from NHSE -I know where its going.