Dr Steve Taylor was speaking on national radio about a survey by Pulse, which found that an estimated quarter of GP referrals to secondary care are returned as unsolicited Advice and Guidance.

He told listeners of Times Radio that the additional workload was putting further pressure on an already overstretched general practice.

Dr Taylor said GPs were paid 20% less in real terms than 10 years ago as he called on the Government to invest in general practice to help ease pressure across the NHS and improve access for patients.

Underemployed GPs

He said there were around 3,000 underemployed GPs who could work more hours if practices had the resources to employ them.

“If the money was available today, we could have 10% more appointments tomorrow,” he said.

Dr Taylor said that hospital waiting lists had increased significantly since 2010, when around 2 million people were waiting for hospital treatment compared with approximately 7 million today.

“Over that period we’ve seen 20% more work being done in general practice,” he said. “Last month a record 35 million appointments took place in general practice, half of those with GPs. Compare that with the 2 million who attended A&E.

“GPs are really frustrated. We just want to see more funding in primary care, to employ the unemployed and underemployed GPs and get the whole thing working better again.”

Advice and Guidance

Advice and Guidance was introduced to help GPs seek specialist input while patients waited for hospital care, or before making a referral.

However, Dr Taylor said it had increasingly resulted in hospitals returning referrals to GPs with requests for further work to be carried out in primary care.

He said: “If I’m dealing with all the referral bounce backs, and I’m also dealing with the people that are waiting for hospital treatments, then there are going to be issues for me providing appointments for today.”

Listen to the interview with Dr Taylor on the DAUK Instagram.

DAUK committee members are all volunteers and campaign on issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Speaking to Pulse Today, Dr Steve Taylor, GP co-lead for the Doctors’ Association UK (DAUK), questioned what the plans aimed to achieve.

Dr Taylor said: “What are we trying to invent here? Is it outpatients in the community or is it actually community care?

“I think there is a sort of mixed up approach that we’ve got going on here, and I’m slightly concerned that we are missing something in terms of what we already have, and how do we integrate that better.”

Dr Taylor pointed out that general practice already provides local neighbourhood care across the country.

He said: “There are already 6,300 neighbourhood centres in the community within walking distance of 85 per cent of the population.

“In a city like Manchester people can access hospitals relatively easily. Rural communities need local access.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Dr Taylor, GP co-lead for the Doctors’ Association UK (DAUK) said the proposals reflect wider failures to properly fund general practice.

He was responding to the Government’s announcement of a £340 million expansion of the Pharmacy First scheme.

Dr Taylor acknowledged that pharmacies ‘form an integral part of Primary Care’ and for decades have ‘provided advice and guidance to patients’, despite being ‘significantly underfunded’.

Diagnosis and management

“However there are significant concerns that diagnosis and management of even ‘simple’ conditions might mean things are missed,” he said.

The Government says the changes, due to come into force this autumn, will allow more pharmacists with prescribing qualifications to treat patients directly without referral to a GP.

Five new conditions are expected to be added to the Pharmacy First scheme, although ministers have yet to confirm details.

Dr Taylor said: “If Pharmacies and GP practices were funded in proportion to the need then there would be no need for Pharmacy First as access to GPs would be there.

Pharmacy First

“Even the 3.3 million Pharmacy First consultations over the past 12 months needs to be put in context. This represents less than 1% of GP practice consultations of 1.5million a day.

“The broader question is whether pharmacies are the best place to put diagnosis and prescribing, or whether this is better in GP practices.

“Experienced pharmacists are likely to be more likely to know what they don’t know, it is debatable whether this can be true for all.”

DAUK is run by frontline doctors for frontline doctors. Please support our work by joining DAUK or donating to our GoFundMe.

Dr Steve Taylor, GP co-lead for the Doctors’ Association UK (DAUK), said he was concerned at reports patients were being told they have serious illness through the app rather than face to face.

Speaking on LBC, he said the Government needed to strengthen GP services instead of relying on technology.

Dr Taylor said: “The reality is it’s trying to do things cheaply without actually investing in what we really need.

Face-to-face appointment

“A face-to-face appointment with a GP is an important interaction that makes a massive difference.

“There are fewer GPs now than 10 or 15 years ago, and the reality is we need more.”

Dr Taylor was responding to reports that patients have learned they may have serious conditions such as cancer or Parkinson’s disease through the app.

Dr Taylor said the app works well for booking appointments and ordering prescriptions, he that it cannot replace human care.

Empathy and understanding

He said: “GPs warned this might be a problem right at the beginning when they started releasing all the information onto the app.

“It’s not good at sharing empathy, nuance, and understanding. It can’t tell you whether or not the result you’ve got is abnormal for you or is normal for you.

“It really isn’t good enough to be told that you’ve got cancer via an app. As a GP, I want to see you face to face, look you in the eye, and talk to you.”

Listen to the interview in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

That’s the view of DAUK’s GP committee.

It follows a report in GP Online that NHS England has confirmed the DES specification ‘has been updated to enable ICBs to request local variations’.

DAUK GP co-lead Dr Steve Taylor told GP Online it could be an ‘amazing’ opportunity in areas where general practice and their ICB had a strong relationship.

General practice

However, he cautioned that ‘restrictive practices that make things harder for general practice’ could follow in some areas.

Dr Taylor said: “A potential good outcome would be that an ICB could say it needs to fit a service better with a certain locality and decide to increase funding to support that.

“The flip side is they could decide that although the national DES specifies a certain level of funding for something, the ICB feels it can’t afford that so they restrict funding, or try to make practices do more to obtain it.”

Read the article in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

According to a report in GP Online, Operose Health has approached practices with proposals to take over their NHS contracts.

DAUK GP lead Dr Steve Taylor warned that such models risk fundamentally reshaping general practice.

“It’s a sort of creeping corporatisation of general practice, which I think in the end will basically cause worse care,” he said.

Dr Taylor followed up the article with a post on social media.

He said: “General practice at risk. Email from Operose Health is a sign of things to come, creeping corporatisation of general practice, which will end in worse care

“There has been a significant decline in GP partners as costs rise and no funds.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

GP co-lead Dr Steve Taylor highlighted the work of DAUK on fit notes during an interview on national radio.

Dr Taylor was discussing a survey by BBC that found that hundreds of GPs have never refused to sign a patient off work for mental health issues.

Some respondents told the BBC they were frustrated with the current system, saying providing fit notes should not be part a GP’s role.

Fit notes

The Doctors’ Association UK (DAUK) GP co-leads Dr Taylor and Dr Sarah Jacques last year took part in discussions with the Department for Work and Pensions about the future of fit notes.

Ahead of the meeting, DAUK surveyed GPs to ensure their views were represented.

The survey found:

• 69% of GPs said fit notes should not remain part of their remit
• 85% felt a new service should take responsibility for issuing fit notes
• 46% supported a return to four weeks self-certification
• 51% did not favour self-certification by patients
• 94% reported that refusing a fit note negatively affects the doctor/patient relationship

Dr Taylor, speaking to Tom Swarbrick on LBC, said: “The majority of respondents said they didn’t think GPs were the best people to issue fit notes.

Work health

“I wasn’t expecting that many, but the majority did agree with the survey the BBC have done that actually it’s hard for GPs to assess health in work.”

He added: “GPs usually only hear one side of the story.

“The person in front of us says they are struggling to work, but we don’t know the workplace situation or the employer’s perspective.

Self-certify

“What worked well was during the pandemic when people could self-certify for a month.

“And so the conversations were occurring between the employee and the employer.”

Listen to Dr Taylor’s LBC interview on the DAUK Instagram.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Dr Sarah Jacques, GP co-lead, represented DAUK at the event to launch the Solve the Maze campaign, a joint drive by the Royal College of General Practitioners (RCGP) and the Patients Association.

It brought together policymakers, clinical leaders, patient advocates, and frontline clinicians.

The campaign has three main aims:

• Every patient should be able to navigate their care
• Every patient should be able to see their GP when they need to
• Every patient should be able to access information about their care

Dr Jacques said: “At DAUK, we strongly support the core message of this campaign.

“Frontline GPs see daily how complex, fragmented pathways create unnecessary stress for patients and increase administrative burden for clinicians.

“An NHS that is easier to navigate is essential not only for improving patient experience, but also for enabling GPs to spend more time delivering clinical care rather than managing bureaucracy.”

Professor Victoria Tzortziou Brown, RCGP chair, said: “Decades of underfunding and poor workforce planning have left GP numbers far behind where they need to be, and it’s our patients who suffer when they have to wait too long, particularly for an appointment with a GP they know and trust, for appointments that are too short.  

“The government has committed to ‘thousands’ more GP but we now need to see a detailed, fully funded plan to recruit, employ and retain the GP workforce patients need.”  

Read Dr Jacques’s blog on the launch on the DAUK Substack.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

The referendum for BMA GP and GP registrar members will run from midday on Wednesday 4 March to 12pm on Wednesday 25 March.

It will ask whether members accept the contract, or want the Government to return to direct talks with the GPCE to develop a deal that ‘restores the viability of partnerships, provides fair remuneration for all GPs, and implements workload safeguards to keep GPs and patients safe’.

Dr Steve Taylor, DAUK GP co-lead, said: “The new imposed GP contract is extremely poor.

“It is no surprise that it has been rejected in principle by the BMA General Practice Committee.

“The real problem is for patients with loss of options for referral, very poor funding will reduce their ability to see GPs despite the headlines.

“The headline of £485m extra is only just over inflation and will not fix the problem for patients.

“The Health Secretary says he is ‘fixing the front door’ but patients need GPs not doors.

“It is vital that patients understand that this rejection is about protecting patient care.”

GPC England chair Dr Katie Bramall said: “GPs are in despair, uncertain how on Earth they can achieve the Government’s unrealistic expectations and fear this contract will drive away more experienced GPs increasing the risk of further practice closures.”

Read the full response.

Meanwhile, the BMJ has reported on Dr Taylor comments that the increase in general practice funding ‘merely tinkers around the edges of what’s needed’.

And Medscape has reported on Dr Taylor’s comments that financial incentives linked to prescribing weight-loss drugs, are ‘a smokescreen’ for an ‘appalling’ new contract.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Dr Steve Taylor, GP co-lead for the Doctors’ Association UK (DAUK), said the £485 million announced by the Government was actually worth around £85 million when adjusted for inflation.

He said the contract fell short of what was required to meet the Labour Government’s manifesto pledge to ‘bring back the family doctor’.

And he added that there was an ‘incredibly disappointing’ lack of vision for the future of general practice.

Dr Taylor said: “We welcome any increase in GP funding, but this is not bold enough.

“The new GP contract merely tinkers around the edges of what is needed to genuinely bring back the family doctor, which was Labour’s manifesto pledge.

“The funding increase for core general practice is only £85m, when adjusted for inflation, and will not go very far.

“The lack of genuine core funding, combined with a lack of vision for what can be achieved, is incredibly disappointing given the Labour Government is nearly two years into its tenure.”

Dr Taylor highlighted DAUK’s Your GP, here for you campaign, which calls for a GP contract that puts patients at the heart of care.

DAUK’s contract is designed to strengthen continuity, improve access, and ensure GP services are properly funded.

DAUK’s proposals are based on The future of general practice, the 2022 Health and Social Care Committee report produced with cross-party support.

Key recommendations are around continuity of care and removal of the tick-box top-down management of care.

Delivering this vision will require the Government to increase core GP funding by £40 per patient per year – less than £1 a week – to restore funding to the real-terms level of 2016. 

Dr Taylor said: “DAUK has proposed a genuine alternative, ‘Your GP, here for you’, which puts patients first, frees GPs from bureaucratic barriers and encourages improvement in continuity of care.

“The next steps must include these otherwise this will see the end of general practice, patients will suffer, and the health of the nation will deteriorate.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.