Around 1,600 GPs and hundreds of other signatories have backed a complaint to the press standards watchdog by the Doctors Association UK (DAUK) over Telegraph articles on access to general practice.

In a letter to the Independent Press Standards Organisation (IPSO), DAUK chair Dr Jenny Vaughan said negative coverage risked ‘eroding public trust’ in primary care services and that this could represent a serious ‘patient safety issue’.

More than 2,500 people have signed an online petition in support of the complaint, which questions the accuracy and potential impact of two articles in the Telegraph.

One of the articles was headlined ‘GPs are improving their work-life balance while worsening the life-death balance of everyone else’, and the other ‘Time to turn the heat up on GPs who won’t see us face-to-face‘.ADVERTISING

GP access

The articles have also drawn criticism from the RCGP and the BMA, with college chair Professor Martin Marshall last week speaking out to defend GPs’ response during the pandemic and warning that growing levels of criticism and abuse were undermining doctors’ mental health.

Tne DAUK complaint letter, which asks for a formal response and an apology, says: ‘GPs are doing their best to help patients within a broken system during unprecedented times. We are extremely disappointed by the lack of central and governmental support, and we agree that our patients deserve more from our NHS.’

The letter points out that ‘83% of our patients report a “good GP experience” during the pandemic’ and that GPs want this to be even higher – but warns that ‘attacks’ on the profession in the media ‘make it hard for us to succeed’.

The DAUK letter warns that suggesting GPs are refusing to see patients face-to-face could stop patients seeking help for serious symptoms, or mean they present to emergency departments.

Patient safety

A DAUK spokesperson said: ‘The narrative that general practice has been closed throughout the pandemic has filtered down to patients. This needs to be called out.’

Last month, BMA GP committee chair Dr Richard Vautrey responded to Telegraph coverage of GP access, warning: ‘Many of the family doctors I represent are at the end of their tether, and such constant undermining and chastising will push them further towards the door, leaving us with even fewer GPs and making it even more difficult for patients to get the treatment they need.’

A recent survey by the MDU revealed that four in five GPs say abuse from patients has worsened during the COVID-19 pandemic, with delayed treatment and high demand for appointments fuelling frustration.

The Telegraph was approached for comment.

Read the full article here.

A Doctors’ Association UK (DAUK) letter of complaint to the media regulator about ‘misleading’ anti-GP columns in the Telegraph has garnered more than 2,500 signatures.

The DAUK wrote to the Independent Press Standards Organisation (IPSO) on Friday to report Telegraph columnist Allison Pearson for breaching the Editors’ Code of Practice with ‘inaccurate’ articles.

The letter, penned ‘in response to an outbreak of misleading articles’ on the current GP crisis in the newspaper, called for a formal apology.

The DAUK today announced that ‘over 2,500 signatures of support were added over the weekend, demonstrating the sense of injustice being felt in primary care’.

The letter said the DAUK has ‘concerns’ about Ms Pearson’s ‘inaccurate suggestion that GPs are “hiding” despite NHS data confirming they are providing more consultations than ever before’.

It also raised her ‘incitement of attacks and abuse against GPs and primary care workers by using inflammatory language’ and her ‘potentially libellous statement that care from general practice is “cruel, negligent and, frankly, inhuman treatment”.’

It added that ‘responsible media reporting is a patient safety issue’, as assumptions that practices are closed could lead to patients not seeking help for serious symptoms or inappropriately using emergency departments and 111.

DAUK chair Dr Jenny Vaughan’s letter said: ‘Factual inaccuracies and negative portrayal of GPs in the press erode the trust that is vital in the doctor-patient relationship. 

‘There is already an increase in physical, verbal and online abuse towards NHS staff and we are extremely concerned about the potential impact such journalism might have on the safety of NHS staff. We call for a formal response and apology from Ms Pearson.’

The DAUK is ‘extremely disappointed by the lack of central and governmental support’, she added.

The letter also said that the DAUK is ‘aware that this is not the first time Ms Pearson has been reported’ to IPSO and has previously invited her to ‘experience a typical day in general practice with no response’.

Several prominent GPs have signed the letter, including RCGP president Professor Dame Clare Gerada, NHS England medical director for Covid vaccination Dr Jonathan Leach, GP Survival Chair Dr John Hughes and media GP Dr Punam Krishan.

Read the full article here.

Dear Independent Press Standards Organisation,

On 24 August 2021, Ms Pearson wrote an article entitled, “GPs are improving their work-life balance while worsening the life-death balance of everyone else”:

https://www.telegraph.co.uk/columnists/2021/08/24/gps-improving-work-life-balance-worsening-life-death-balance/

Subsequently, a further article was published on 1 September 2021 entitled “Time to turn the heat up on GPs who won’t see us face to face”:

https://www.telegraph.co.uk/columnists/2021/09/01/time-turn-heat-gps-wont-see-us-face-face/

In reference to the Editors’ Code of Practice, we wish to report breaches of the following sections of Clause 1 (Accuracy):

i) The Press must take care not to publish inaccurate, misleading or distorted information or images, including headlines not supported by the text.
ii) A significant inaccuracy, misleading statement or distortion must be corrected, promptly and with due prominence, and — where appropriate — an apology published. In cases involving IPSO, due prominence should be as required by the regulator.
iii) A fair opportunity to reply to significant inaccuracies should be given, when reasonably called for.
iv) The Press, while free to editorialise and campaign, must distinguish clearly between comment, conjecture and fact.

Upon reading both articles, our concerns about the nature of Ms Pearson’s articles relate to:

1. Ms Pearson’s accusation that GPs are improving their work-life balance at the cost of ‘everyone else’ when the evidence shows the opposite in terms of burnout and stress. (“GPs are improving their work-life balance while worsening the life-death balance of everyone else”)
2. Ms Pearson’s demeaning description of dedicated GP receptionists as “Gorgon gatekeeper”
3. Ms Pearson’s inaccurate suggestion that GPs are “hiding” despite NHS data confirming they are providing more consultations than ever before. (“There is mounting anger that a highly-rewarded, once highly-respected profession continues to insist that it is “fully open” when personal experience suggests it is hiding behind an increasingly threadbare Covid sofa”)
4. Ms Pearson’s diminution of life-saving Covid measures that GP practices have been instructed to adopt, whilst also implying that GPs are deliberately unkind and inconsiderate. (“How about the doctors’ union tries being “kind and considerate” to patients by not insisting on strict Covid measures”)
5. Ms Pearson’s inaccurate comment that the use of virtual consultations somehow precludes ‘normal’ face to face service. (“As long as social distancing is maintained in surgery waiting rooms, there will be no return to normal face-to-face service. I’m sorry to say, that seems to suit a lot of GPs just fine…..GPs who prefer not to see the men and women who pay their salaries”) This is conjecture on Ms Pearson’s part.
6. Ms Pearson’s incitement of attacks and abuse against GPs and primary care workers by using inflammatory language like ‘Time to turn the heat up’ as though we were lobsters. (“The BMA seems shocked that long-suffering patients are finally losing it with doctors. I’m not, are you?” “Time to turn the heat up on GPs who won’t see us face to face”)
7. Ms Pearson’s potentially libellous statement that care from General Practice is “cruel, negligent and, frankly, inhuman treatment”

Throughout Ms Pearson’s articles, it appears that no GPs were interviewed and no professional medical bodies were approached for comment. We are also aware that this is not the first time Ms Pearson has been reported to the Independent Press Standards Organisation. This is neither the first time Ms Pearson has attacked GPs publicly nor is it the first complaint she will have received from frontline general practice. DAUK members have previously attempted to engage with The Telegraph and invite Ms Pearson to experience a typical day in General Practice, with no response.

Responsible media reporting is a patient safety issue, for two main reasons:
1) Patients who believe false rhetoric or conjecture may assume their surgery is closed, thus not seek help for serious symptoms. During the Covid pandemic we have already seen reduced rates of cancer diagnosis by around 40%, along with reduced presentations of other major non-Covid illnesses.
2) Those patients who believe false rhetoric or conjecture may inappropriately use emergency departments and the NHS 111 helpline, adding further pressures on our secondary care colleagues at a critical time for the NHS.

Important background information:

DAUK have publicly stated that NHS General Practice is in crisis. Contrary to inaccurate reports from Ms Pearson, GP practices have remained open throughout the pandemic.

GPs were instructed by NHS England to provide remote consultations when deemed appropriate for everyone’s protection. GPs were also informed that if a single member of staff were to contract Covid, the entire practice would need to close for 10 days, jeopardising the care of thousands of patients.

During a virtual consultation, if a GP deems that a patient needs a face-to-face assessment, they arrange for the patient to be seen. Meanwhile, many cases have been safely managed by virtual consultations, thus preventing countless possible cases of Covid transmission and avoidable deaths.

However, it is clear that demand for GP services presently exceeds capacity. This is not the fault of our doctors, and we continue to appeal to our leaders for further support for our patients. Blaming GPs for the decimation of our workforce is akin to blaming lorry drivers for the shortage of lorry drivers.

The number of full-time equivalent GPs has fallen by almost 20 percent in recent years. We have far fewer GPs per 1000 people than comparable nations, whilst the scope of our work is increasingly extended without additional funding.

GPs are doing their best to help patients within a broken system during unprecedented times. We are extremely disappointed by the lack of central and governmental support, and we agree that our patients deserve more from our NHS. Although 83 percent of our patients report a “good GP experience” during the pandemic, we wish for this figure to be closer to 100. But with the mounting attacks against our profession led by Ms Pearson and her like-minded colleagues make it hard for us to succeed.

Factual inaccuracies and negative portrayal of GPs in the press erode the trust that is vital in the doctor patient relationship. There is already an increase in physical, verbal and online abuse towards NHS staff and we are extremely concerned about the potential impact such journalism might have on the safety of NHS staff. We call for a formal response and apology from Ms Pearson. In the words of the NHS Five Year Forward View, if General Practice fails the NHS fails.

Dr Jenny Vaughan
Chair – Doctors’ Association UK
Press@dauk.org

From July 1 the way NHS Digital collects data from GPs will change to give researchers and planners easier access to anonymised medical records.

This data has already been collected for over a decade, NHS Digital say, for bespoke requests related to planning of healthcare services and medical research.

Now the medical histories of 55 million patients, including information on mental and sexual health, will be collated into one database.

But campaigners have warned better communication around the plans to pool the data is needed amid concerns it could damage patient-doctor relationships.

The Doctors’ Association UK said it could “erode the doctor/patient relationship, leaving patients reluctant to share their problems due to fears of where their data will be shared”.

Dr Ellen Welch, a GP and the editorial leader of DAUK, told The Guardian: “NHS Digital has failed to publicise this adequately to patients or healthcare staff, and we feel more time is needed to explain to patients how exactly their data will be used, who will benefit from it and what implications it may have for individuals.”

The Royal College of GPs is broadly in support of the plans, but has written to NHS Digital urging it to improve communication to the public.

Professor Martin Marshall, chair of the RCGP, told the newspaper: “The job of informing the public must not be left to busy GPs, especially at a time of extreme workload pressures and focus on the Covid-19 vaccination programme, so we have written to NHS Digital urging them to undertake greater communications with the public about this new collection and their options for opting out.”

Patients have until June 23 to opt out of the new scheme, this can be done by filling in a form and taking it to their GP.

An NHS Digital spokesperson said: “Patient data is already used every day to plan and improve healthcare services, for research that results in better treatments, and to save lives.

“During the pandemic, data from GPs has been used to benefit millions of us: helping to identify and protect those most vulnerable, roll out our world leading vaccine programme, and identify hospital treatments which have prevented people dying from covid.”

The spokesperson added they engaged with doctors, patients and privacy experts to design the new system and the data will only be used for health and care planning and research purposes.

“We take our responsibility to safeguard patient data extremely seriously. Researchers wanting to access this data will need each request to be approved by the Independent Group Advising on the Release of Data (IGARD) and a GP Professional Advisory Group (PAG), with representatives from the British Medical Association and the Royal College of General Practitioners,” they added. 

Available here: https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-news-covid-vaccine-oxford-lockdown-tiers-deaths/

The chief medical officer on Thursday night attempted to head off a growing rebellion by GPs over delaying the second dose of the Pfizer vaccine, insisting the new strategy was the “right decision”.

In a letter co-signed by his counterparts in Scotland, Wales and Northern Ireland, Professor Chris Whitty told medics “the public will understand and thank us” for administering as many first doses as possible rather than giving people a second jab within the recommended three or four weeks.

It came as GPs across the country vowed to defy the Government’s new strategy, describing it as a “huge gamble”.

Doctors’ leaders said the decision to cancel appointments for elderly patients due to have their second Pfizer coronavirus vaccination next week was “grossly unfair”, encouraging GPs to press ahead with the planned jabs in defiance of the strategy.

In a letter to ministers, the Doctors’ Association said there was no evidence that delaying the second dose of the Pfizer vaccine would be effective, suggesting the move “undermined the vaccine programme as a whole”.

In a joint letter sent to medics, all four of the UK’s chief medical officers said: “We recognise that the request to reschedule second appointments is operationally very difficult, especially at short notice, and will distress patients who were looking forward to being fully immunised.

“Halving the number vaccinated over the next two to three months because of giving two vaccines in quick succession rather than with a delay of 12 weeks does not provide optimal public health impact. We have to follow public health principles and act at speed if we are to beat this pandemic, which is running rampant in our communities, and we believe the public will understand and thank us for this decisive action.” 

The letter added that for every 1,000 people boosted with a second dose of the vaccine in January, 1,000 new people were unable to have substantial initial protection.

The Government’s advisory joint committee on vaccinations and immunisation (JCVI) meanwhile insisted that an extended time period between doses would not prove detrimental.

In a lengthy statement explaining the decision, it said the short term efficacy from the first dose of the Pfizer vaccine was around 90 per cent, 20 per cent higher than that of the Oxford vaccine.

“Given the high level of protection afforded by the first dose, models suggest that initially  vaccinating a greater number of people with a single dose will prevent more deaths and hospitalisations than vaccinating a smaller number of people with two doses,” it said.

Meanwhile, it emerged that a million doses of the newly approved Oxford vaccine will be ready by Monday amid concern over the ability of the NHS to carry out a mass vaccination programme at speed.

The Medicines and Healthcare Regulatory Agency (MHRA) and the (JCVI) announced the last-minute change of approach on the Pfizer vaccine in order to reach as many people as quickly as possible, extending the time between doses from three to 12 weeks.

The decision brings it in line with the Oxford vaccine regime, meaning that more than 500,000 elderly people who have already been vaccinated will have their second dose delayed. Pfizer said there was “no data” suggesting that a first dose of its vaccine would offer immunity after three weeks.

The Doctors’ Association on Thursday wrote to both the NHS and Matt Hancock, the Health Secretary, highlighting “major concerns” about the decision to change the regimen, which they said could leave people without immunity.

The Black Country and West Birmingham clinical commissioning groups are among several understood to have vowed to continue with the original three-week regime, defying the new edict. 

Dr Martin Stevens, a GP partner at Umbrella Medical in Walsall, told the Telegraph: “Our patients consented to a vaccine schedule of two doses, and doing anything other than that would be doing them a disservice. The Walsall CCG told us they would support us in making a pragmatic decision that was in the best interests of our patients and that is what this is about. It is sensible and it keeps up staff morale.””

Lizzie Toberty, a GP spokeswoman for the Doctors’ Association, warned the intervention “undermined the vaccine programme as a whole”, telling The Telegraph: “The idea that the Government can come in and change the schedule without an evidence base is extremely concerning.

“It is population protection versus individual protection. Their logic seems to be that if we confer some protection on as many people as possible, perhaps that is better than fully protecting certain cohorts. But the over-80s need the fullest protection. This is an untested strategy. It’s a huge gamble.”

Dr Toberty warned that patients who had not consented to receiving the Pfizer vaccine 12 weeks apart might now legitimately request the Oxford vaccine, rendering the last eight weeks “wasted”.

Read the full article here: https://www.telegraph.co.uk/news/2020/12/31/gps-rebel-govt-change-pfizer-vaccine-strategy-12-weeks-calling/

“I think January is going to be a very difficult time. If we’ve not vaccinated staff and we’ve got sickness going on due to self-isolation and possible Covid infection then we’re going to be in big trouble, more than we already are.”

NHS workers and police are asking to be at the front of the vaccine queue, as they plead for priority over the elderly in order to tackle a winter surge in infections.  

Medics warned of a January crisis in care if swathes of NHS staff are struck down by the virus or forced to isolate due to exposure.

The new Covid-19 strain, which the Prime Minister said on Saturday was up to 70 per cent more transmissible, has led to increased worry about the risk to staff.

Dr Zainab Najim, a junior doctor and Doctors Association UK spokeswoman, said the new strain meant the virus was more likely to get “out of control” as medical staff vaccinated vulnerable people.

She said the arrangement was affecting morale among staff, who felt “forgotten” after months of putting themselves at risk.

“I think January is going to be a very difficult time. If we’ve not vaccinated staff and we’ve got sickness going on due to self-isolation and possible Covid infection then we’re going to be in big trouble, more than we already are,” she said.

A poll carried out by the association, of 1,000 frontline doctors, found that 70 per cent had not yet received or been offered the vaccine. 

The rest of the article can be read here.

Dr Vinesh Patel warned.

This is a huge undertaking and poses a significant financial risk to primary care, who will have to shoulder the financial burden,” the letter says. “We cannot ask this of GPs when so much is at stake nationally… There needs to be a higher fee to acknowledge the huge ask and realistic costs of this programme.

Renting buildings with enough space to ensure social distancing and adequate parking could push practices to the brink.

Read the full article here.

‘Ministers appear to have been sitting on their hands and not learning the lessons from the first wave.

You tend to have more patients that are not intubated and ventilated than are using other therapies. From a staffing point of view, it would also make sense to have it as a step down facility so you’re not then required to staff it with intensive care doctors and nurses who are already in short supply.”

Ministers have been accused of “sitting on their hands” over warnings that the country’s largest Covid-19 field hospital is ill-prepared to help the capital cope with a second wave of infections.

Last week, Matt Hancock, the Health Secretary, confirmed that the Nightingale hospitals set up earlier this year would be ready to receive patients once again as conventional hospitals in some parts of the country faced becoming overwhelmed.

However, despite warnings in the spring that the London Nightingale needed to undergo a transformation to play a significant role over the winter, NHS England has admitted that no changes have been made to the facilities since the field hospital was put on “standby” in May. 

The hospital, which has the potential to accommodate up to 4,000 patients, was constructed at east London’s ExCeL exhibition centre in April.

It was initially set up to provide up to 500 intensive care beds, but only cared for 51 patients, and senior critical care medics had suggested that it should instead adopt the ‘step down’ model used for the temporary hospitals in Manchester and Birmingham.

Research has shown that far fewer patients require ventilators than was previously thought, but the London Nightingale is designed for patients who have already been put on ventilators and require ongoing critical care.

Dr Rinesh Parmar, a specialist registrar in anaesthetics who chairs the Doctors’ Association, said: “Ministers appear to have been sitting on their hands and not learning the lessons from the first wave.

“You tend to have more patients that are not intubated and ventilated than are using other therapies. From a staffing point of view, it would also make sense to have it as a step down facility so you’re not then required to staff it with intensive care doctors and nurses who are already in short supply.”

Read the full article in The Daily Telegraph here.

They are worried,” said Dr Jenny Vaughan. “And what we’re hoping is that the government will get a grip of this situation and that they will get hold of more gowns.”

Dr Alison Pittard, from the Faculty of Intensive Care Medicine, said not enough testing had gone into the washing and re-using of PPE and “you have to err on the side of caution”.

She added: “If there are any signs that it is degraded in any way when it has been washed then it shouldn’t be used because that would put us at unnecessary risk.”