BMA pushing back against ‘endless’ access targets, says GP leader
The BMA’s GP committee is continuing to push for safeguards against ‘endless’ access targets, the leader of English GPs said, after she revealed NHS England had proposed a ‘mini QOF’ of access metrics as part of this year’s contract consultation.
In an update to LMC representatives at their conference in Belfast, GPC chair Dr Katie Bramall said the committee was having conversations with the Government pushing for safeguards around unlimited access.
It comes as the union is currently coordinating GP collective action in protest against this year’s GP contract, which could escalate as of next month should the Government fail to provide ‘sufficient concessions’ and put safeguards in place around unlimited access.
Dr Bramall revealed that NHS England had proposed to use money from the PCN Capacity and Access Payment (CAP) to fund a series of access incentives. Following the contract consultation, the money was instead repurposed to fund a new practice-level reimbursement scheme which will only cover salaried GPs.
‘What they offered, what they proposed, was a whole mini QOF of endless access metrics, whereas we felt investing in more GPs in perpetuity was the best use for this funding,’ Dr Bramall said.
She added: ‘The conversations we’re having right now with Government are the same conversations we were trying to have 12 months ago around “okay, if you’re going to insist on online consults, how is that going to work safely?”’
On the contract proposals involving repurposing CAP funding, she said: ‘CAP was going, end of. The reason it was going was because the neighbourhood teams [at NHS England] were eyeing it up as a way of putting some money into these novel contract mechanisms. They’ve got no idea what they are or what they’re going to do, or how they’re going to pay for it.’
She said that the Government’s approach around neighbourhood health ‘sets out its current focus of working around the medical profession rather than with it’.
Dr Bramall added: ‘There is no intent to engage GPs or work with us to guarantee that we’re a key part of this agenda. And there’s nothing here that’s going to make general practice sustainable. It’s just a set of unrealistic targets and expectations.’
At the conference, LMC leaders called on all UK governments to ‘pause and re-evaluate’ their policies on unlimited GP access, as they create an environment for ‘clinician burnout and unsafe practice’.
They also demanded that Governments ensure any advice and guidance (A&G) systems ‘are optional’ and do not delay access to clinical care.
On the new A&G requirements set out in the contract, Dr Bramall reassured GPs that there will be ‘a clear route to referral’, and that the BMA and RCGP joint IT committee is going to be involved in shaping a new electronic referral system software.
She said: ‘The decision to refer is going to remain with a GP based on their clinical judgment. If a GP believes a referral is clinically necessary, there will be a clear route to referral.
‘There will be no national target around reducing referrals at all. They’ve been completely scrapped. There will be a named consultant response on advice and guidance.
‘The joint GP IT committee are going to be involved in what the new electronic referral system software looks like and how it’s going to function more like a messaging app for a patient, so that you’ll keep that continuity between the GP and the specialist where you’ve got the need for tests or investigations.’
Pulse has contacted NHS England for comment.
As part of collective action which started at the beginning of the month, GPs should notify their ICB that they are stopping voluntarily sharing data using a template letter provided by the union’s GP committee.
The Government remains in discussions with the GPC, as it said that collective action will have ‘no impact’.
