Access to GP Appointments

Maria Caulfield Excerpts

Wednesday 12th January 2022 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) for bringing the debate to the Chamber. I echo much of what she says, and the Government are delivering on much of it, so perhaps this is an opportune moment to update Members on the progress we are making.

We owe a huge amount of gratitude to general practice staff for their efforts throughout the pandemic, stepping up to run vaccination programmes, continuing with flu vaccinations, looking after house-bound patients and continuing their day-to-day work. They have been absolutely outstanding. Since 30 November last year, more than 52 million covid vaccinations have been delivered by general practice, which is an amazing achievement. They are incredibly busy and have been throughout the pandemic, as reflected in appointment data. In November, general practice delivered an average of 1.39 million appointments nationally per working day, an increase of 6% compared with November 2019. Once covid vaccination appointments are factored in, the increase is greater than 20%. GPs and their teams have been working incredibly hard.

The focus on the booster programme has meant some patients experiencing delays in getting an appointment, but that does not mean that general practice has been closed. GPs and their teams will always be there for patients, alongside NHS 111 and community pharmacy teams. It is important that people do not delay coming forward. We saw patients stay away during the first lockdown, and so unfortunately there was a delay in starting some of their treatment, so it is important that we all get out the message that GP practices are open for business. In my right hon. Friend’s constituency, under North Central London CCG, excluding covid-19 vaccinations, approximately 16% more appointments took place in November last year compared with November 2019, of which 57% were face to face. The crux of the matter that we hear from many constituents is around face-to-face appointments. That is why, in October, the Secretary of State launched the winter support package to tackle many issues my right hon. Friend mentioned. I will just touch on several.

First, we are improving telephone access, because sometimes the problem is that patients cannot get through by phone, rather than their not being able to see a GP. My hon. Friend the Member for Southport (Damien Moore) touched on that. Part of the package is a cloud-based telephony system to help increase that capacity for GPs, who may only have one or two receptionists and a couple of phone lines that get busy pretty quickly as soon as 8 o’clock hits. The improved functionality has the potential to free up existing telephone lines for incoming calls and will be available at no additional cost to practices. We will require GP practices to sign up to this cloud-based telephony system, which will be up and running pretty soon. All those that expressed an interest have been contacted, and we expect many to go live fairly soon. Some practices are already tied into existing contracts, so there may be a slightly delay in roll-out there, but where we can get them up and running, we absolutely will.

Secondly, we are encouraging GPs to offer face-to-face appointments. However, it will not always be a GP that a patient sees. There are a range of healthcare professionals in primary care, from nurses—they do an amazing job, if I say so myself—to paramedics, pharmacists and physios, and the GP is not always the best person for a patient to see. Face-to-face appointments are available, and our message to patients is that they will not always see the GP face to face, but that does not take away from the care that they receive.

On finance, £250 million was announced in the winter support package, which can be used by GPs in a range of ways—whatever suits their local area. For some, it will be a physical expansion of their practice so that they can see more patients. For others, it may be to take on locums, where they are available—that is also a pressure point—or other healthcare professionals or an extra receptionist, or to extend opening times. The money can be used on whatever will help GPs to expand their ability to see patients.

My right hon. Friend touched on bureaucracy and red tape, which is a massive ask for GPs. We have made some temporary changes during the omicron vaccine roll-out period to free up capacity, including extending the sickness self-certification period for people accessing statutory sick pay and suspending requests for medical information from bodies such as the Driver and Vehicle Licensing Agency. We are bringing forth secondary legislation to allow other healthcare professionals to do some of those checks—statutory instruments are going through the system as we speak—and having discussions with other Departments about moving away from always expecting GPs to do medical reports, whether for the Department for Work and Pensions, the Department for Transport or for schools. Patients can do a lot for themselves and a medical report from a GP will not always be required. We are also improving digital technology so that handwritten letters and reports, which take so much time for GPs, can be digitised and made much easier.

One of the most exciting innovations in the package is the promotion of pharmacists, which my right hon. Friend touched on. We have a community pharmacist consultation service whereby patients who phone 111 or contact their GP can be referred direct to pharmacists, who are taking on prescribing skills so that they can prescribe as well as dispense. We are looking towards a more pharmacy-first model as in Scotland and Wales, where patients can go direct to pharmacists without necessarily going first to the GP, opening up primary care and making it much more accessible. I hope that, through a number of the points that I have addressed, it can be seen that we are moving at pace.

Workforce was touched on, and I am pleased that we are making progress on that. We have already recruited 10,000 of an additional 26,000 staff who will be working in general practice by the end of 2023-24. In the North Central London CCG area, 327 additional staff have been recruited to date, with a further 114 anticipated.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) on bringing the debate to the Chamber and draw attention to my entry in the Register of Members’ Financial Interests as a practising NHS doctor. In 2015, the then Secretary of State said that we would recruit an extra 5,000 GPs to the workforce. Can the Minister update us on how many extra full-time equivalent GPs are working in the NHS?

Pensions is also a real issue that is stopping the current workforce extending their careers as they face punitive tax penalties. Will she please commit to addressing that and raising it with the Treasury?

[Maria Caulfield]

Absolutely. I was going to come to the number of GPs. I am pleased, as is my right hon. Friend the Member for Chipping Barnet, that we have 4,000 doctors in GP training places this year, which is an increase from 2,671 back in 2014. We are getting more GPs through the training process. However, in terms of GPs in place, there were 1,841 more full-time equivalents in September 2021 compared with September 2019, so we are seeing increases coming through.

However, there are issues with retention as well as recruitment. I think my right hon. Friend touched on issues with the Home Office and GP trainees once their visas expire. We met Home Office officials just before Christmas and there is better working now between the NHS and the Home Office to help facilitate those who come on a visa and need help to get into the workforce, get their visas extended or their training finished before their visa expires.

My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) made a very valid point about GP pensions. We have discussed that, and we are setting up a meeting with Treasury teams to look at that in more depth. There is no doubt that that is a disincentive to stay in practice, and we will certainly be looking at that further.

I will finish by asking all colleagues to support local GPs. They have had a very tough time. We are taking a zero-tolerance approach to any abuse they receive. That also applies to pharmacists. They have had a difficult time and continued to stay open during the pandemic. Face-to-face appointments were a challenge. We are doing everything we can to support them with the asks to break down some of those barriers. I am optimistic that we will see progress and that patients, who are the most important people in this debate, will see improved access to services in primary care.

Question put and agreed to.