BMA urges health secretary to address ‘micromanagement’ of GPs by NHS England

The BMA has written to the new health secretary Sajid Javid asking him to put an end to the ‘micromanagement of general practice’ from the Government and NHS England.

It calls on Mr Javid to intervene in the fallout from the ‘unacceptable letter’ from NHS England to the profession in May which ‘undermined the confidence and morale of the whole workforce’.

GPs had reacted with outrage to guidance from NHS England to practices which said patients must be offered face-to-face appointments if they wanted.

Since that time, the BMA’s GP committee had resolved to stop to formal meetings with NHS England due to ‘repeated concerns about the use of SOPs, directives and damaging comments to the press’.

The news comes as NHS England has now said it will withdraw the controversial Covid standard operating procedures from next Monday, but its letter to GPs added new guidance on face-to-face appointments.

In his letter to Mr Javid, BMA GP Committee chair Dr Richard Vautrey said: ‘We would like to see progress being made by NHSEI to address our concerns, which would allow us to re-engage with them on key issues, and hope that where appropriate we can work with you to help facilitate this.’

The previous health secretary Matt Hancock had written to the BMA in June asking it to ‘return to negotiations’ with NHS England immediately, while reiterating that that the use of SOPs was a ‘temporary approach’.

But although NHS England has withdrawn the SOP, it announced last week that contractual variations – including requiring practices to keep 1 in 500 appointments free for NHS 111 direct booking, would be extended until September. NHS England has added that this requirement is now under review.

Dr Vautrey said GPs and their staff had ‘made an incredible contribution to fighting the pandemic and caring for our patients over the last 18 months’, making rapid changes to protect patients and staff but also in delivering the Covid-19 vaccine programme.

‘Practices have been able to respond to the challenges of the pandemic because of the flexibility of the independent contractor status and our partnership structure. This enables practices to respond rapidly and effectively with the expert knowledge of our local communities,’ the letter said.

‘However, we have been concerned about the way the Government’s emergency regulations, which have now been extended to September, have led to a command and control way of working which at times has restricted practices rather than empowered them.’

He added that the BMA has ‘significant concerns’ about the impact on practices of significant additional work relating to PCN service specifications in the autumn ahead of a difficult winter.

‘Earlier in the pandemic we produced a widely welcomed report “Trust GPs to lead”, which outlines how GPs can respond to meet the needs of their patients when given the freedom to do so, and are not burdened with unnecessary target setting and bureaucracy’, Dr Vautrey wrote.

‘If the Government is to lift all restrictions on 19 July, we believe you must also make it clear that this date will bring an end to this micromanagement of general practice from both government and NHSEI.’

The letter, sent to Mr Javid on the 12 July, points out that the workforce is exhausted, has not been offered sufficient support to recover is and is having to deal with the impact of the serious NHS backlog in care

‘Because of this we risk losing much needed and highly skilled healthcare professionals at a time when we should be doing all we can to recruit and retain them.’