GPs will no longer be allowed to tell patients to call back later under a new contract starting next month – with practices told to instead ensure the right help is available.
The new contract is to be imposed on family doctors in England, with its union saying it is now “forced to consider all options” including industrial action.
The changes, issued by NHS England, insist for the first time that GP practices must not simply tell patients to call back later, if surgeries are busy – but provide help, or point patients to the right place.
It follows growing concern about difficulties accessing GP appointments, and about a rise in health conditions, such as heart attacks and strokes, which might have been prevented with the right care.
The new contract states: “To ensure consistency in the access that patients can expect, the GP contract will be updated to make clear that patients should be offered an assessment of need, or signposted to an appropriate service, at first contact with the practice.
“Practices will therefore no longer be able to request that patients contact the practice at a later time.”
Contract ‘introduces more bureaucracy’
On Friday the British Medical Association (BMA) said the contract for the financial year, starting next month, was likely to be imposed against the union’s wishes, after a failure to reach agreement.
Dr Kieran Sharrock, acting chair of BMA’s GP committee, said the plans provided “no extra help for practices”, while “lumping more bureaucracy and arbitrary targets on practices that only set them up to fail”.
He said: “It’s extremely frustrating to see a second GP contract imposition forced on the profession, especially one that does absolutely nothing to improve what is fast-becoming an irreparable situation for practices and their patients up and down the country.
“This contract is the result of a failure to listen to what GPs actually need, and totally ignores the calls for any extra support to help practices meet the rising costs of keeping their doors open. Despite warnings from GPC England, it also introduces more bureaucracy and arbitrary targets that only set practices up to fail and take GPs away from direct patient care.”
The union said the BMA’s GP committee for England “would therefore be forced to consider all options, including the potential for industrial or collective action”.
Cuts to funding
Under the contract, funding will be particularly focused on patient access and experience, plus specific boosts to tackle heart disease, by increasing take up of drugs such as statins.
However, the changes will see some cuts to funding for other indicators, including reviews of patients with dementia and rheumatoid arthritis.
Dr Ursula Montgomery, NHS director of primary care, said: “GP teams have worked hard to deliver record numbers of appointments with half a million more delivered each week last year compared to pre-pandemic, and this new contract aims to build on this further with more access for patients.
“As well as providing same day care to more than two fifths of patients, GP teams will also step-up preventive action against heart attacks and strokes over the next year, with health professionals encouraged to prescribe statins alongside other preventative measures such as exercise to a much wider number of patients with heart disease, arterial disease and those who suffered a stroke or who have high levels of cholesterol.”
The contract for the current year was also imposed on GPs after the BMA objected to it.
The terms introduced last April said every area must have a surgery open on Saturdays offering face-to-face appointments.
In November, the NHS began publishing data on every GP surgery in England, showing how long people have to wait for an appointment and the proportion occurring in person.
Ahead of this year’s contract being issued, the BMA committee for family doctors said: “Following the BMA’s England GP committee rejecting a contract offer from NHS England last month, representatives met with Steve Barclay yesterday, in a final bid to negotiate meaningful changes that would provide security and sustainability for practices and patients in England.
“However, Mr Barclay refused to come forth with any improved offer.”