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BMA call to arms on GP appointment time cuts

By Ian Quinn

Exclusive: The BMA has called a crisis rally of doctors to protest against a series of dramatic cuts proposed by NHS managers, including a ‘bombshell' plan to reduce the length of GP consultations by a third.

GP leaders hope for an ‘enormous turnout' at a meeting next month at BMA headquarters, to co-ordinate protests at proposals that also involve closing hospitals, cancelling follow-ups and shifting a huge volume of work to primary care.

Plans by NHS London for a series of budget cuts, following advice from consultancy McKinsey, were uncovered by doctors' leaders last week. They come as SHAs across the country draw up proposals for ‘efficiency savings' of £2.3bn in 2010/11 and up to £20bn by 2013/14.

BMA leaders warned GP services were plunging towards ‘financial meltdown', with the NHS London plans including what managers admit are ‘radical measures' to get GPs to see more patients by cutting appointment times by 33%.

Documents also reveal proposals to cut the number of patients going to hospital A&E departments by 60% and those going to outpatients by 55%, with hospitals facing closure.

SHAs have until March to draw up plans for ‘rigorous' efficiency savings on the back of the Government's operating framework and pre-Budget report.

NHS East of England's report, obtained by Pulse, proposes cuts to A&E admissions and savings of up to £27m by cancelling outpatient follow-ups, claiming: ‘There are many more outpatient follow-ups being carried out than is clinically necessary.'

It also plans to save millions by reviewing GP contracts, with every practice to be given a balanced scorecard by April 2010.

But the SHA appeared to rule out following NHS London in reducing the length of GP appointments, saying: ‘PCTs need to ensure sufficient capacity exists in primary care. It would be counterproductive if GPs couldn't cope and patients returned to the acute setting.'

Dr Kevin O'Kane, chair of the BMA's London regional council, said NHS London had refused Freedom of Information Act requests to release a report provided for it by McKinsey: ‘Having made this bombshell decision [to cut appointment lengths], NHS London has produced not a scrap of evidence to support it.'

He appealed for GPs and hospital doctors to attend the protest rally on 25 February.

Dr Siân Knight, a GP in Lewisham, south-east London, said the plans were disastrous: ‘Reducing appointment times by a third will only escalate referrals, increase prescribing and reduce opportunity for early intervention in preventable diseases. GPs will no longer have the time to listen effectively and diagnose accurately. It will make general practice not only unsafe but also unworkable.'

But Sam Higginson, NHS London's assistant director of strategy, defended its plans, which he said had their origins in Lord Darzi's report on the capital's healthcare in 2007.

He said: ‘Since the report was published, the recession has increased the urgency for change. No change will lead to the death of the NHS in London by a thousand cuts. It is not an option.'

It's unclear exactly how NHS London proposes to shorten GP appointments, although PCTs can set contract targets on the number of consultations a day.

Dr Sian Knight: cutting appointment times will make general practice not only unsafe but unworkable