Give patients ‘right’ to see GP within seven days, says think tank

Patients should be given a new constitutional ‘right’ to see a GP within seven days, or be redirected elsewhere for a remote appointment, a think tank has proposed.

Conservative think tank the Policy Exchange listed the proposal among priorities for the UK’s next Prime Minister, set to be appointed on Monday.

Its report said this comes as ‘consumers of healthcare are increasingly expectant of a service which offers choices to suit their lifestyles – hence demands a shift towards personalised care’.

‘A new national commitment within the NHS Constitution to emphasise that patients have the right to be offered an appointment with a primary care healthcare professional within seven days would signal that the new administration will focus on the things that matter most to patients,’ the report said.

Under the proposals, patients in under-doctored areas ‘will be offered the choice of an appointment with GPs or other primary care healthcare professionals based in neighbouring ICS geographies to meet the seven-day offer, using telephony or video consultation’.

‘Evidence shows that only a minority of patient requests for care stated a preference for in-person face-to-face consultation,’ the think tank added.

The report said that this commitment would require ‘seamless transfer of the patient record across primary care, and new reimbursement approaches to allow for neighbouring-area providers to reimburse for consultations’.

The think tank, which yesterday hosted a high-profile speech by health secretary Steve Barclay, also believes that ‘the Government should expand the role of community pharmacies in delivering appropriate services to patients, to free up GPs to focus on wider clinical care’.

It suggested this could include vaccinations, as the Covid vaccination campaign showed pharmacies were ‘a viable setting for activities such as immunisations’.

Enhanced cooperation would be best achieved through a locally negotiated contract, which brings together qualified providers ­– general practice, pharmacy and local authorities – to collaborate rather compete against each other, the report said.

NHS England recently invited GPs to share their views on plans for a new national vaccination strategy, saying it expects Covid jabs to become a ‘seasonal service’.

Other Policy Exchange suggestions for stabilising primary care in the short term include the launch of a re-entry scheme to encourage retired GPs and nurses back into the workforce.

This week, the Government launched a consultation into extending NHS pension scheme changes that made it easier for retired GPs to return to work during the pandemic.

The think tank’s report also called for reform of NHS pension rules and their relationship with consumer price inflation.

It said that changes to the interrelationship between consumer price index (CPI) and the annual allowance (AA) for public sector pensions could address the problem of GPs seeking early retirement.

And it recommended that the new PM commissions an independent review of NHS pensions and their interactions with taxation policy. The review should commence in 2022 and report by January 2023 to inform the Spring Statement.

The think tank also recommended that action is taken to ‘transform’ the role of general practice within primary care.

It proposed a 10-year transition for general practice by introducing a new scaled model of integrated primary care in which workforce planning, estates development, data analytics and change management are supported by ICSs.

Relationship-based medicine and ‘continuity of care’ at practice-level should be supported through the growth of ‘integrated neighbourhood teams’ as envisaged in the Fuller Report, said the plan.

It said disparities, such as under-doctored areas, could be addressed by making contracting a more local process, with provider contracts negotiated and held with the relevant ICB.

These changes should be accompanied by ‘an improved and unified access route to primary care services called NHS Gateway, with standards and oversight from NHS England, but delivered and coordinated at system level’, said the report.  

Earlier this week, a major Pulse investigation revealed that 474 GP surgeries across the UK have closed in the past nine years without being replaced, with small practices on lower funding in more deprived areas most likely to be affected.

A version of this article was first published by Pulse’s sister title Management in Practice