The new health secretary Therese Coffey’s new “Plan for Patients” under which patients should not have to wait more than two weeks to see their GP, is already receiving considerable criticism from GPs.

Prof Martin Marshall, chair of The Royal College of GPs (RCGP) has accused Coffey of expecting already hard-pressed GP surgeries to meet new targets, without a plan to deliver them:

Lumbering a struggling service with more expectations, without a plan as to how to deliver them, will only serve to add to the intense workload and workforce pressures GPs and our teams are facing, whilst also having minimal impact on the care patients receive”.

Prof Marshall also noted that: 

around 85% of appointments in general practice are already happening within two weeks of being booked, with 44% being delivered on the day they are booked – both higher figures than in 2019 – and those taking longer than two weeks after booking may be routine or regular appointments for which the timing is therefore appropriate”.

What is needed, Prof Marshall, added is:

the implementation of a new recruitment and retention strategy that goes beyond the target of 6,000 GPs pledged by the Government in its election manifesto, funding for general practice returned to 11% of the total health spend, investment in our IT systems and premises, and steps to cut bureaucracy so that we can spend more time delivering the care our patients need and deserve.

Responding to the Health Secretary’s announcement, Dr Farah Jameel, chair of the BMA’s GP committee for England, said: 

She could solve this better with meaningful dialogue and constructive engagement with GPs rather than yet another new set of ill-advised undeliverable targets….If the new Health Secretary had met with us before this announcement we could have suggested a workable strategy to address the unfolding crisis before us for this winter and beyond – instead we have in reality minor tweaks that will make no tangible difference to patients struggling to access care.” 

Coffey also plans to:

  • Use pharmacists, physiotherapists and other health professionals, many working in surgeries, to free up 3m GP appointments per year;
  • Fund better cloud-based telephone systems for practices to help callers get through more quickly;
  • Increase the number of people with minor ailments seeing high street pharmacists;
  • Make GP surgeries publish appointments data.

Dr Jameel noted that surgeries already have good telephone systems, just not enough staff to answer the calls. 

And the RCGP are concerned that the publication of appointments data could lead to a “league table” of GP surgeries, something that does nothing to improve access to or standards of care:

Introducing arbitrary performance rankings compares apples with pears and will only serve to work against and demoralise those working in practices that ‘rank’ lower.

In reality the fundamental issue is lack of staff, in particular GPs. The number of GPs in England has fallen every year since 2015. There were 29,364 full-time-equivalent GPs in post in September 2015, but by September 2020 the number of family doctors had dropped to 27,939, a fall of 1,425. NHS workforce data for June 2022 show the number has fallen still further to 26,859.

The plan put forward by Coffey will do nothing to solve the problem of falling GP numbers. A recent survey by the Kings Fund, which found that 63% of trainee GPs in England plan to work no more than six four-hour “sessions” a week one year after qualifying, highlights how difficult it will be to fill vacancies 

Those replying to the survey said they do not want to work any more shifts than six because the job is so intense and the extra work generated by seeing patients, such as referral letters, means a four-hour shift actually takes six or seven hours.

Prof Marshall noted that:  

GPs need to be freed up to deliver the care that we know patients so desperately need – that means we need a genuine strategy to address the workforce crisis. There simply aren’t enough GPs and staff to deliver the care our patients need and deserve.” 

Wes Streeting, the shadow health secretary, reminded Coffey that the last Labour government had given patients a right to see a GP within 48 hours – “until the Conservatives scrapped it”.


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