The new contractual ban on asking patients to call back at a different time will not mean having to offer them an appointment on first contact, the GPC has said.
NHS England has imposed a contract this month with a focus on access, and the imposition has led to talk of potential industrial action, with the BMA’s GPC England convening a special meeting on 27 April to discuss next steps.
The contract papers for the Network DES were released at the end of last week.
The papers said: ‘The GP contract in 2023/24 has been updated to reflect the different ways that patients now contact their practice whether this in person, online or by telephone.
‘Patients will be treated equitably and can expect a response on the same day they contact their practice.’
Speaking at a webinar on Thursday (30 March), Dr Clare Bannon, a member of the GPC executive, clarified that the ‘response’ does not necessarily mean offering an appointment, but it includes signposting to other services, including 111.
She said: ‘The GMS regulation changes require us to do something with patients the first time they contact us, so that may be signposting, that may be offering an appointment. But it does not mean it has to be offering an appointment – there is a range of different dispositions, and what we are saying to practices is that they really need to think about what they do with those patients.
‘We’ve talked extensively over the last few months around safe working and I would encourage people to look at the safe working guidance because we really should be making sure we are not having more than 25 appointments a day – we know it adds to stress and increases the risk of burnout.
‘For patients that call up, we need to think about how we signpost them – signposting to 111 is okay, as is signposting to the pharmacy service and signposting to self-referral schemes.’
She also said that it was made ‘very clear’ in the regulations that the response does not have to be face to face, but done with ‘the right method.’
Dr Bannon said: ‘It does not mean we have to see our patients – if the right thing for the patient is to signpost them, ask them to self-care, to refer them to the community pharmacy scheme, then that’s what we should be doing.
‘But if you feel the patient needs to speak to a doctor that could be by telephone, video consultation or face to face.’
The Network DES capacity and access payment guidance published last week also mentioned ‘signposting’ and that ‘patients seeking routine care should have an appointment within two weeks of contact where appropriate.’
Dr Bannon explained that providing a response on the same day is a change in regulation, while the fact that patients seeking routine care should be offered an appointment within two weeks is ‘purely a target.’
She added: ‘[The first] is a change in the GMS regulations so just like anything that is in the GMS regulations – when we decide whether to see a patient, as we do now, that hasn’t changed.
‘If it’s appropriate to see a patient when we speak to them, then we would see the patient.
‘If we deem it’s appropriate to signpost a patient somewhere else, then we should be speaking to them and as long as they are in agreement, then it’s a negotiation, just like it is now, when we decide to do home visits or ask a patient to come to surgery. It will very much work in the same way.
‘If we don’t meet that requirement, we could risk a breach of contract, it’s not getting us to a target – there will be no measurement of this, it will be a question of if someone raised concerns that as a practice you weren’t doing this and you weren’t signposting appropriately.
‘The two-week target is not just GP appointments, it does include other appointments but we need to be really clear that this comes back to how you arrange your appointment book and the appointment category.
‘I know everyone went through a process of matching their appointments to the seven different appointment categories and this is really important.’
Further guidance on access will be published by the BMA in the upcoming weeks.