On 28th April, during an interview with BMJ, the MP and chair of the Health Select Committee Sarah Wollaston, revealed that the ‘Seven Days a Week Forum’ by the UK National Health Service (NHS) for GPs will not be based on a ‘one size fits all’ approach and will be ‘flexible’ to facilitate the GPs.
The development was revealed in an interview published online, titled ‘Five minutes with MP Sarah Wollaston’. In the interview Wollaston talked on the developments which took place last week when the NHS announced it will invest £2.4 billion in primary care to assist GPs as part of the ‘General Practice Forward View’ initiative, which will take place by 2020 to 2021.
The plan was unveiled on 21st April and as part of the plan in which the government will recruit more health professionals to help struggling practices and develop the workforce with a complete redesign of the care. The blueprint of the initiative was developed in collaboration with the Health Education England and the Royal College of GPs and was launched when it was found GPs had been more under pressure in recent years than ever in the UK.
Even though the number of GPs will be increased to 500 active GPs in the next five years, a major influx of the funds will be projected towards increasing the medical and non-medical general practice workforce. To cater to and increase additional workforce so as they can facilitate the GPs or decrease their workload, the NHS will set aside an investment of £206 million. The funds will go towards the appointment of more healthcare professionals such as physiotherapists, nurses, pharmacists etc.
Another part of the initiative was the seven-day NHS services plan to ensure consistent high quality care for patients and had been in the works since 2013. The Forum developed 10 clinical standards to better facilitate care outcomes at end of the weekend. Basically the plan would include more access to GP appointments in the evenings and at weekends along with 24/7 urgent care, since primary care has been seeing difficulties due to unavailability of timely access to health care professionals.
However, the plan raised some concerns as many at the Royal College of General Practitioners and others felt the program would not work for all of England. The GPs urged the government to ensure if there is even a demand for weekend calls and asked for a full evaluation of the pilot programs before the system is unveiled. Previously even Wollaston had stressed the seven-day plan required further local designs and evidences to come up to the local challenges so it can have a positive impact on patient care.
“In terms of seven-day working, what works for rural Devon won’t work for central Birmingham. We want to avoid a ‘one size fits all’ approach,” said Wollaston. “Some patients seem to think that a seven-day service means being able to see their own GP at 7 pm on a Sunday evening when we know that’s not going to be the case. We need much more clarity on the issue.”
According to Wollaston, it is a good point that the arrival of the GP Forward View came from the NHS rather than the Department of Health, because it reflected the main issues associated with workforce. GPs have been facing increased pressure and complexity with increase in number of shifts and consultations, basically handling both secondary and primary care.
“It was very clear to me from discussions with colleagues that what is getting to GPs is the relentless pressure, the people doing marathon surgeries, and the remorseless treadmill of 10 minute consultations,” said Wollaston. “There is a sense of perennially running behind, finishing the surgery, and facing a backlog of bureaucracy.”
Wollaston then explained how they had a hearing with the NHS Chief Executive Simon Stevens to discuss the issues with the seven-day NHS plan which provided them more ‘clarity’ on issue and the implementation of the plan. Wollaston stated: “It doesn’t mean surgeries from 8 am till 8 pm. It needs to be about local flexibility, and what works in a rural area is different to what works in a city.”
On the words of Wollaston, even though the GP Forward View has an objective of recruiting 1,000 associates to help the physician in the UK general practice, when first announced the move was met with mixed responses. Wollaston said: “Some GPs are very keen to have physician associates having a limited prescribing list, and some felt physician associates shouldn’t be prescribing at all.”
Wollaston also highlighted the ‘registration’ of GPs in her comments and stressed it was a key problem for the professional group since they were an unregistered workforce and with the level of responsibility GPs had they needed to be registered by the government. Another area addressed by Wollaston was ‘technology’, so the GPs can email each other and have more online consultations. Wollaston said, “Having made the shift from GP to MP, the impact of my emails is huge. I regularly get 300 emails a day.” Wollaston’s points were in line with a majority of the aims of the NHS plans.