GP appointment figures and workload pressures (England)
The latest GP appointment figures in England were published yesterday which show that practices delivered almost 5 million more appointments in March than they did the month before, and nearly 3 million more than they did in the same month two years ago, long before the onset of the pandemic.
These figures underline the immense efforts that practices are going to providing care to their communities and the intense workload pressures that staff are under as we continue to respond to the pandemic alongside patients’ wider health needs.
GPs and their teams are consistently telling us they’re busier now than they have ever been, and this data – which does not include a large proportion of the vaccine programme undertaken by practices, nor a vast amount of other daily tasks – backs this up.
Every day, more than a million patients in England had an appointment with their practices, whether this was the significant proportion seen face-to-face, on the phone, or via video call. With too few GPs and practice nurses, and a promise in 2015 of 5,000 extra family doctors within five years actually delivering a loss of almost 1,500 by September last year, individual doctors are taking on more and more as demand rises and the workforce diminishes.
So for GPs and many others in practices working 11 or 12-hour days, often leading heroic efforts to protect as many people as possible in their communities against a disease that has had such a devastating impact on all of us, it is heart-breaking and completely demoralising to hear accusations that general practice is not open and that patients are not being seen.
This narrative, categorically proven wrong by this data, is extremely damaging at a time when morale is already reaching rock bottom and many GPs, practice managers and others practice staff are reaching breaking point. With the ongoing use of telephone triage advised by NHSE/I , changes put in place for the protection of staff and patients alike due to the limits of the size of most practice reception areas - general practice is open, and staff need support, patience and understanding as they work harder than ever before. Read my full statement here
COVID-19 vaccination programme
As of today, people aged 40 and over are eligible to book an appointment via the NHS national booking service to receive the COVID-19 vaccination. Practice groups can invite these patients for their first vaccination if they have sufficient supplies alongside continuing with second vaccinations to those patients who are due to receive it.
Since the vaccination rollout began in December, over 34 million people in the UK have received their first dose, and 14 million have also received their second dose.
New photographs show the people behind the national vaccination effort
To mark the start of World Immunisation Week 2021, a series of photographs documenting the vaccination programme has been published by the Government. The photo montage comes as a new campaign begins urging under-50s to get the jab. Find out more here
Read more about the latest changes, including the arrangements for the second phase of the vaccination programme and what practices need to do, in our updated guidance page about the COVID-19 vaccination programme.
Weekly COVID-19 data
The BMA weekly COVID-19 data summary is attached.
Racism in primary care report
Humberside LMC have published the attached report following a survey in their area exploring the experience of racism in primary care. This is a challenging but important document and I am grateful for the LMC sharing it. The report is based on findings from a survey across all staff groups, and forms part of their wellbeing strategy. Further information can be obtained from Dr Zoe Norris, Wellbeing Lead for Humberside LMC, via email@example.com
LMC UK Conference 2021
The Agenda for the 2021 UK LMC Conference (to be held virtually on Tuesday 11 May and Wednesday 12 May and Thursday 13 May) has now been published, and we have emailed the representatives with all the necessary information.
We would urge representatives to read the information in that email as soon as possible, ahead of the conference, to be fully aware of what is required to participate, and the deadlines involved (e.g. 12 noon on 7 May for chosen motions, emergency motions etc).
Representatives will join via a virtual conference platform and we recommend that ahead of the conference you test your connection to the virtual platform, log in as soon as possible, and watch the short YouTube films that have been prepared for representatives on now to navigate the virtual conference platform.
We also suggest that all those scheduled to propose motions send a pre-record of their speech wherever possible, by Friday 7 May at 12 noon, to help in case of any connectivity challenges. These should be emailed to firstname.lastname@example.org, ideally using a MP4 format (video or audio).
Note that the deadline for registration of representatives has now passed, but the conference will be webcast live on the day.
More information, including the link for the webcast, will be published here
Sir Simon Stevens to stand down as NHS England chief executive
NHSE/I have announced that Sir Simon Stevens is to stand down at the end of July as NHS England chief executive. We have worked with Sir Simon and his team over the 7 years he has spent in this role and as a result have secured the landmark 5 year contract agreement with its significant funding increase, and more recently enabled GP practices to play a leading role in the successful delivery of the COVID vaccination programme. He has been a strong advocate for the vital role of General Practice within the NHS and we wish him all the best for the future.
NIGPC meeting update
I was pleased to be able to attend the online meeting of NI GPC this week. Please see attached a summary report from the meeting.
Domestic Abuse Bill receives Royal Assent
This week saw the Domestic Abuse Bill receive Royal Assent to become the Domestic Abuse Act. This means the provisions in the Bill will come into law over the coming months, and probably before the Summer. The Bill contains a new measure which will prevent doctors from charging patients experiencing domestic abuse for letters to access legal aid. While BMA guidance has previously advised against charging for these letters, we continue to push for GPs to be removed from this legal aid process entirely – as we believe the current system disempowers victims and is unnecessary bureaucratic.
Serious Shortage Protocol for Estradot
A Serious Shortage Protocol (SSP) for Estradot® 75 microgram patches, was introduced yesterday. The prescriber will need to decide whether it is reasonable and appropriate to substitute the patient's prescribed order for the active SSP. The patient would also have to agree to the alternative supply for that dispensing month. Read the guidance on endorsement, prescription charges, remuneration and reimbursement, and Q&As here
Extension to the shingles immunisation programme (England)
Individuals become eligible for routine vaccination against shingles when they reach age 70, and all those aged up to and including 79, are now eligible to receive the vaccine until they reach age 80.
Individuals who are eligible for the shingles vaccination programme who turned 80 years during the pandemic and missed the opportunity to be vaccinated can now be vaccinated until 31 July. There are no contractual changes to this programme, the offer of vaccination is opportunistic or if requested for the catch-up cohort. GPs will continue to be reimbursed via the standard item of service fee, which should be claimed manually.
Launch of framework for suppliers of digital services to general practice (England)
The new Digital first online consultation and video consultation framework has been launched this week, which is intended to improve the standards of systems available for patients and practices. The new procurement framework means that PCNs working with commissioners can choose assured systems from a range of suppliers to better meet local needs.
The framework will allow products to be better tailored to user needs, including integrating online consultation systems with GP clinical systems and sending requests to other primary care services to reduce pressure on practices and navigate patients effectively.
Appraisal 2020 survey (England)
NHS England and Improvement is conducting a survey on Appraisal 2020. If you’ve used the new, streamlined format, which was introduced following our concerns about workload pressures and the impact on wellbeing during the pandemic, then your thoughts will be valuable to help develop the format and make appraisal more useful for all doctors. Everyone who has used the new format is encouraged to take part, especially if you’re a Responsible Officer. To take part please email email@example.com who will share a survey link according to your designated body.
Global health leaders back BMA call for urgent action as COVID crisis in India worsens
The scenes we are witnessing in India, Brazil and other countries with rising cases of COVID-19 are deeply concerning and demonstrate how important it is to have a global approach to tackling the pandemic. Following the unanimous passing of an emergency motion, proposed by BMA council chair Chaand Nagpaul at last week’s virtual meeting of the World Medical Association in South Korea, the BMA has called on the UK Government to do more to support countries tackling a worsening COVID-19 crisis. Read the letter to the prime minister.
Clare Wand Fund trustee elections (UK)
Nominations are now open for three trustees to the Claire Wand Fund 2021-2024. Any registered medical practitioner who is, or has been, actively engaged in practice as a general medical practitioner in the UK under the NHS Acts is eligible for nomination by an LMC representative.
If you are interested in standing for election, please contact your LMC representative and complete the self-nomination process online via this link. You will be asked to specify your nominating LMC representative during the online self-nomination process. We also ask that the nominating LMC representative confirms the candidates name via email to firstname.lastname@example.org. An LMC representative may make not more than one nomination. If you are unsure of your LMC representative please find the contact details of your LMC here.
To participate in these elections you must have a BMA web account, if you do not have one please click here to create one. Please follow the link to ‘request a temporary non-member account’ and email your temporary membership number to email@example.com. The deadline for nominations is 5pm Tuesday 11 May. To submit your nomination please visit https://elections.bma.org.uk/
Voting for these positions is only open to LMC UK conference representatives and will conclude on 17 May.
I was interviewed by the Yorkshire Evening Post about the number of patients waiting more than 52 weeks for treatment, which in Leeds rose from 22 to more than 2,700 in just over a year. I said: "This is a sign of the massive impact the pandemic has had on the wider NHS. Staff at GP surgeries and hospitals have prioritised the huge number of patients coping with Covid-19. This has clearly left a number of other patients in this situation. It concerns clinicians at much as patients. We want to provide the best possible service to our patients and it is really frustrating to see these sort of delays."
A number of BMA spokespeople were interviewed on local BBC TV and radio stations, including David Wrigley (3hrs 37mins), Rob Barnett (5mins 20secs) Mary McCarthy (3hrs 5mins) and Christine Clayton (2hrs 9mins), about BMA's latest survey highlighting doctors' concerns over the growing backlog of care. GPC England member Rob Barnett said: "People can cope for a period of time, but if you have a painful hip, for example, that's not going to get better. That's only going to get worse. So, actually, conditions are going to progress, which means that when we actually come to deal with them, they are going to be even more difficult." ITV also reported about the BMA survey.
I was interviewed on Radio Humberside (from 2hrs 11mins) this morning, discussing the latest case rates in the area. I said: "Our focus is very much on the backlog of care that exists of people who would have had procedures over the last year that've been postponed. That's proving to be really tough for a workforce that's already tired and exhausted after such a difficult year, to now have to deal with large numbers of people on top of the routine work."
Northern Ireland GPC deputy chair Frances O’Hagan was interviewed on the BBC Evening Extra show (from 41mins) about figures showing only 56% of those who are eligible to take the Covid vaccine and under the age of 50 have chosen to take it. Dr O'Hagan said: "We are progressing through the age groups and a really rapid pace and the number of vaccines given has been fantastic in Northern Ireland. The under 50s have been rolled out relatively recently... and I would say to people it is a very good vaccine and it is very safe."
Krishna Kasaraneni, GPC England Executive team member was interviewed by the New York Times about social prescribing where he said: “It’s now part of normal practice. We use it for vulnerable older patients who live by themselves, for people with diabetes who are overweight, and we put them in touch with community groups that can help get them outside and exercising. I have young patients with other chronic conditions, people with mental health issues,” he said. “There are no age barriers, no limits on what social prescribing can support people with.”
Read the latest GP bulletin here.