Our exclusive this morning, which revealed that the data used to identify the 20% ‘worst performing’ practices was based on a single month, shows up how pointless and unfair NHS England’s and the Government’s access plans really are.
Let’s for a moment take NHS England at its word and say that it really believes that access to some GP practices is affecting patient care. Does it look like they are serious about improving access to benefit patient care? Absolutely not.
First, they wouldn’t target a percentage of practices in every region. It is completely arbitrary to believe that patient care is being affected in 20% of practices in a region. What if that region had a high overall level of access? Or, to expand that, what if England has a generally high level of access?
If NHS England was serious, they would have specified the levels of access that practices should be providing, which – as horrific as it would be – at least has some rationale, and would give practices something to aim for. Along the same lines, their actual strategy leads to perpetual ‘underperformance’ – there will always be a bottom 20%, however you define this.
Second, if they were serious, they would scrap the idea of publishing practice-by-practice level data on access. The health secretary claims these are not ‘league tables’, but this is semantics. Any regional newspaper editor worth their salt would publish this data as a league table as soon as it is released, gleefully proclaiming the best and worst practices on its patch. This won’t help improve patient care, it’ll just shame those who are struggling most, usually through no fault of their own, or simply reflecting the wishes of their patients.’
And finally, if the NHS was serious about access, they would use robust data, looking at trends stretching back months and years. Yet, as our exclusive today revealed, they are doing nothing of the sort. They are looking at a single month of experimental data, and August no less, a month that is most likely to be an outlier due to falling completely in the school holidays. This data will tell you nothing.
I still believe that the case linking access – either face to face or general availability of appointments – to patient outcomes hasn’t been made, and certainly not when accounting for factors such as demography or deprivation.
But even if someone was to establish a link, this strategy would do nothing to address it.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at firstname.lastname@example.org