> GPs must offer face-to-face Saturday appointments, under a new NHS contract which is opposed by doctors’ leaders.
> Health officials have issued terms which say patients must be able to access in-person appointments six days a week.
> The contract also promises to boost access for patients, with online booking for all types of appointment, including screening checks, and same-day appointments.
> Family doctors have been told that routine appointments must be available between 9am and 5pm on Saturdays in their local area, as well as on weekdays.
> It means patients should be able to access such appointments locally, though not necessarily at their own practice.
> But the British Medical Association (BMA) has reacted with fury to the new contract, saying it has been imposed without their agreement, and with too little funding.
> The rows follow long wrangles over access to face-to-face appointments.
> Latest figures show the proportion of GP appointments held in person fell for the third month in a row to 60.3 per cent in January.
> Before the pandemic the figure was about 80 per cent.
> The new contract says Primary Care Networks (PCNs), which are responsible for GP services, must “ensure a reasonable number of appointments for in person face-to-face consultations are available” in their area – including on Saturdays.
> Each PCN covers a population of up to 50,000.
> The arrangements, for 2022/23, call on GPs to increase diagnosis of cancer, which has fallen during the pandemic, with a particular focus on prostate disease
> **Ramping up cancer checks**
> Extra funds have been allocated for increases in checks for bowel cancer, and heart conditions.
> Officials say too many patients with symptoms that should have been checked have not been seen since the pandemic, because they struggled to access care, or feared being a burden on services.
> Dr Nikki Kanani, NHS medical director for primary care said: “The NHS is focused on recovering services and tackling the covid-19 backlogs that have inevitably built up over the pandemic and so as part of the contract for General Practice in 2022/23, extra funding will be given to primary care teams to increase checks for cancer and heart conditions for our patients.”
> Estimates suggest that 14,000 men with prostate cancer have yet to be diagnosed, along with more than 12,000 women with breast cancer.
> But the BMA said it was “bitterly disappointed” by the terms – saying there was too little funding attached.
> The union said it had called for extra funding to cover increased employers national insurance contributions, due in April, as well as for a recovery plan for general practice, and more flexibility to hire a range of support workers.
> Dr Farah Jameel, BMA England GP committee chairman, said: “We are bitterly disappointed that NHS England has chosen to ignore the appeals from the profession and the needs of patients in today’s letter.
> “Despite our best efforts to outline a number of positive and constructive solutions that would make a difference to practices’ ability to improve care for patients, NHS England has instead decided to follow a path laid out three years ago, long before the arrival of Covid-19, and roll over a contract that fails to address the current pressures faced by general practice.
> “Failing to offer practices something as simple as reimbursement to cover additional costs for national insurance contributions means they are losing funding that should be going towards looking after patients.
> “Therefore, a tax aimed at funding the NHS, has become a tax on the NHS itself. The result will be fewer members of staff to care for the growing needs of patients.”
> She said patient care would suffer – with longer waits to see a GP – unless surgeries were given “an emergency rescue package”.
> The union said it began negotiations with NHS England in January over annual amendments to the five-year contract deal, which was agreed in 2019, but said the terms had now been agreed without their agreement or endorsement.
> “We approached this year’s negotiations in good faith, recognising the need to uphold previous agreements but striving for improvements in patient care.
> “Today’s letter, presented to us with only a few hours’ notice, defies everything we were aiming to achieve in building a constructive relationship and sits at odds with positive conversations with government,” Dr Jameel said.
GPs have not painted themselves well during this pandemic.
All these essential services should be working when people aren’t typically at work.
So tired of having to play phone lottery at 8am on a crowded bus to work.
I predict this will go down like a pint of cold sick with GP’s.
> Health officials have issued terms which say patients must be able to access in-person appointments six days a week.
> Family doctors have been told that routine appointments must be available between 9am and 5pm on Saturdays in their local area, as well as on weekdays.
From a patient access point of view: great!
But were I such a GP, I really wouldn’t be keen on working 6 days’ a week and I wouldn’t blame any who feel similarly.
Therefore they’d have to have staff on rotation or hire more staff to cover the increase in service. If there’s money to do this then again – great – but if they’re expecting existing services to cover another day without any more support? Well that’s going to stretch things even further, surely…
GPs say “bye bye NHS”, remember what happened with NHS dentists? Don’t forget there already is a chronic shortage of GPs.
Edit: It looks even worse in the context of people talking about the 4-day week.
My NHS GP surgery already does, and it is open 8am to 8pm Monday to Saturday.
It is also open 9am to 4pm on a Sunday.
Also on any day of the week if you can’t book an appointment you can just turn up at a two hour ‘drop in session’ in the evening.
However… you **never** get to see the same GP twice as the whole service is run by locums. So some of them only work weekends or some only work weekdays or part weekdays, and as the surgery is part of a larger group of surgeries they rotate around where they are needed.
Now I don’t care that I don’t see the same GP each time, but certainly some people do.
And those people who do care tend to be the elderly or those with continuing care needs.
So those stay or move to the more traditional Monday to Friday ‘9 to 4’ GP surgery in the town – so that surgery has to deal with the ‘expensive’ patients and the flexible surgery gets all the ‘cheap’ patients.
I think your GP’s have a rather difficult job.
Only to be scorned for that work.
As someone that wanted to work in the UK in your NHS for the community mental heath service.
I chose not to. Because of the public attitude that chooses to blame an overworked professional and not the years of cuts underfunding Degradation of service failure to train enough replacements that are all governmental choices.
GPs should be open all weekend and close more during the week.
I am waiting for the Tories to blame Ed Balls for the doctors contract he agreed when Health Secretary. Or is that too recent or cannot be linked to Jeremy Corbyn?
At my GP practise there are 3 GP’s only one of which is full time.
This was the case pre rona, and everyone was complaining about how over stretched the surgery was, but the surgery kept saying it couldn’t find any more GP’s willing to come and work in a rural over stretched practise so we were stuck with the situation.
Then Rona struck, things got very bad, we were down to three locum Nurse practitioners and one GP who worked “remotely” take from that word “Remotely” what ever you care to make of it, that was the official statement and no I have no idea of what it actually meant other than that GP wasn’t seeing anyone face to face.
It emerged that the two other part time GP’s were Lead GP’s shared with other practises in the county, so were next to not available.
In lockdown I became ill with symptoms of Ovarian cancer, No one at my GP surgery would see me, I was told to go straight to A&E.
At A&E I was told I should at least have been given a referral so that I could have been sent as an emergency appointment to Oncology.
I took up a bed in A&E for 8 hours totally unnecessarily as to release me from A&E I had to have a diagnosis but the CT scan dept was only doing emergency scans and I wasn’t booked in via oncology.
A month later I underwent surgery, at discharge I was told I’d need a follow up via GP
It never happened.
I had to ask my GP’s surgery to provide a dressing pack, they refused said it was hospital issue only, hospital had to ring surgery and TELL THEM.
I never got the pack.
The one GP up until lockdown restrictions were eased worked only “Remotely” a well founded rumour emerged that he was not even in this country when working “Remotely” but it would take a whistleblower to prove that and so far no one has the financial security to attempt that (but would if they did)
I think a lot of GP’s surgeries are far less saintly in practise than they have a reputation for, but to prove it is to go against a strong narrative put out by well, GP’s.
For what its worth the Hospital I was at had a palpable lack of respect for GP’s full stop, but then the Hospital were the ones mopping up GP mistakes.
Unfortunately the only good reason to become a GP now is that you get to be a part time patient seeing doctor. It provides the basis for a portfolio career with many GPs only working a proportion of full time as GPs. And if you took away that flexibility there would be far less GP trainees.
Of course there are some people that truly love it (which I really cannot comprehend!)
12 comments
[Archive link for paywall bypass](https://archive.is/ZWgb9). Article text follows:
—
> GPs must offer face-to-face Saturday appointments, under a new NHS contract which is opposed by doctors’ leaders.
> Health officials have issued terms which say patients must be able to access in-person appointments six days a week.
> The contract also promises to boost access for patients, with online booking for all types of appointment, including screening checks, and same-day appointments.
> Family doctors have been told that routine appointments must be available between 9am and 5pm on Saturdays in their local area, as well as on weekdays.
> It means patients should be able to access such appointments locally, though not necessarily at their own practice.
> But the British Medical Association (BMA) has reacted with fury to the new contract, saying it has been imposed without their agreement, and with too little funding.
> The rows follow long wrangles over access to face-to-face appointments.
> Latest figures show the proportion of GP appointments held in person fell for the third month in a row to 60.3 per cent in January.
> Before the pandemic the figure was about 80 per cent.
> The new contract says Primary Care Networks (PCNs), which are responsible for GP services, must “ensure a reasonable number of appointments for in person face-to-face consultations are available” in their area – including on Saturdays.
> Each PCN covers a population of up to 50,000.
> The arrangements, for 2022/23, call on GPs to increase diagnosis of cancer, which has fallen during the pandemic, with a particular focus on prostate disease
> **Ramping up cancer checks**
> Extra funds have been allocated for increases in checks for bowel cancer, and heart conditions.
> Officials say too many patients with symptoms that should have been checked have not been seen since the pandemic, because they struggled to access care, or feared being a burden on services.
> Dr Nikki Kanani, NHS medical director for primary care said: “The NHS is focused on recovering services and tackling the covid-19 backlogs that have inevitably built up over the pandemic and so as part of the contract for General Practice in 2022/23, extra funding will be given to primary care teams to increase checks for cancer and heart conditions for our patients.”
> Estimates suggest that 14,000 men with prostate cancer have yet to be diagnosed, along with more than 12,000 women with breast cancer.
> But the BMA said it was “bitterly disappointed” by the terms – saying there was too little funding attached.
> The union said it had called for extra funding to cover increased employers national insurance contributions, due in April, as well as for a recovery plan for general practice, and more flexibility to hire a range of support workers.
> Dr Farah Jameel, BMA England GP committee chairman, said: “We are bitterly disappointed that NHS England has chosen to ignore the appeals from the profession and the needs of patients in today’s letter.
> “Despite our best efforts to outline a number of positive and constructive solutions that would make a difference to practices’ ability to improve care for patients, NHS England has instead decided to follow a path laid out three years ago, long before the arrival of Covid-19, and roll over a contract that fails to address the current pressures faced by general practice.
> “Failing to offer practices something as simple as reimbursement to cover additional costs for national insurance contributions means they are losing funding that should be going towards looking after patients.
> “Therefore, a tax aimed at funding the NHS, has become a tax on the NHS itself. The result will be fewer members of staff to care for the growing needs of patients.”
> She said patient care would suffer – with longer waits to see a GP – unless surgeries were given “an emergency rescue package”.
> The union said it began negotiations with NHS England in January over annual amendments to the five-year contract deal, which was agreed in 2019, but said the terms had now been agreed without their agreement or endorsement.
> “We approached this year’s negotiations in good faith, recognising the need to uphold previous agreements but striving for improvements in patient care.
> “Today’s letter, presented to us with only a few hours’ notice, defies everything we were aiming to achieve in building a constructive relationship and sits at odds with positive conversations with government,” Dr Jameel said.
GPs have not painted themselves well during this pandemic.
All these essential services should be working when people aren’t typically at work.
So tired of having to play phone lottery at 8am on a crowded bus to work.
I predict this will go down like a pint of cold sick with GP’s.
> Health officials have issued terms which say patients must be able to access in-person appointments six days a week.
> Family doctors have been told that routine appointments must be available between 9am and 5pm on Saturdays in their local area, as well as on weekdays.
From a patient access point of view: great!
But were I such a GP, I really wouldn’t be keen on working 6 days’ a week and I wouldn’t blame any who feel similarly.
Therefore they’d have to have staff on rotation or hire more staff to cover the increase in service. If there’s money to do this then again – great – but if they’re expecting existing services to cover another day without any more support? Well that’s going to stretch things even further, surely…
GPs say “bye bye NHS”, remember what happened with NHS dentists? Don’t forget there already is a chronic shortage of GPs.
Edit: It looks even worse in the context of people talking about the 4-day week.
My NHS GP surgery already does, and it is open 8am to 8pm Monday to Saturday.
It is also open 9am to 4pm on a Sunday.
Also on any day of the week if you can’t book an appointment you can just turn up at a two hour ‘drop in session’ in the evening.
However… you **never** get to see the same GP twice as the whole service is run by locums. So some of them only work weekends or some only work weekdays or part weekdays, and as the surgery is part of a larger group of surgeries they rotate around where they are needed.
Now I don’t care that I don’t see the same GP each time, but certainly some people do.
And those people who do care tend to be the elderly or those with continuing care needs.
So those stay or move to the more traditional Monday to Friday ‘9 to 4’ GP surgery in the town – so that surgery has to deal with the ‘expensive’ patients and the flexible surgery gets all the ‘cheap’ patients.
I think your GP’s have a rather difficult job.
Only to be scorned for that work.
As someone that wanted to work in the UK in your NHS for the community mental heath service.
I chose not to. Because of the public attitude that chooses to blame an overworked professional and not the years of cuts underfunding Degradation of service failure to train enough replacements that are all governmental choices.
GPs should be open all weekend and close more during the week.
I am waiting for the Tories to blame Ed Balls for the doctors contract he agreed when Health Secretary. Or is that too recent or cannot be linked to Jeremy Corbyn?
At my GP practise there are 3 GP’s only one of which is full time.
This was the case pre rona, and everyone was complaining about how over stretched the surgery was, but the surgery kept saying it couldn’t find any more GP’s willing to come and work in a rural over stretched practise so we were stuck with the situation.
Then Rona struck, things got very bad, we were down to three locum Nurse practitioners and one GP who worked “remotely” take from that word “Remotely” what ever you care to make of it, that was the official statement and no I have no idea of what it actually meant other than that GP wasn’t seeing anyone face to face.
It emerged that the two other part time GP’s were Lead GP’s shared with other practises in the county, so were next to not available.
In lockdown I became ill with symptoms of Ovarian cancer, No one at my GP surgery would see me, I was told to go straight to A&E.
At A&E I was told I should at least have been given a referral so that I could have been sent as an emergency appointment to Oncology.
I took up a bed in A&E for 8 hours totally unnecessarily as to release me from A&E I had to have a diagnosis but the CT scan dept was only doing emergency scans and I wasn’t booked in via oncology.
A month later I underwent surgery, at discharge I was told I’d need a follow up via GP
It never happened.
I had to ask my GP’s surgery to provide a dressing pack, they refused said it was hospital issue only, hospital had to ring surgery and TELL THEM.
I never got the pack.
The one GP up until lockdown restrictions were eased worked only “Remotely” a well founded rumour emerged that he was not even in this country when working “Remotely” but it would take a whistleblower to prove that and so far no one has the financial security to attempt that (but would if they did)
I think a lot of GP’s surgeries are far less saintly in practise than they have a reputation for, but to prove it is to go against a strong narrative put out by well, GP’s.
For what its worth the Hospital I was at had a palpable lack of respect for GP’s full stop, but then the Hospital were the ones mopping up GP mistakes.
Unfortunately the only good reason to become a GP now is that you get to be a part time patient seeing doctor. It provides the basis for a portfolio career with many GPs only working a proportion of full time as GPs. And if you took away that flexibility there would be far less GP trainees.
Of course there are some people that truly love it (which I really cannot comprehend!)