DAUK is part of SOS NHS Coalition of health organisations and unions which has written to the prospective prime minister urging him to secure the long-term future of the NHS.

The letter, which has been featured in the Guardian, also asks Burnham to meet members of the coalition to listen to their experiences of the NHS and social care.

Meanwhile, DAUK GP co-lead Dr Steve Taylor has contributed to an article exploring ‘a surge in portfolio working’ among GPs.

Underemployed and unemployed GPs

GP Online has reported that two-thirds of UK doctors have portfolio careers, which combine clinical work with work in other areas such as teaching and research.

Dr Taylor said: “There’s the element of underemployed and unemployed GPs – many have been forced to look for alternatives.

“It’s also the case that the intensity of working five days a week in NHS general practice is too high.”

Dr Taylor also provided comment to GP Online on its report that half of GP workforce growth in the last financial year came from jobs created through the additional roles reimbursement scheme (ARRS).

Workforce rebalancing

He said: “There needs to be a rebalancing of the workforce, because we’ve been under-employing GPs for some time.”

Elsewhere, Dr Taylor welcomed new NHS England guidance for planned patient care which sets out what patients and carers should expect when patients are referred for non-urgent NHS care as ‘a step in the right direction’ but said it ‘doesn’t go far enough’.

Speaking to Pulse, he said: “Patients are currently left in the dark about the referral process and where they are on the journey to seeing a specialist or waiting for an investigation. This should save some time for GP practices.”

Picture credit: Andy Burnham/Facebook

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Dr Taylor contributed to a new investigation by Pulse into the ‘lottery’ of local enhanced services funding experienced by GPs.

He said: “You could be on the other side of the street from another GP surgery and not be able to offer a service, just because you’re in a different ICB.

Funding lottery

“It’s a lottery, depending on which part of the country you’re in – you really don’t know what you can get and what you can’t get.”

Read the Pulse investigation.

Dr Taylor has also spoken to GP Online for its report on how some additional roles reimbursement scheme (ARRS) GPs are facing redundancy or reduced hours due to budgetary issues.

Core contract

He said: “It reflects the complexity of funding streams in general practice … GP practices, the BMA, RCGP have all been asking for money to be moved to the core contract [to help practices hire GPs] rather than it being manipulated via ARRS.”

Read the GP Online report in full.

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Dr Sarah Jacques, GP co-lead for the Doctors’ Association UK, warned the plan risked undermining patient confidentiality, professional accountability, and public trust.

Speaking to GP Online, Dr Jacques said that while GPs broadly support better communication and appropriate information sharing across the NHS, the current proposals appear to extend beyond improving patient care.

Serious unanswered questions

She said: “In principle, I believe GPs support better communication and appropriate information sharing across the NHS.

“However, the current proposals appear to go far beyond improving direct clinical care and raise serious unanswered questions about confidentiality, governance, liability, transparency, and public trust.

“I think one of the biggest concerns is around the GP data controller role. Yet there has been very little clarity about what happens to those responsibilities under the single patient record model.

Health Bill

“GPs need to know whether they will still retain legal and professional liability for information that may ultimately be shared more widely or potentially altered by external organisations and providers.”

DAUK’s concerns around the Health Bill and the creation of a Single Patient Record have also been reported in Pulse Today.

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 at the Doctors Association UK (DAUK), was contributing to a report in GP Online that a £55m ARRS funding uplift does not cover rising costs or provide extra funding to hire experienced GPs.

He said: “There’s not enough funding within the funding envelope to employ more GPs without making somebody else redundant.”

Dr Taylor added: “Now the rules have shifted so on paper you have more freedom, but you’ve already spent the money on staff that were in scope in the previous year. So what do you do now?”

However, Dr Taylor said the numbers of GPs recruited through ARRS would continue to rise.

This was because increasing amounts of the budgets of Primary Care Networks were being moved from ARRS into GP roles.

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.

It reports that NHS England has excluded GPs from early planning for new neighbourhood healthcare models.

GP Online reported that NHS England had written to integrated care boards (ICBs) and acute trusts asking for their plans on delivering neighbourhood health.

Neighbourhood models

Dr Steve Taylor, DAUK’s GP co-lead, said the omission of GPs ‘highlighted significant issues with the current approach’ to neighbourhood models.

He said: “The top down approach from government with imposition and expectation of ICBs to implement community care will be more costly and fail to provide genuine services closer to home, unless there is genuine consultation and engagement with GPs.”

Read the GP Online 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.

Dr Steve Taylor was speaking to GP Online on the findings of the latest Health Survey for England.

GP Online reported that the survey reveals rising pressure on general practice as a growing proportion of the population lives with poor health and long-term illness.

He said: “The lack of investment in health has created this.

“We are reaping what we sowed over 15 years of austerity.

“There’s also an element of an ageing population, more long-term issues because of the huge waiting list, more people who are ill and overstretched GPs with not enough time to spend on prevention, so the problems increase again.”

DAUK in the media

Read the GP Online article on what the Health Survey for England shows about pressure on GPs.

Meanwhile, Dr Taylor spoke to Pulse on a survey by United Medical Associate Professionals (UMAPs).

The survey found that 76% of PAs said their scope of practice has been restricted since the publication of the Leng review.

Dr Taylor said: ‘I would say their scope has been reduced rightly, because I think there was significant risk for patients with somebody that’s had such limited training to be seeing undifferentiated patients.”

Read the Pulse article in full.

DAUK’s committee members are all volunteers. They campaign and speak in the media about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

People wanting GP appointments are at the highest ever since October 2019. But how can GPs continue to work under this pressure? 

Read the full article here

In a letter to health and social care secretary Matt Hancock, along with the DHSC and Healthwatch – a statutory body representing patients – GPs from the Doctors Association UK (DAUK) warned that for frontline GPs, demand is ‘going through the roof’.

The group called for an urgent review after a Healthwatch report that highlighted a rise in negative feedback about GP services around the time national COVID-19 lockdowns were imposed.

The Healthwatch report said that while for many people experiences of general practice had continued to be positive through the pandemic, others had reported concerns around booking, remote consultations and access to regular checks and treatment. It highlighted ‘concerns that this would result in extra pressure on emergency services’.

GP workload

However, DAUK’s GP committee warned that if the current colossal workload being delivered in general practice was ‘still not meeting demand’, the government and NHS England must investigate.

NHS England said last month that general practice is currently delivering around 7m consultations a week including work on COVID-19 vaccinations – up around 1m appointments a week from pre-pandemic levels.

This figure is likely to be an underestimate, because data from NHS Digital do not fully reflect the number of telephone consultations in general practice – and GPonline has reported on RCGP surveillance data that show GP practice workload far outstrips pre-pandemic levelseven before COVID-19 vaccination work is taken into account.

The DAUK letter said the Healthwatch report confirmed that ‘the health of the population is suffering as general practice is drowning’.

Remote consultations

The letter said: ‘If primary care is having contact with 10% of the population each week and this is still not meeting demand there must be an urgent review to find out why.

‘The introduction of e-consults has made us more accessible than ever, and has opened the gates to a lot of trivia, which still uses GP time and resources, sometimes inappropriately. GPs are working flat out, and it is incredibly demoralising to find that our best is not enough.’

The letter said it was unacceptable if large numbers of patients were attending emergency departments for care available from their GP practice. But it added: ‘Practices are working at and beyond full capacity which has led to unprecedented levels of burnout, sick leave and tiredness amongst GPs.

‘General practice has been consistently underfunded over the last 10 years. Currently 90% of NHS contacts happen within primary care for less than 10% of the total budget. We desperately need a huge funding increase to aid much needed innovation, improvements in IT and infrastructure, and to increase staffing levels.’

The letter called for reduced bureaucracy, measures to address GP burnout and staff retention, and a review into access ‘so we can work towards finding a solution that involves the whole health service working together’.

Read the GP Online article here

(View the letter in full here)

Healthcare leaders have urged the government to speed up plans to halt GMC appeals against fitness to practice decisions – warning the regulator has used its powers more than a dozen times since its controversial appeal in the case of Dr Hadiza Bawa-Garba.

The government accepted a recommendation in 2018 from the Williams review to strip the GMC of its power to appeal against decisions by the Medical Practitioners Tribunal Service (MPTS).

The move was seen as a key step towards promoting a culture of transparency and openness in the NHS in the wake of the case of Dr Bawa-Garba. However, the regulator has yet to be stripped of its power of appeal and has continued to use it – with figures obtained by the Medical Protection Society revealing 14 appeals in total since the start of 2018.

A group of 13 healthcare organisations have now called on the government to speed up removal of the GMC’s appeal powers.

GMC appeals

The government set out plans earlier this month to press ahead with removing the GMC’s power of appeal as part of a wider programme of changes to healthcare regulation.

But the group behind the call for faster action – co-ordinated by Medical Protection Society president Professor Dame Jane Dacre – say it should be pushed through as part of the health bill currently going through parliament, and not slowed down while complex decisions are made about wider changes to regulation.

The Williams review recommendations followed the GMC’s controversial handling of the case of Dr Hadiza Bawa-Garba, a junior paediatrician convicted of manslaughter following the death of a six-year old child at Leicester Royal Infirmary in 2011.

A medical tribunal ruled that Dr Bawa-Garba should face a 12-month suspension, but the GMC appealed the ruling in the High Court and struck her off the medical register at the start of 2018 – although this was later reversed on appeal.

NHS culture

Then health and social care secretary Jeremy Hunt said at the time he was ‘totally perplexed’ at the GMC’s handling of the case – warning along with a number of healthcare organisations at the time that he was ‘deeply concerned’ about the impact it would have on efforts to create a culture of openness and transparency in the NHS around mistakes.

In a letter to current health and social care secretary Matt Hancock, 13 leading healthcare organisations have called for section 40A of the Medical Act 1983 – which sets out the GMC’s power of appeal – to be scrapped as part of the health bill currently going through parliament.

The letter was signed by Medical Protection Society, The Doctors’ Association UK, Hospital Consultants and Specialists Association, BMA, RCGP, Royal College of Surgeons of England, Royal College of Physicians, Royal College of Paediatrics and Child Health, Royal College of Surgeons of Edinburgh, Medical Women’s Federation, Association of Anaesthetists, British Association of Physicians of Indian Origin, and Medical Defence Shield.

The letter highlights the conclusion set out in the Williams review that removing the GMC’s right of appeal would help to tackle mistrust of the regulator among doctors and help to build a culture of openness – and with it improved patient safety.

Fitness to practise cases

MPS president Professor Dame Jane Dacre said: ‘The strength of feeling on this issue from right across the healthcare community is clear to see. The GMC’s power to appeal decisions made by the Medical Practitioners Tribunal Service (MPTS) has led to fear across the medical profession and a lack of confidence in the GMC.

‘It is also unnecessary as the Professional Standards Authority has the authority to appeal decisions. The GMC is the only UK health regulator that has such a right of appeal.

‘The government agreed that the GMC should be stripped of the power in June 2018, following the Professor Sir Norman Williams review into gross negligence manslaughter in healthcare. However, until the relevant legislative changes are made to the Medical Act, the GMC can and does continue to challenge decisions.

‘The government’s recommitment to removing the GMC’s right to appeal within the recent consultation on broader professional regulation reforms is welcome. It is however almost three years since it committed to making this change, and it should not be held up while a wide range of other complex proposals go through a round of further consultation.

‘Implementing this change as part of the forthcoming Health and Social Care Bill would give the profession confidence that their concerns and the recommendations of the Williams review are now being acted on.

‘There has never been a more important time to address this shortcoming. COVID-19 has sparked discussion about the extent to which individuals should be held to account when working in pressurised and extreme circumstances, and now more than ever, the regulator needs to be able to operate in a way that instils confidence amongst patients and doctors.’

A GMC spokesperson said: ‘We have made it clear that we are not opposed to this decision [to remove the power of appeal]. The government will decide how and when to bring in these changes. As the Williams review acknowledged, we have used these powers proportionally. To protect the public we will continue to use them while our legal obligation to do so remains in place.’

Read the article here