I am writing to update you on access GP services. I hope the information below will help you to respond to any queries and concerns your constituents may have.
General practice is busy and working hard to provide care to their communities. Appointment numbers have returned to pre-pandemic levels, despite general practice remaining subject to infection prevention and control measures. Average appointments per working day in general practice for June 2021 are 2.8% higher than in June 2019 from 1.19 million in June 2019 to 1.22 million in June 2021. When Covid-19 vaccination appointments are also included, there were 1.42 million appointments per working day in June 2021, a 18.9% increase compared to 1.19 million in June 2019. To put this into context in there were on average approximately 70,000 A&E attendances per day in same period.
In the last twelve months (to June 2021) an estimated 294.7 million appointments (excluding Covid-19 vaccinations) were booked across practices, compared to the twelve months up to June 2019 (306.9 million), and over half (56.3 per cent) of all appointments were face-to-face. Including Covid-19 vaccinations, an estimated 334.4 million appointments were booked across all general practices in England in the twelve months up to June 2021. Compared to the twelve months up to June 2019 (306.9 million) this is up 8.9%. Alongside appointments, General practice and Primary Care Networks (PCNs) delivered 4.2 million Covid-19 vaccinations in June, and a total of 39.7 million vaccinations since December. This is over 60% of all Covid-19 vaccinations to date.
General practice teams rapidly changed how they delivered care to their population, triaging patients (a system to assess a patient’s care needs online and by telephone) and offering more remote consultations. This change enabled practices to reduce the risk to patients and staff from exposure to Covid-19, and ensures patients receive care from the right person at the right time. But regardless of how people access GP services, they should receive the same high quality of care they would normally receive from their practice.
We know that telephone or online consultations, which many patients prefer, can provide extra flexibility and convenience for patients but we know it is not appropriate for all patients or in all cases. This is why GPs and their teams have continued to offer face-to-face appointments, when clinically appropriate and respecting patient preferences, but it is a fact that there is considerable demand in the system.
Although the way GP services are delivered has changed, the GP Patient Survey (conducted from January to March 2021) reported that 83% of patients described their overall experience of their GP practice as good or very good, and that almost all patients (94%) felt that their needs were met during their last general practice appointment.
We are extremely grateful for the continued efforts of general practice teams support their patients and communities, including playing a vital leading role in the Covid-19 vaccination programme. However, it is shocking and disappointing to hear about NHS staff facing abuse or violence while trying to do their job. I would like to be clear the NHS should not and will not tolerate abuse or violence directed at staff. Despite the despicable actions of a minority, the overwhelming support from the public during the pandemic has meant a great deal to GPs and their teams, who are proud to have helped millions of patients over the last year.
The Government and NHSE&I continue to support general practice to maintain and improve access to care for patients in the following ways:
• The provision of additional funding to ensure GPs and their teams are able to continue to support and provide quality care to their patients in the challenging circumstances presented by the pandemic. We have made available an extra £270million from November 2020 until September 2021 to help expand GP capacity.
• The NHSE&I-led Access Improvement Programme to support practices whose patients are experiencing the greatest challenges in providing good access to patients. NHSE&I is currently supporting over 900 practices to design and deliver tailored support packages for those practices.
• Our commitment to support general practice to deliver an extra 50 million appointments a year by March 2024, and to expanding its workforce so that practices have more capacity to deliver better care. Part of that expansion is enabled by the Additional Roles Reimbursement Scheme. This is open to all PCNs to reimburse 100% of the employment costs of a wide range of primary care professionals, such as pharmacists and physiotherapists. We are also training more GPs than ever before. The highest ever number of doctors accepted a place on GP training in England in 2020 – 3,793, against a target of 3,500 – and we have committed to increasing the number of GP training places to 4,000 in 2021.
• Evaluation and learning from rapid service change - NHSE&I has an independent evaluation underway to understand the implications for staff, patients and the wider health and care system of using digital tools in primary care, including the effectiveness of online consultation systems and triage in general practice. Findings from this evaluation will support improvements to the services practices provide.
All guidance and communications issued to general practice throughout the pandemic can be found on the NHSE&I website at www.england.nhs.uk/coronavirus/primary-care/generalpractice.
If your constituents are struggling to access general practice services, they should raise this with their practice who will provide details of the complaints process. If they are not comfortable raising a complaint directly or do not feel they have had a satisfactory response, they can raise their concern with their CCG, with NHSE&I or with Healthwatch England.
There have been big changes to the way that much of healthcare operates, but I would like to reassure your constituents that general practice stands ready to see, diagnose, treat and vaccinate your local populations.
It goes without saying that my door is open should you wish to discuss the matter further.
Kind regards,
JO CHURCHILL
Parliamentary under Secretary of State for Primary Care and Health Promotion