NHS England (20 May 2021) has released an update to its ‘guidance and standard operating procedures’ publication to recommend that all practices ‘must offer patients online routes to make requests and ask for support through online consultation systems’, at any time.
The guidance notes that practices should not limit access to online systems for patients to make requests outside normal hours, and states it does not mean that practices are expected to respond to requests outside of core hours.
The SOP also notes “switching off online consultation systems out of hours is likely to be less convenient for patients and reduce patient satisfaction. For this reason practices should inform their CCG before proceeding and explore whether additional support may be available.”
On Twitter, Dr Nikita Kanani, Medical Director of Primary Care for NHS England and NHS Improvement, responded to highlight “the guidance (SOPs) issued, are only in response to an ask for guidance through the hardest times we’ve ever faced. We are looking forward to moving away from their use, and going back to supporting practices to work in the way that makes sense for their patients and teams.”
The guidance also notes that “patients’ input into the choice (face-to-face or online) should be sought and practices should respect preferences for face-to-face or remote care unless there are good clinical reasons to the contrary.”
In the latest BMA newsletter, the body highlighted that “as part of the 2019 GP contract deal, GPC England agreed that it would eventually become contractual for practices to offer online consultations during core hours. It is therefore for practices to determine how best they use online consultation systems, including what hours they are available, and they should try to use them in such a way that helps with triage and workload management, enabling the delivery of a safer and more accessible service to all their patients.”
It also notes a need for “the Government and NHSE/I to do far more to support general practice at this critical time, not just with IT, but practical support for the workforce and funding to improve practices by creating safer environments”, the BMA said.
“The whole model of access to general practice, including the impact on practice workload and the patient experience, must be reviewed as we move toward a new normal. Practices need the flexibility to find a model that works for their patient population and the practice workforce – this cannot be a one-size-fits-all approach with total or majority online service, but equally cannot be a total face-to-face service; there needs to be a balance.”
At the coal-face, GP practices are calling out for support. Dr Ben Allen, Birley Health Centre this week issued an apology to patients, and a reflection on the current situation.
Dr Allen wrote to anyone who is disappointed with his surgery or profession: “At times GPs may appear impossible to get hold of and don’t listen when you do. You may feel not taken seriously or feel ‘fobbed off’.
“I can’t imagine what it must be like if you’re ill or worried. It is understandable to feel angry. I’m sorry if this has happened to you. The cause is something that neither patients or GPs are in control of, but it is eroding the relationship between us nationally. GPs are overwhelmed by patient ‘demand’ and patients are angry about our service.
“What we are expected to achieve has increased far beyond funding and staffing, year on year, for well over a decade. With medical advancements, giving quality care becomes far more complex, people live longer with multiple conditions and medications, and GP workload becomes exponentially more challenging. Hospital work shifts to GPs without funding. Each tiny change drains more time.
