AOP responds to plans to improve access to GP appointments
The AOP has warned that the ‘major multi-million pound overhaul of primary care’ fails to recognise the value of optometrists
11 May 2023
The Delivery Plan for Recovering Access to Primary Care, published on Tuesday 9 May, aims to make it easier for patients to contact and see their GP in a timely manner.
Speaking in Parliament, health and social care secretary, Steve Barclay, explained that the plan has a three-pronged approach: equipping GPs with new digital tools, freeing up GP appointments by utilising ‘Pharmacy First,’ and providing more staff and more appointments in GP surgeries.
Barclay said he hopes the plan “funds and empowers our GPs and pharmacists to do more so we can prevent ill-health, keep cutting NHS waiting lists, and improve that vital front door to the NHS for many millions of people.”
However, the AOP has emphasised that the answer to providing high quality and specialist care lies in utilising skills from every part of primary care.
Adam Sampson, AOP chief executive, said: “We’re encouraged to see some pragmatic solutions in the GP access plan, including the expansion of pharmacy services for the benefit of patients. However, it is also clear that the plan fails to recognise the value of the whole primary care family, which is ultimately the answer to high-quality and specialist care that every patient deserves.
“Our optometrist members, for example, already provide vital support to the NHS and where extended eye care services have been commissioned the evidence points to a significant reduction in pressure on other NHS departments in secondary care, but this could also apply to GP services.”
Sampson continued: “Over a quarter of patients (32%) turn to their GP for help when they have an eye complaint and our highly skilled workforce are expertly placed to improve the experience for patients. Like pharmacists, the network of community-based optometrists working in High Streets up and down the country provides a huge potential resource to help alleviate pressure on GPs. Optometry provides an immediate solution that ensures easy and more convenient access to eye care, quicker.”
The Association is pleased to see implementation of reforms recommended in the Fuller Stocktake for integrated care, Sampson said, but believes that there needs to be a greater push from Integrated Care Systems in order to “deliver a greater parity of esteem across all elements of primary care.”
This, alongside greater IT connectivity, is required to improve patient outcomes, Sampson said.
NHS England and the Department of Health have committed over £1.2 billion of funding to support the plan, Barclay told MPs on Tuesday.
The plans will see £240 million invested this year in improving the technology and phone systems used in GPs’ practices across the UK.
Changes will include replacing analogue phones with modern systems so patients no longer get engaged tones, and implementation of online booking tools.
Patients who cannot reach a receptionist on the phone will be placed in a queue or offered a call back option. Functionality will also be implemented so that calls, when required, can be directly routed to the most relevant professional.
The phone system will also be integrated with the clinical systems, so practice staff can quickly identify patients and their information from phone numbers.
Patients will be able to find out how their request will be handled on the day they call, without being asked to call the practice back later.
If their need is urgent, patients will be assessed and given appointments on the same day. Non-urgent appointments will be offered within two weeks, or patients will be referred to NHS 111 or a local pharmacy.
The ability for patients to access their health records via the NHS App will also be improved.
The number of people able to self-refer for services including hearing tests, physiotherapy and podiatry without a GP appointment is expected to rise by around 500,000.
The role of doctors’ receptionists is set to be expanded, improving receptionists’ triage skills, “to make sure patients are directed to the most suitable healthcare professional and to simplify and streamline the process,” the Department of Health and Social Care (DHSC) said.
To facilitate this, the Government will fund 6500 ‘care navigator’ training places. It is then expected that the trained members of staff will be in a position to share their training with the rest of the GP practice team.
Developed with the NHS, the plan has been described as part of a ‘major multi-million pound overhaul of primary care.’
The waiting list
It is hoped that the investment will help to cut NHS waiting list times and improve patient satisfaction.
The AOP’s Sight Won’t Wait campaign recently highlighted the patient backlog, and called on the Government to use optometrists’ skills to help ease waiting list pressure.
Barclay noted that GPs are seeing 10% more appointments than they were before the pandemic.
This equates to half a million more appointments a week, according to Dr Amanda Doyle, NHS England’s national director for primary care and community services.
Doyle said: “Produced by the NHS, this plan will make it easier for patients to access the care they need.”
She added that healthcare staffing “needs to be put on a sustainable footing,” and that the NHS is also working with the Government to publish a long-term workforce plan.
The AOP hopes that the NHS workforce plan “will do more to recognise the full spectrum of healthcare professionals across primary care, and the vital role they can play to truly address the extremely difficult challenges patients in England are facing,” Sampson said.
Barclay said he wants to “make sure people receive the right support when they contact their general practice and bring an end to the 8am scramble for appointments.”
Neil O’Brien, minister for health, added: “Where GPs have already moved over to these new technologies we see they free up the phones, making it much easier for people to get through to their general practice team.
“As well as being more convenient for patients, these really easy to use digital tools allow a lot of patients to get the help they need without ever needing to go in for an appointment, which will help cut waiting lists.”
The plan will make the workload more manageable for general practice teams, O’Brien said.
The DHSC highlighted that an average sized GP practice, with 10,000 patients, often receives more than 100 calls in the first hour every Monday morning.
The CEO of Healthwatch England, Louise Ansari, called the plans “a step-change in how primary care services will be delivered,” but acknowledged that frustrations in accessing GPs’ services “have boiled over in recent years, translating into some of the lowest-ever satisfaction levels with the NHS.”
“We know that part of the solution to addressing problems in primary care is to create more capacity, but this will take time,” Ansari said. “This plan acknowledges that there are actions the NHS can take today to make accessing care easier.”
She added: “Over the coming months, we will be working with NHS England to communicate these changes to patients and the wider public, helping them understand how to access the right service at the right time, and feeding back people’s ongoing experience to ensure plans stay on track.”
An expanded role for pharmacies
In his speech to Parliament, Barclay noted that 80% of people live within a 20-minute walk of a pharmacy, “so making it easier for pharmacists to take referrals can have a huge impact.”
The new plan will also allow patients who need prescription medications to collect them directly from a pharmacy for the first time, without the need for a GP appointment. Conditions including ear aches, sore throat and urinary tract infections are expected to be covered, as well as access to oral contraceptives and an increased number of blood pressure checks.
NHS chief executive, Amanda Pritchard, said that the ambitious measures will see “pharmacies playing a central role in managing the nation’s health, including providing lifesaving checks and medication for common conditions for the first time.”
Pritchard added: “This blueprint will help us to free up millions of appointments for those who need them most, as well as supporting staff so that they can do less admin and spend more time with patients.”
Janet Morrison, CEO of the Pharmaceutical Services Negotiating Committee, called the plans “a very welcome step towards putting pharmacies even more at the heart of primary care and prevention – where they belong – and making better use of pharmacists’ clinical skills.”
The chair of the National Pharmacy Association, Nick Kaye, said: “We warmly welcome this commitment to invest in a nationwide, pharmacy-based common conditions service, which will improve access to NHS care, free up GP appointments and help cut waiting times for primary care."
He added: “Everyone will benefit from this development – GP practices, pharmacy teams, the NHS as a whole and, above all, the general public whose day-to-day experience of healthcare will be significantly enhanced by this new service.”
An investment of £645 million is being made to facilitate the Pharmacy First plans.
The changes are expected to be in place by winter 2023, freeing up around 15 million GP appointments in the next two years.