GPs and patients want honesty not games
The BMA launched its campaign #NoMoreGames last week, calling for an open and honest public debate about securing the future of the NHS.
This comes at a time when all political parties are jockeying for support in the forthcoming general election.
GPs are utterly fed up with political propaganda from all parties, bearing no resemblance to the harsh reality we and our patients face daily.
It’s no surprise that a recent Ipsos MORI poll shows that 77 per cent of the population believe political parties design health policies to win votes rather than basing them on what is best for the NHS.
This has led to widespread cynicism and is seriously undermining public confidence in the responsible use of their hard-earned contribution to the NHS via taxation.
Perhaps the biggest game of all was the pretence that the Health and Social Care Act would ‘free the NHS from political interference’.
There is an endless list of political games that affect general practice but notable examples include:
Promises to somehow magic up several thousand more GPs, while the reality shows worsening recruitment and an impending escalation of early retirements
Pledges of routine GP seven-day opening, or offering appointments within 48 hours, when we don’t have enough GPs to provide core general practice or the appointments for patients to be routinely seen in two weeks in many cases
Blaming GPs for patients turning up for emergency care – totally ignoring the elephant in the room, ie, the impact of NHS 111
Creating political targets merely to generate headlines, such as paying GPs to increase dementia diagnosis rates, rather than focusing on the needs of those suffering with dementia and their carers
Claiming to have learnt the lessons of the Francis report, yet expecting GPs to work in ways that compromise patient safety.
The BMA GPs committee will use this campaign to expose – and step up the pressure to end – the games affecting general practice.
The public deserves political honesty regarding funding and pressures on the NHS and what can be provided by this finite resource, so that money is spent on the needs of patients rather than political whim.
Get involved with #NoMoreGames and download campaign materials
NHS England finally agrees NHS 111 centres need GPs
GPC has long argued that urgent care call-handling needs senior clinician presence and input.
This is drawn from the experience of effective GP OOH (out-of-hours) providers, and is the reason we have always opposed NHS 111’s reliance on computer algorithmic advice by non-clinical staff.
A recent BMA analysis showed that in addition to escalation in ambulance dispositions and referrals to emergency care, NHS 111 also referred more than five million patients last year to general practice.
We know a sizeable number of these to be inappropriate, blocking GP appointments and reducing ill patients’ access.
A recent letter from NHS England to all commissioners in England now recommends GP presence or advice at NHS 111 sites, admitting it would reduce ambulance dispositions and emergency department attendances.
It is unfortunate that NHS England has taken so long to acknowledge the self-evident benefit of clinician triage, the lack of which has, since the inception of NHS 111, resulted in millions of patients receiving suboptimal advice and management.
GPC also believes that NHS 111 should cease being a stand-alone call-handling service, but should instead be integrated within a wider urgent care pathway to include GP OOH providers. This would bring together the range of unscheduled care services that are duplicating provision and confusing patients.
Indemnity subsidy for GPs working OOH sessions
GPC has actively highlighted the substantial increase in indemnity costs for GPs working in OOH settings, which is a financial penalty that puts off many GPs from working OOH sessions.
This comes at a time of severe shortages of GPs and consequent gaps in OOH rotas in some parts of the country.
It is therefore welcome that NHS England has listened to our concerns and in the sameNHS 111 letter has announced it is developing a scheme with the main medical defence organisations whereby GPs who commit to new or additional sessions in NHS 111 and OOH care providers will have any additional costs reimbursed.
The scheme will initially be a pilot, but we are vigorously arguing that this needs to be a permanent arrangement if we are to secure GPs willing and able to work out of hours.
We will let you know when we have further details.
Finally, don’t miss the latest news from GPC
With best wishes,
BMA GPs committee chair
GP networks guidance
The BMA GPs committee is continuing actively to engage in the development of GP networks (also known as GP federations).
As a part of that programme of activity, GPC launched guidance covering the different legal forms these networks can adopt.
Additional guidance, including key steps to setting up a GP network, is being developed and will be launched soon.
The BMA GPs committee is holding a series of roadshows around England, organised through local medical committees, starting on 3 March.
These are an opportunity to hear from one of the GPC executive team about issues affecting general practice and to discuss them.
Find out dates and venues – GPs are encouraged to attend.
Wanted: regional representatives and a prison representative
The BMA GPs committee represents all UK GPs: partners and sessional, GMS and PMS, men and women, whether members of the BMA or not.
It is important that the composition of the committee reflects the diversity and all the interests of the profession.
To achieve this, the more doctors standing for election to GPC seats, the better.
GPC is holding elections now for regional representatives in 14 different constituencies.
GPC is also looking for a GP who provides NHS primary care in prisons and other secure environments to represent other GPs who work in similar settings.
GPC’s remit covers all the areas of work affecting all GPs. GPs who want to change things need to get in there and do something about it.
Anyone even vaguely considering election is urged to find out more on the BMA websiteor contact Holly Higgs for more details.
Deadline for nominations for regional representatives: 5 March, 2015
Deadline for nominations for a prison GP representative: 12 March, 2015.
GPC in the media
We continue to publicise the workload pressures on GPs and the messages of our workload management paper Quality First.
I was quoted in GP magazine on its survey highlighting the millions of pounds of unfunded additional work GPs are carrying out for free.
BMA GPs committee deputy chair Richard Vautrey has written an article on how practices can safely drop unresourced services.
We once again highlighted the ‘financial cliff edge’ facing practices suffering significant minimum practice income guarantee losses, and have issued a press release on upcoming urgent talks with NHS England for a transparent and fair process for eligible practices to receive reprieve funding. This story was picked up in Pulse and GP magazine.
A story on so-called ‘sick-note culture’, with comments from Dr Vautrey, made the front page of The Times and featured prominently in the Daily Mail, Daily Telegraph, Daily Star and on BBC Radio 4 and LBC radio.
As part of the BMA’s a day in the life of a GP series, BMA equality and inclusion committee chair Krishna Kasaraneni was the focus in an article by the Guardian’s Polly Toynbee, looking at the pressures in the NHS.
The story was quickly followed up by the Daily Mail, who focused on how pressures are affecting general practice, with additional coverage in Pulse.
In other day in the life activity, Shropshire GPC representative Mary McCarthy is continuing her weekly articles for the Shropshire Star and Dr Kasaraneni was also interviewed and profiled by BBC Look North and BBC Radio Sheffield.
Elsewhere, Dr Vautrey and Doncaster LMC medical secretary Dean Eggitt were interview by ITV Calendar as part of a package looking at GP pressures and the BMA’s#NoMoreGames campaign.
Dr Vautrey was also interviewed by BBC Look East and BBC Radio Northampton on the issue of GPs closing their lists and in the Independent on Sunday about the NHS trying to attract GPs back from working abroad, and I was featured in the Lancashire Evening Telegraph as part of a story looking at GP recruitment.