GPs are giving up on attempts to join NHS 111’s Covid clinical assessment service (CCAS) due to ‘bureaucracy and hurdles’ in the onboarding process, Pulse has learned.
Many who have been successful in getting signed up have had to wait around a month to get started, Pulse understands.
The CCAS, which is supported by Capita, is staffed by clinicians to further triage Covid-19 patients after the NHS 111 algorithm has been unable to determine whether or not they need hospital admission.
A spokesperson for NHS England said ‘it’s only right’ that all GPs undergo the ‘necessary’ legal and regulatory checks to ensure patient safety.
According to the BMA, NHS England needs to recruit around 1,000 GPs to support the service – but at the last count only around 700 had been onboarded.
BMA sessional GP Committee chair Dr Ben Molyneux told Pulse that there is a ‘big attrition rate’ during what is on average a month’s wait to get set up.
He said: ‘There are seven separate agencies required to get you from expressing an interest to doing your first session and on average it appears to be taking about a month.
‘I know a lot of locums personally who signed up and gave up because it wasn’t worth their time and have ended up working in hot hubs for example or hubs generally because localities can work more quickly.’
Locum GPs who are currently seeing less work in-hours in practices are struggling to sign up for CCAS work ‘through a combination of a lack of IT and difficulty accessing the work itself ’, Dr Molyneux added.
One locum GP, who wished to remain anonymous, told Pulse that it took almost six weeks to ‘overcome all the bureaucracy and hurdles’ and get started at the CCAS.
The various steps included mandatory training for ‘returning doctors’, ‘irrelevant’ training modules such as one on how to don PPE and ‘insufficiently clear instructions’, they added.
They also faced ‘numerous’ IT difficulties and ‘frustrating waits for replies to emails seeking guidance’, they said.
Although they were eventually successful in getting signed up, they told Pulse that worrying about being able to assess how ill patients were remotely made their first session ‘very stressful’.
Locum GP Dr David Church, who is based in Wales, told Pulse he has been unable to sign up to work CCAS shifts because many questions over locum arrangements remain unanswered.
Payments for time over and above GMS commitments are made directly to practices, rather than GPs, making it difficult for locums, he said.
And it is unclear whether GPs on the Welsh providers’ list are eligible to work for the service, which is based in England, he added.
He said: ‘These doctors – experienced in GP, telephone consultation and working in different situations by virtue of our day job – are a lost opportunity for CCAS, who seem only interested in England.’
Dr Church added: ‘I think it is too late to bother now. The gap between starting lockdown/cancelling routine sessions and the ‘peak’ of Covid arriving and making me busy again – the window of opportunity for doing sessions of telephone support – is rapidly shrinking.’
Colleagues from the National Association of Sessional GPs are finding that the CCAS ‘does not appear to want them’, he said.
NHS England only recently confirmed that locums are eligible to work for the CCAS in a webinar, but retired doctors – who were those originally asked to staff it – have not been immune to difficulties with signing up.
Dr Tessa Barton, a retired GP from Devon, told Pulse she and her husband were both ‘close to giving up’ on their own attempts to join after ‘going around in circles’.
Neither have yet had a shift at the CCAS, despite starting the process about seven weeks ago in mid-March, she said.
After making a complaint about the ‘very frustrating’ process, she received a ‘very apologetic’ reply from NHS England, she added.
Retired Northamptonshire GP Dr Hadrian Moss said he also ‘nearly gave up more than once’ after delays getting signed up.
In a GP webinar last Thursday, NHS England director of primary care strategy Ed Waller clarified that CCAS participation is open to locums as well as retired doctors and that so far over 700 GPs had been onboarded to the service.
He added: ‘If you are waiting to be onboarded to that service – please stick with us, we do still need you. Sorry for any delay if you’ve experienced it’.
An NHS England spokesperson said: ’It’s only right that every GP undertakes the necessary legal and regulatory checks to ensure patients are safe, and most importantly over 38,000 patients have got help from the CCAS already.’
Capita, whose PCSE arm is involved some of the administrative checks such as vetting all NHS returners and putting GPs onto the providers’ list on behalf of NHS England, declined to comment.
It comes as doctor-led tech firm Credentially signed up 3,000 GPs to the CCAS in a week after being brought in to help streamline the onboarding process.
NHS England recruited Credentially to automate the CCAS sign-up and verification process after registering hundreds of GP volunteers to NHS 111 as part of a grassroots scheme led by GP Dr Simon Hodes.