There was much fear that the GP recovery plan, published in May, was set to be a damp squib. And those fears were very much realised.
The plans set out how the Government plans to help general practice to survive with some key themes, some of which built upon those outlined in the GP contract that was imposed on the profession back in March. One such theme was around investment in IT to improve how patients access general practice.
Updated IT, the recovery plan said, should enable more patients to see their own records and messages, order repeat prescriptions and book appointments on the NHS app. The target is for patients at more than 90% of practices to be able to do this by March 2024.
Most notably, the plan outlined support for practices to upgrade antiquated analogue telephone systems to digital technologies by July, with funding to the tune of £240m to achieve that.
These improvements would mean patients calling in to their surgery would ‘never get engaged tones’ and could choose a call-back option.
Furthermore, under new triage proposals, practices should implement ‘Modern General Practice Access’ – with digital tools and training provided – so that 15-plus % of patients can be directed more appropriately, whether that be to community pharmacy, other local provisions, admin teams or self-care. Only in ‘exceptional circumstances’ should patients be directed to 111, NHS England said.
Straight away, it was easy to pick holes in the requirement for practices to improve access. However nice an extra £240m is, delving into the figures revealed that it is DHSC money being redirected from elsewhere.
Crucially, having more telephone lines and ways for patients to contact their practice adds to GPs’ already heavy workload.
Perhaps a glimmer of hope can be found in the recovery plan’s commitment to the Pharmacy First scheme. That could see more patients getting advice and treatment from community pharmacies instead of their GP.
Specifically, pharmacists will be able to provide prescription-only meds for seven common ailments, including UTIs, earache and sore throats, as well as oral contraception and blood pressure services.
According to NHS England, this is ‘expected to free up around 15 million GP appointments over the next two years for patients who need them most’.
ICBs were also tasked with implementing measures to improve self-referral pathways for musculoskeletal, audiology, podiatry and weight management services, as well as making it easier for opticians to send patients straight to ophthalmology, for example.
Elsewhere, the recovery plan looked at reducing workload GPs take on liaising with their hospital-based peers and cutting bureaucracy.
But as RCGP chair Professor Kamila Hawthorne pointed out, positive steps in supporting general practice falls far short of being the ‘silver bullet that [GPs] desperately need’. What good are all these initiatives when there are too few GPs to deal with all the work?
The recovery plan hinted at a few solutions, specifically aimed at new doctors entering the profession and experienced GPs leaving it.
First, it said, the DHSC will work with the Home Office to help remedy problems international graduates experience with securing visas. Together with more training places that were announced in the NHS workforce plan, this measure was touted as the route to boosting numbers of new doctors in general practice.
For GPs at the other end of their careers, the Government hopes that reforms to pension taxation, which were set out in the Spring Budget, will convince them to stay in practice.
All we need now is for patients to never be sick, and general practice will be well on its way to recovery.
“Continuity of care” is held to be a gold priority, except when patients can access Pharmacy First and see a totally different person for 7 ‘common ailments’ that can indicate significant pathology in a significant number of them; and also miss out on opportunistic contact and reviews….
Recovery! What an insult. Recovering from 13 years of mismanagement at best and likely deliberate sabotage. GP is being crippled by other parts of the NHS that can’t recover because they are moribund. Only GP is performing more with less resources and fewer senior people.
I agree with you Simon, GPs are performing above pre-Covid activity with a shrinking workforce & virtually every day I see or hear something suggesting we are somehow under-performing, and “recovery plan” implies the same. We do multiple extra consultations supporting people whose treatment is delayed and we do a great chunk of secondary care work when they discharge people early & leave the further investigation to us. When will our leadership counter this negative rhetoric?
Depressingly predictable piss poor offerings from a government that never had the first idea what meaningful “recovery” looks like.
Some free advice: Try funding the core service properly, then sit back and watch the “transformational improvements” that will miraculously deliver.
Well, you all know the answer———–strike