Sanctions threat to GPs if they don’t see patients

HEALTH Secretary Sajid Javid is planning to cut doctors’ workloads by removing some of their responsibility for prescriptions – but is demanding they hold more face-toface appointments in return.

Under the plans, hospitals and pharmacies could prescribe drugs such as antibiotics.

GPs could also be spared writing ‘sick notes’ for the Driver and Vehicle Licensing Authority, which governs if patients are fit to drive.

In return, they will be expected to hold more in-person appointments – or suffer unspecified sanctions.

It comes amid growing concern that patients are still finding it difficult to obtain face-to-face appointments with GPs, leading to more going straight to accident and emergency departments instead.

Before the pandemic, about 80 per cent of GP appointments were held in person. That slumped as lockdown was imposed, and even now only 58 per cent of appointments are being conducted face to face.

Amid reluctance from GPs to offer more, ministerial aides have opened informal talks with the British Medical Association.

The doctors’ union has firmly resisted a full return to face-to-face appointments, saying general practices are ‘overloaded’ and there are not enough family doctors.

It points out there are 1,904 fewer fully-qualified full-time GPs than in 2015. A Government source said the hope was to open a constructive dialogue by acknowledging the work pressures GPs were under and offering suggestions about how these could be eased.

One idea being floated is to link the number of in-person appointments with GP pay, providing a financial carrot to see patients faceto-face – and a penalty for those who resist. Such incentives are commonly used to improve patient care in GPs’ NHS contracts. The source said: ‘The vast majority of GPs do an excellent job under great pressure, but we need to be able to hold to account those who do not pull their weight.

‘Sajid is determined to get faceto-face appointments back to prepandemic levels.’

That is a break from his predecessor, Matt Hancock. Last year, he hailed ‘Zoom’ medicine, telling the Royal College of Physicians that the NHS must not ‘fall back into old habits’ after the pandemic.

But the ‘remote first’ plan caused a backlash, first from patients and now from hospital doctors.

Yesterday, the Royal College of Emergency Medicine warned that a ‘lack of access to primary care’ and the shift to telephone consultations were driving people to A&Es.

Last night, Dr Richard Vautrey, who chairs the BMA’s GP Committee, said: ‘There have been informal but confidential discussions ... but at this time these remain just that. When proposals to remedy the crisis within general practice are shared with the BMA, we will consider and respond accordingly.’