Londonwide LMCs response to NHS England Publication B0497, 14 May 2021

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Yesterday evening NHS England issued a letter, which instructs practices to open their receptions for walk in triage and provide in-person appointments unless there is a “good clinical reason” not to. According to the letter, this must commence on Monday morning, 17 May, giving practices just one working day for the changes to be implemented. To the best of our knowledge there has been no consultation with our national BMA GP Committee elected representatives on this.

So let us be completely clear.

  1. The move towards ‘total triage’ was an NHS England instruction, as was delivering a large increase in online consultations. Practices deserve credit for making this work, in particular finding work-arounds to ensure often sub-standard, centrally commissioned online consultation platforms could meet patient needs at the start of the pandemic, and working with the software providers to get improvements made as it progressed.
  2. Our practices in London have been working at levels which exceed their full capacity throughout the pandemic, especially during this last winter, with staff making personal sacrifices for their patients’ safety, at the cost of their own.
  3. We are ever-aware of the extraordinary level of demand practices are currently experiencing, not least from online consulting platforms – also mandated with questionable evidence of benefit at the expressed instruction of NHS England – and will continue to make the case for good general practice care which meets both the needs of our patients the needs of our already exhausted and increasingly burned-out workforce.
  4. On top of this extra workload general practice has delivered the majority of the Covid Vaccination Programme in London. You have done so in spite of the Enhanced Service that contracted the programme, rather than supported by it: continually adapting to onerous requirements, moving goal posts and under-resourcing.

This is not the first time during the pandemic that GPs have been given guidance instructing them to work in a particular way, then found themselves subject to public statements decrying such practices from the very same commissioners.

In a statement today Dr Richard Vautrey, Chair of the BMA’s GP’s Committee, said:

“The letter from NHS England is sadly completely tone deaf and rather than recognising the efforts GPs are making and the stress they are feeling as a result of the massive workload pressures they are currently experiencing, it has let them down and left them believing their efforts have gone unrecognised.”

This most definitely reflects the tone we are hearing from our GPs and practice teams today. We will now await a further update from Dr Vautrey next week.

Best wishes

Dr Michelle Drage FRCGP
Londonwide LMCs