BMA moves to vote on GP contract protest

Doctors may limit their daily appointments to 25 as part of protest action against this year’s contract.

The BMA has launched a ballot which will involve GP partners and contractors. The BMA says initial action will not involve breaching the NHS England contract – but doctors would stop or reduce work that’s not formally in the contract. This could involve refusing to write fit notes and sending prescriptions and investigations back to hospitals when the hospital has asked the practice to organise them.

Dr Katie Bramall-Stainer, Chair of the BMA’s GP Committee for England, said: “The care GPs want to provide, and the services patients want to receive are the same. GP services have been eroded to the tune of hundreds of millions of pounds in recent years, with over a thousand practices lost across England. There is funding but practices are forbidden from using it to hire more GPs and more practice nurses, which is just crazy given the patient experience in trying to see their family doctor.”

New guidance on associate supervision

Physician associates working in practices should always be supervised by fully trained GPs, according to new BMA guidance. The guidance says that the supervising doctor should be reachable throughout an associate’s shift. It represents the latest move by medical organisations to ensure that associates do not become confused with doctors. The guidance says that both the associate and the GP should have adequate time every day to discuss and review cases. There should also be appropriate indemnity.

BMA Chair, Professor Phil Banfield, said: “This is the first time such clear guidance has been produced for the NHS and for doctors, and the BMA is once again filling the void left by others by providing a straightforward set of recommendations that can be implemented locally so that doctors and employers are clear about their responsibilities.”

Patient representatives call for new practice access rights

According to Healthwatch England, the public overwhelmingly wants the right to have an urgent GP appointment within 24 hours of requesting it. Healthwatch says the existing constitution offers no minimum expectations on what primary care should deliver.

In a poll, it found widespread backing for flexibility over appointments. 68% wanted the right to choose the way in which they book a practice appointment, while 65% wanted to choose the type of appointment they have – whether face to face, on the phone or online. Healthwatch, a publicly funded agency representing patient interests, now wants these rights included in a new NHS Patient Promise.

NHS should improve practices in poorest areas

New proposals to improve access in deprived areas have been compiled by The Health Foundation working with the Royal College of GPs, the primary care network of the NHS Confederation and the National Voices. The organisations want improved funding for practices in the poorest areas together with projects to encourage GPs to work in these areas, especially when they have a shortage of doctors. Writing to the Department of Health and Social Care, the organisations say the poorest areas have 14.4% more patients per GP than the rest of the country while they receive 7% less funding than would be expected for the extra needs of their populations.

Dr Becks Fisher, senior policy fellow at The Health Foundation, said: “For almost 20 years policymakers have known that the funding formula for general practice directs money to richer over poorer areas. If government is serious about tackling health inequalities this must change.”

Campaign to reduce missed appointments in Wales

Ken Skates, a member of the Welsh Senedd, representing Clwyd South, collected details of missed appointments from his local practices, and found that at least 13,000 were missed in the last year. He received data from half the local practices.

One Practice Manager said: “DNAs are an increasing problem. Our rates have never been so high. It’s frustrating that we can’t take any real action against those who repeatedly do not attend.”

Mr Skates told the Wrexham Leader: “If we take the average appointment as being 15 minutes, we are talking thousands of hours lost in Clwyd South. Those are hours that GP and primary care staff won’t get back where they could be helping other people.”