2022 in review: Thérèse Coffey’s plan for the NHS

Like most of the population, at Pulse Towers we’ve had trouble keeping up with the turnover of bosses at the health department.

In September, Thérèse Coffey became the latest MP to have a go at steering the ship. Although she managed just seven weeks at the helm, she certainly made waves in that time.

A few weeks into her tenure Coffey unveiled what was simply titled ‘Our plan for patients’; in it, some pledges to improve access to primary care and therefore impacting GPs.

First up, she implored GPs to provide appointments within two weeks for ‘everyone who needs one’. It seems she hadn’t got the memo from NHS Digital, whose latest data showed that this target was already being achieved 85% of the time.

There was also no detail as to what measures practices would face if they failed to hit the mark.

The implication was that patients would up sticks and sign up with a different GP, able to choose which one based on practice-level appointment data.

Obviously, this could create longer waiting lists at the receiving practice.

It’s unlikely the additional 31,000 telephone lines Coffey pledged for general practice from January 2023 will help, either, without the extra reception staff to man the phones and clinicians to provide the consultations.

Perhaps Coffey’s resolve to make more than a million extra appointments available by funding different types of staff to work in general practice will plug some of the gap.

Again, the devil was in the conspicuously absent detail. Hints abound of the advanced nurse practitioners GPs are calling out for, but no certainty over if or when they would be made available.

Instead, the DHSC told Pulse, the non-GP staff will be more of the ilk of GP assistants and ‘digital transformation leads’, whatever they are. And so far, the extra workforce brought in under the ARRS is of limited value.  

However, the plan included a move to enhance the role of community pharmacy to take on some patient appointments and prescribe and supply more medications. 

In reality, it seems this will be in the form of a contraception service from 11 January, so unlikely to free up the two million GP appointments the DHSC told Pulse it has the potential to do.

Next up in the grand plan was a promise to remove inflation-related pension tax to keep experienced, senior GPs from leaving the profession.

But this pledge was little more than a ‘sticking plaster’ solution, according to the BMA.

Finally, Coffey outlined that the NHS locally – namely, integrated care boards (ICBs) – would be expected to ‘intervene where services need to be improved’.

Yet again the plan was bereft of any clarity on what this means and how it will work, but essentially, it demonstrated a lack of understanding of the role of ICBs and of general practice more generally.

In their very nature ICBs are not as local as the CCGs they replace, so they may not have the eyes on the ground to know what services are struggling, nor the capacity to manage them.

As a result, GPs are concerned these supposed interventions will be punitive in nature.

All told, Therese Coffey, like many health secretaries before her, looked like being a thorn in the side of GPs before the latest Cabinet shakeup put her in charge of the environment portfolio instead.

Will her successor, Steve Barclay, fare any better in understanding and providing what general practice needs? Don’t bank on it.

Worst ways, if the government’s various strategies to boost GP numbers don’t bear fruit, you could always ask the chiropractors to step in.