Sajid Javid says lack of face-to-face appointments are piling pressure on A&Es as he tells GPs it’s a sign ‘patients want to be seen’

  • Warned patients resorting to turning up at A&E  because they can’t access GP
  • Figures show 60% of GP appointments in-person compared to 80% pre-Covid 
  • In warning shot, Sajid Javid said: ‘Patients now want to be seen and that is right’

Sajid Javid, the Health Secretary, warned a lack of face-to-face GP appointments is putting ‘significant’ pressure on A&Es

A lack of face-to-face GP appointments is putting ‘significant’ pressure on A&Es, the Health Secretary revealed today.

Sajid Javid warned patients are resorting to turning up at emergency departments because they can’t access a doctor in person.

Putting pressure on GPs to see more people face-to-face on the back of the pandemic, he said patients ‘stayed away from the NHS when they were asked to, they now want to be seen’. 

It comes after a top GP last week blamed Britons’ ‘Amazon Prime mentality’ for the increasing number of patients turning up at A&E with symptoms that could be managed by a GP.   

Mr Javid made the comments, which risk stoking tensions further with doctors, today to MPs on the Commons Health and Social Care Committee. 

He said: ‘[A] significant portion of people are turning up for emergency care when they could have actually gone to their GP.

‘That is not the fault of those people at all. They have stayed away from the NHS when they were asked to, they now want to be seen and that is right.

‘But part of the reason I think people are turning up in A&E perhaps when they don’t need it is because they’re not able to get through to their primary care services in the usual way.’

Asked again if a lack of availability of GP appointments had led to increased pressure on A&E, he said: ‘I think that that general point is correct.’

It comes amid an explosive row about a lack of face-to-face consultation. Mr Javid has threatened to name and shame the worst-performing surgeries, while unions are considering industrial actions over what they deem to be unfair treatment.

Some four in ten appointments are still not being carried out face-to-face, figures showed. The above graph shows the proportion of appointments that have been face-to-face since September two years ago

Figures show that around six in 10 GP appointments are in person now compared to more than 80 per cent before Covid. 

Mr Javid said he did not believe in setting a target for face-to-face GP appointments but hinted that the pre-pandemic proportion was a good ballpark.

Cheshire GP blames NHS pressure on country’s ‘Amazon Prime mentality’ as he slams patients for their ‘inability to wait for anything’ 

A prominent GP has blamed Britons’ ‘Amazon Prime mentality’ for a surge in demand for emergency NHS care.

Dr Jonathan Griffiths said an increasing number of patients were turning up at A&E with non-urgent symptoms that could be managed by a GP.

He likened the situation to Amazon’s same-day delivery service, adding that people had ‘high expectations’ and an ‘inability to wait for anything’.

But patients have reported struggling to get a timely face-to-face appointment with their doctor during the pandemic, even as surgeries bounce back from lockdown.  

Dr Griffiths, a GP in Winsford, Cheshire, made the comments in a blog post about the current pressures on the NHS, and emergency departments in particular.

He wrote: ‘We talked about the “Amazon Prime” mentality that we all now have – high expectations and inability to wait for anything.

‘There are significant numbers of people aged 30-50 presenting to the ED with undifferentiated symptoms that are possibly better managed by GPs. 

‘These individuals do not want to wait for GP assessment and want everything investigated and sorted in one trip. 

He added: ‘By and large, they have nothing wrong with them and should never have been there in the first place.’ 

It comes amid a furious row over a lack of in-person GP appointments, with family doctors threatening industrial action over the Government’s plan to name and shame the worst performers.

In his most recent blog entry on Sunday, titled ‘The Emergency Department’, Dr Griffiths reflected on a chat with an ED consultant.

He added: ‘The historic number was around 80 per cent it’s around 60 per cent now… for me it’s never been about a number, it’s about dong the right thing.

‘I guess it’s about choice, where you have a patient that wants to be seen face-to-face, it’s really important to meet that.’  

Mr Javid was asked about claims from the Royal College of Emergency Medicine (RCEM) that virtual GP appointments have led to increased demand on emergency departments. 

He added: ‘During the pandemic, it’s understandable why virtual access … became a necessity, for many people there was sadly no alternative because of all the necessary rules.

‘Where we are with that now is that as we move back to normal, those rules that kept people away are no longer there, plus there will be people that stayed away from their GPs, understandably, when they were asked to protect the NHS … as (people) come forward, it is important that ultimately there’s a choice in terms of how they’re seen.

‘I think as we get more and more access to primary care, that will certainly help with demand in accident and emergency care.’

But Mr Javid accepted that GPs were under ‘huge pressure’ due a backlog of people who never came forward during lockdowns.

He said: ‘I’m really proud of our GPs up and down the country… the last few months GPs have stepped up and as a nation we couldn’t be more proud of what they’ve done.

But in a subtle warning shot, he added: ‘It’s important patients can be seen as quickly as possible and where they have desire to be seen face-to-face, that choice should be respected.’  

Last month, Mr Javid revealed that performance data from individual surgeries would be published regularly, including the number of face-to-face appointments.

GPs warned that publishing ‘league tables’ was unfair and demoralising. Some unions warned it could trigger a wave of retirements.

Mr Javid today distanced himself from the so-called league tables, telling MPs: ‘I never planned on having league tables, that never came from my Department, or the NHS.’

But family doctors warn the move – announced in the NHS blueprint to improve patient access – would inevitably be used as a league table, even if wasn’t the Government’s intention.  

During his session with MPs, Mr Javid also admitted the Government would not hit its target of recruiting 6,000 more GPs by 2024.

Asked if the Government was on track, Mr Javid said: “No, I don’t think we are….We’re not on track, I am looking at what more we can do, I want to see that increase but I’m not going to pretend we’re on track when clearly we are not”.

Mr Javid also warned NHS leaders that they must embrace technology, adding that some hospitals are still using fax machines.  

GP leading plans for industrial action over No10’s plan to boost face-to-face appointments RESIGNS from role at British Medical Association

Dr Richard Vautrey will step down as chair of the BMA’s GP committee later this month

The GP leading plans for industrial action over face-to-face appointments last night quit his post at the doctors’ union.

Dr Richard Vautrey will step down as chair of the BMA’s General Practitioners Committee later this month.

His resignation came on the day ballots were sent to GP practices across England asking if they would be willing to take industrial action.

Dr Vautrey, a GP from Leeds, has led the left-wing union’s rebellion against Government plans to force family doctors to see more patients in person.

But his stance on face-to-face appointments has been condemned by moderate doctors, MPs and patient groups for being ‘tone deaf’.

On Friday Dr Vautrey insisted the BMA would not back down over plans for industrial action aimed at ‘reversing the unsustainable workload’ of GPs.

He accused the Government of ‘adding fuel to the fire’ by telling doctors to increase the number of appointments they hold face-to-face.

Latest figures showed four in ten GP appointments were still not being carried out face-to-face in England this September. For comparison, over the same period two years ago more than nine in ten were in person.

Health Secretary Sajid Javid last month unveiled a £250million package of measures to get patients more face-to-face appointments, including a controversial proposal to name and shame underperforming surgeries. 

Despite his militant rhetoric in recent weeks, Dr Vautrey’s surprise resignation announcement last night did not mention the recent row over patient access.

He said: ‘I’ve decided that the forthcoming first meeting of our delayed annual session is the right time for a new chair to take on this role. With the need to begin planning for a new contract as we approach the fourth year of our current five-year agreement, a new chair and team need to be given the opportunity to do this.’

Yesterday the BMA launched an indicative ballot of GP practices in England, asking if they support taking industrial action in four key areas.

These include refusing to go along with the ‘naming and shaming’ of practices which fail to improve face-to-face access.

They will also be asked if they will refuse to comply with rules on ‘pay transparency’, which would mean GPs earning over £150,000 are named.

And they will be balloted on whether they should refuse to oversee medical exemptions for people who cannot get vaccinated, which they complain has added to their workload and opens them up to more abuse.

The ballot closes on November 14 and could pave the way for the first industrial action by doctors since the junior doctors strike five years ago.

Patient groups, MPs and moderate doctors had all urged the BMA to back down and reach a compromise with ministers for the sake of millions of patients.

It comes as a major study today revealed only three per cent of doctors think remote consultations are better for patients than face-to-face appointments.

Researchers at Cambridge University concluded the shift towards phone and video appointments is proving ‘disastrous’ for many patients.

They said online consultations ‘increased the risk of misdiagnosis and barriers to care’, and were particularly damaging for the elderly, poor and disabled.

Some 93 per cent of doctors agreed that remote appointments are worse than face-to-face for accurately assessing and diagnosing illnesses.

In the first study of its kind, experts evaluated the NHS’s ‘rapid move towards telemedicine’ — video or phone appointments — during the pandemic.

Researchers surveyed 1,340 rheumatology patients and more than 100 hospital consultations and GPs between April and July this year.

About one third of the patients had inflammatory arthritis and another third had the immune disease lupus, with many needed regular appointments for flare-ups.

Some 93 per cent of doctors said telemedicine was worse than face-to-face consultations for accuracy.

The study said that a lack of in-person examinations and tests meant ‘misdiagnosis and inaccuracies were frequently reported’.

Nine in ten doctors also said phone and video consultations are ‘worse than face-to-face for building a trusting relationship’ and only three per cent said they were better overall.

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