You might be forgiven for thinking that COVID-19 and flu aren’t new news. You might also be forgiven for wondering why, as we embark on the flu campaign for this year, we’re only now receiving details of the plan of support put in place for practices and PCNs over the winter.

The ICS Framework should, in theory, make life easier. We should see funding and investment in the technology aspects of primary care, but if I’m candid, any kind of major infrastructure input needs months of planning, and I’m not sure that my practice has the capacity to deal with this. We’ve been flat out all year; if we add in winter demand and a major project to boot, I may well find my staff have run screaming for the hills.

I look at the Annex 1 list and think, “Well, that’s a load more questions headed my way!” Not to mention the general level of irritation I’m feeling given the overall tone. As if we haven’t considered whether we have staffing vacancies. And we’ve certainly never thought about care navigation for our teams; I mean, it’s not like they do it every day now, is it? Clearly, I’m shuffling deckchairs on the Titanic if they think that a redesign of my practice website is high on my list of priorities. As with many of the edicts from on high, I’m left wondering whether: a) any of those responsible have ever worked in general practice, or if not: b) have they ever considered spending a day at the coal face, because as far as I can see it’s not in any way designed to actually support us.

As for the System Development Funding, don’t get me started! It’s not that I’m not on board with Digital First; they might need to consider how the message is delivered to some of our patients though. We can be as eager about “transformation” as you like, but given the narrative appearing in the mainstream media about GP practices, some of our patients feel that we’re avoiding seeing them. Yes, I’m all for improvements in practice, but I need capacity to make them, and to have patients feel supported, not ignored.

We can’t just conjure up capacity, even if we throw money at the problem. We need clinical space for additional staff, training time for GP assistants, and recruiting staff isn’t all that easy when there’s a limited sized pool of people. With ARRS roles, it’s all fine, but where am I getting them from? Acute Trusts, other PCNs and my PCN are all competing for the same group of people.

The changes to the IIF are the icing on the cake. We’ve already done some work on these, and although I suppose it’ll reduce the burden going forward, where is the joined-up thinking? Target removed for patients seen within two weeks. Given the narrative in recent days, should I be worried that next year’s target will be 24 hours, not two weeks?

I can’t help but feel that these changes have been deliberated on and announced without any consultation and that they would have been far more helpful/effective if they had been suggested in April 2022, not at the end of September.