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What is hidden behind Sajid Javids’ quarrel with doctors? | Health policy

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Why are Sajid Javid and medical doctors in England involved in a war of words?

The health secretary has irritated GPs by making it clear that he wants them to provide more face-to-face meetings than talking to patients on the phone or video calling. Tensions between the doctors and Javid have risen in recent weeks, with family doctors describing the minister as ignorant of the great strain under which they are.

The number of face-to-face appointments dropped dramatically during the pandemic as GP surgeries followed the advice of the NHS and the government to use distance appointments as much as possible to ensure the safety of patients and practice staff. But the percentage of all physician meetings held in person has now turned to 58%, the latest figures show. Before the pandemic it was 80%.

Javid wants GPs to offer a face-to-face consultation for anyone who wants it. In his speech at the Conservative conference last week, he said: The public expects to be able to see their medical doctor, in the way they choose.

How does this relate to the new general practitioner support plan?

He upheld the personally-if-wanted principle in this controversial policy initiative, which launched Thursday and aims to improve access for NHS patients and support GPs. This made the ability of physicians to share in a new fund 250 million winter approaches dependent on patients’ ability to choose how they interact with the GP, and surgeries that offer more face-to-face meetings, such as and more games with a practicing physician or nurse for patients who call that day.

From next spring, the NHS will publish monthly figures showing how many patients were seen in person, an action some doctors say will appoint and embarrass surgeries that do not provide enough face-to-face care, perhaps because they do not have enough staff. as are many.

What do doctors say about this?

Medical executives have become increasingly concerned with the language recently used by Javid, Jacob Rees-Mogg, and the official spokesman for the prime minister on behalf of Boris Johnson. They worry that calls for medical doctors to see more patients in person are unrealistic due to the constant threat from Covid and, in particular, the widespread shortage of medical doctors and their heavy workload.

It’s really scary that we have a government so ignorant about the needs of such an essential part of the NHS, said Dr Richard Vautrey, chairman of the British Medical Association committee. Professor Martin Marshall, president of the Royal College of General Practitioners (RCGP), said Javids’ plan was a missed opportunity that would do little to improve the strong pressures facing surgeries.

For family physicians, the lack of general practitioners and the difficulties that surgeries have in filling vacancies is the most urgent issue they face, not the way they treat patients.

The government promised in 2015 to expand the medical workforce in England by 5,000 by 2020, but lost that target. Johnson has pledged to increase the number of general practitioners by 6,000 by 2024.

However, the number of full-time equal doctors in England fell from 29,403 in 2015 to 28,023 in August a drop of 1,380.

The total number of general practitioners increased during that time, from 36,120 to 38,792. But the total amount of doctor time is reduced as more family doctors have chosen to work part time.

What do medical doctors say about government plans?

The BMA and RCGP are angry that the government, in its new action plan, called for the return of routine face-to-face meetings, but took some of the steps they had suggested would help alleviate the strain caused by aging and growth. of population and the ever-increasing demand for care created by Covid.

For example, they wanted to see the suspension or removal of the Quality Scores Framework, a system under which physicians are paid to monitor patients with long-term conditions such as asthma and diabetes, to reduce the number of patients they need to see each day Me

They would prefer to see ministers deliver on promises to expand the medical staff workforce by 6,000 and help operations hire 26,000 more staff by 2024.

Why do face-to-face meetings matter so much?

Most patients still prefer to see a personal physician in person, due to the privacy involved. Some doctors believe what the BMA calls governments’ preoccupation with face-to-face appointments is a response to an ongoing campaign by the Daily Mail, and other coverage in the Daily Telegraph and Times, which family doctors have interpreted as doctor’s basting.

Ministers say doctors may lose signs or symptoms of illness or injury if they do not see someone in the flesh, in part because then they cannot perform a physical examination.

Dissatisfaction about the difficulty of getting an appointment with the medical doctor had increased among patients even before the pandemic hit in the spring of 2020, with a delay of two weeks. There is some evidence that patients are going to A&E in frustration because they are unable to see a doctor.

BMA and RCGP both point out that not only are there too few physicians to see anyone who wants an appointment, but also that some patients prefer a telephone or video consultation and that some routine tasks, such as medication reviews, can be done safely from a distance.

Sources

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2/ https://www.theguardian.com/politics/2021/oct/14/whats-behind-sajid-javids-row-with-gps

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