NHS England has said GPs are delivering ‘well beyond’ pre-pandemic activity levels and are busier than ever – at the same time as it prepares to introduce a target on GP appointments.
NHSE chief operating officer Amanda Pritchard and national director for primary care Ian Dodge made the comments the same day NHS England published a new set of metrics aimed at ensuring GP practices deliver appointments ‘at or above’ pre-pandemic levels in 2021/22.
Speaking at an NHS England board meeting on 24 June, Ms Pritchard said the body owed a ‘really big thank you’ to those working in primary care who are ‘working at an astonishing rate at the moment’.
She added that primary care staff ‘are working now well beyond pre-Covid levels of activity’, including their ‘significant contribution’ to the vaccination programme as well as sitting ‘at the heart of’ recovering elective care, prevention, supporting those with chronic conditions and preventing demand reaching urgent and emergency care.
Ms Pritchard also commended the ‘really excellent work’ done by primary and community care staff in keeping people ‘well looked after out of hospitals’ amid ‘comparatively low levels’ of Covid-related hospitalisations.
However, she added that NHS England must ‘keep a very close eye on [this] over the course of the next few weeks and months to make sure that the NHS is as resilient as we need it to be’.
Mr Dodge later added that ‘it has never been busier’ in general practice. He said: ‘Our colleagues in general practice have been working incredibly hard on the vaccination programme, continuing to offer urgent care and access through a variety of different modalities and now focussing on the backlog of chronic disease management as well as other preventative services.’
He added that while PCNs had successfully hired 9,100 full-time equivalent staff under the additional roles scheme ‘ahead of schedule’ by the end of March last year, general practice ‘will need all the capacity we can get’.
But NHS England documents published on the same day said that practices will be assessed by ICSs – which are due to take over from CCGs from April 2022 – on the number of available GP appointments and access to remote consultations.
They set out a target for ‘all general practices to be delivering at, or above, pre-pandemic appointment levels, including through consolidating and maximising the use of digital consultation methods and technology’ in 2021/22.
In its latest GP Committee bulletin, the BMA said it was ‘pleased to hear some acknowledgement and praise for the significant activity and related workload pressures in general practice in the NHSE/Improvement board meeting’.
However, it condemned the new target, saying that the goal should be for GPs to do ‘fewer not more appointments’ and called for the metric to be replaced with one on GP recruitment.
It said: ‘As we’ve repeatedly highlighted, the Government and NHSE/I are failing abysmally to deliver on another Government commitment of an increase in 6,000 GPs.
‘If they were serious about both improving the workforce’s wellbeing and the quality of care for patients, they’d be setting this as the metric for general practice, not the narrow and misguided focus on appointment numbers.’
It added: ‘This is their target, not ours, and whilst including the appointments done by the additional PCN-related workforce will mean this is delivered, what we all know is needed is for individual workload pressures to be reduced, and rather than suggesting we all work harder the goal should be for GPs to do fewer not more appointments.
‘Given the current state of general practice, with workload and appointments being at an all-time high, the impact of the ongoing respiratory epidemic across the country, alongside rising Covid cases, NHS care backlog and other patients who have not come forward during the pandemic now coming forward, we would again advise practices to meet the reasonable needs of their patients in line with their contracts.’
It comes as the latest GP appointment figures demonstrated the ‘immense pressures’ GP practices are under, with practices in England carrying out 31.5 million recorded patient appointments in April.
Meanwhile, the BMA has met with a health minister to call for a further delay to the introduction of new primary care network (PCN) services that are due to begin from this autumn, citing the additional workload pressures they will bring.
NHS England issued guidance to practices in May that said GPs’ patients should be offered face-to-face appointments if that is their preference. The advice was contradicted by Public Health England guidance published around the same time that stated GP practices should use virtual consultation ‘where possible’.