Contract proposal would mean “awful choices”

The BMA is planning a referendum of GPs if the Government sticks to the proposed 1.9% contract increase. BMA leaders say they will continue talks throughout this month to seek improvements.

Practices are desperately worried about their finances, even before they face a below inflation increase in contract payments, GPs have warned.

A new survey of practices, undertaken by the BMA, found that 67% reported serious cashflow problems in the last year. A similar proportion (64%) warned that continuing inflation could have an impact on the stability of the practice.

Dr Katie Bramall-Stainer, Chair of the BMA’s GP Committee for England, said: “We have seen over 1,000 practices close since 2015, and with them the exodus of thousands more GPs from NHS roles, whilst patient numbers have risen by over six million. The current offer means that practices will not be able to break even and will face awful choices over staff redundancies and service delivery.”

GPs express concerns about online patient access to medical records

According to a survey of family doctors in England, giving patients online access to their medical records will increase GP workloads and open the door to litigation.

The survey, led by Uppsala University, Sweden, received responses from 400 GPs, of whom 33% felt that having online record access (ORA) was a good idea. However, 91% believed that providing ORA would lead to more worries among patients, and 85% believed patients are likely to find their records confusing rather than helpful.

Respondents also reported concerns about an increase in workload and potential litigation, with 89% believing they will, or already do, spend more time addressing patients’ questions outside consultations as a result.

GP concern at physician associate roles

In a recent BMA survey, just 12% of doctors said that having physician associates in general practice improved their job role, while 60% alleged that associates increased their workload.

One locum claimed that associates were the “most expensive” members of staff per consultation. All their appointments are selected by a senior triage doctor.

BMA Chair, Professor Phil Banfield, said: “Too many doctors are telling us that working with PAs is instead draining their time and energy. The responsibility for signing off prescriptions and ensuring the PAs are working within their proper scope of practice quite rightly falls on the supervising doctor, but also those doctors working alongside them. As scope has inappropriately crept ever further, it has made far more work for doctors than it has saved. Their scope should be strictly defined and, to ensure patients are not confused, the title returned to the more accurate ‘physician assistant’ – then they can play their valuable role in supporting the delivery of NHS care safely.”

Super practices would help primary care

According to the Times Health Commission, creating “super practices” may solve some of the problems of primary care as large-scale practices would help to spread administration costs.

The Commission warns that fewer doctors will want to be partners – leading to practices employing more salaried GPs.

Professor Kamila Hawthorne, Chair of the Royal College of General Practitioners, commented: “Many of the suggestions put forward, if implemented correctly, could certainly help to tackle the grave challenges facing our health service – many of them echo calls the College has made in recent years. A greater emphasis on preventative and community-based care, the focus on health outcomes as opposed to box ticking, the recognition that GPs need more time with their patients, and the acknowledgment of the importance of continuity of care, something we know is valued by healthcare professionals and patients alike, are all encouraging.”

COVID vaccines for the most vulnerable

The Government has accepted the proposals that the spring COVID vaccination campaign should focus on the most vulnerable patients.

These would be adults aged 75 years and over, residents in a care home for older adults and those aged six months and over who are immunosuppressed, according to the Joint Committee on Vaccination and Immunisation.

Dr Mary Ramsay, Director of Public Health Programmes at the UK Health Security Agency, said: “Our ongoing surveillance shows that COVID-19 continues to cause severe illness, particularly in older age groups and those who are immunosuppressed, but also clearly shows that spring and autumn vaccines are effective in helping to protect those most at risk – halving the likelihood of hospitalisation from the virus.”

Managers to get appraisal kit

Practices are to get a specialist toolkit for appraising practice managers.

The new toolkit is to be unveiled next week by the Institute of General Practice Management (IGPM). In practice, the appraisal is often carried out by a clinician or partner unfamiliar with the complexities of management in general practice.  The toolkit aligns with the ten domains of the IGPM accreditation framework, which will enable Practice Managers to demonstrate the breadth and depth of the role.