GP practices in Wales have been told they must stop releasing daily appointments in the morning, as part of a series of new changes to the 2021/22 GP contract.
The revised contract sets out that it is ‘no longer acceptable’ for practices to release appointments at 8am, in a bid to improve access to appointments by ending the ‘morning scramble’.
The Welsh Government said the new GP access commitment will ‘help ensure people are triaged appropriately’, with some people offered appointments while others are signposted to other services.
Although backed by £12m extra investment, it is currently unclear how practices are expected to implement the changes to the ‘8am bottleneck’.
A spokesperson for the Welsh Government told Management in Practice: ‘Many practices have introduced innovative ways of meeting local need, but we recognise that the changes announced today will require practices to think differently to ensure the 8am bottleneck is resolved.
‘More detailed guidance in relation to the contract changes will be developed in collaboration with key partners, including GPC Wales.’
Gareth Thomas, business manager at West Quay Medical Centre in Barry, told Management in Practice: ‘Practice managers and their teams are used to designing and implementing many different types of appointment systems and have been doing this for years to try and meet patient demand.’
‘Under the revised contract this allows practices to continue with existing total triage systems overlapped with a blended access arrangement (remote, f2f, urgent, on the day & pre-bookable), whilst continuing to appropriately signpost patients to other services.
He added, however, that practices will still only have ‘finite capacity’ to manage appointment demand, ‘regardless if the bottleneck is at 8am or spread throughout the day or week’.
Commenting on the changes, the BMA Welsh GP Committee – which negotiated the contract with the Government and NHS Wales – said that patients must understand the pressures facing practices.
‘GPs and their teams want to provide the very best access they can for patients – often working way beyond their contracts to do so – but it is crucial that patients understand the pressures facing the profession and what the existing workforce can realistically deliver,’ Dr Phil White, chair of the committee, said.
‘Put simply, there are not enough GPs working in primary care to manage current levels of demand. What this means, is that patients will be signposted to alternative services if they are deemed more appropriate and may have to wait to see their GP when they need to.’
In a statement to the cabinet, Eluned Morgan, Minister for Health and Social Services, said he recognised staff ‘have worked hard, often in the face of immense challenge and pressure, over the course of the pandemic’.
He added: ‘I’m also very aware that the system hasn’t worked as well as it could for everyone and in some instances, people have found access to their GP practice difficult.’
Practice staff get 3% pay rise
Practice staff and GPs will also receive a 3% pay uplift, backdated to 1 April, as part of the new contract deal.
It follows a 3% increase for NHS staff, including salaried doctors, which was announced by the Welsh Government in July.
The BMA said the raise will go ‘some way to support practices under great duress’ but maintained that it was ‘inappropriate’ to link the pay award to contractual change.
Other changes to the GP contract include:
- A winter capacity fund of £2m for the remainder of the financial year,
- From April 2022, the capacity fund will be increased to £4m and will run recurrently for three years,
- Reform of data legislation to de-risk general practice,
- Protected learning time and investment into care navigation training.
