In 2020, the BMA’s GP Committee will reach down the back of the sofa and discover a lever. It’s not the mechanism for bringing up the footrest for them to rest their weary pedicles, but for exerting leverage upon NHS Employers.
And for once, they’ll use that leverage to negotiate meaningful changes to the General Medical Services contract in England and deliver what GPs are requesting – something that will utterly change general practice for the better.
Home visits will be removed from the GMS contract and responsibility for housebound patients will be transferred to the CCG, joining out-of-hours care, which was transferred in the new contract of 2004.
Thanks to the ‘lever’, GMS income won’t be decreased, but the BMA GPs Committee won’t reveal how it exerted its leverage, as it never reveal details of its negotiations with NHS Employers.
Instead, NHS England will brief the medical press in hushed whispers, confiding: ‘Well, you think this is bad? If only I could tell you what the starting negotiating position was of these bloody GPs…’
All 6,000 of the new GPs must complete at least four sessions a week for ‘UberDoc’
One solution that CCGs will come up with is to contract home visiting to a transformative vanguard digital platform pilot solution, an amalgamation of two digital champions creating ‘UberPushDoc’, or perhaps simply ‘UberDoc’. Housebound patients will be able to download an app, as it’s well-known that all frail and/or elderly patients are at the cutting edge of technology. They’ll need to register at Daffodil Road Surgery in Hammersmith, facilitated through a portal.
Then, the app will show them the number of doctors circulating in their cars. Those on an ‘UberDoc Gold’ scheme can choose a visiting GP who comes with a chaperone, functioning sats machine and blood pressure machine with a choice of cuffs.
The ‘UberDoc Gold’ will eventually travel in driverless cars that simply navigate between patients who request visits. The ‘UberDoc Silver’ service, meanwhile, will entail doctors travelling alone, armed only with printouts of patient records.
The Bronze level will be provided by Uber taxi drivers 24/7.
All 6,000 of the new GPs entering, remaining in or returning to our workforce must complete at least four sessions a week for ‘UberDoc’. If successful, this service could replace surgery-based general practice by 2025.
Dr Samir Dawlatly is a GP in Birmingham