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NHS launches same-day GP access plan – but you’re still not likely to see a doctor

Patients have little chance of seeing a doctor under the North West London Integrated Care Board's new plan
Patients have little chance of seeing a doctor under the North West London Integrated Care Board's new plan - Anthony Miller/Moment RF

The NHS is launching a scheme promising “same-day access” to GPs, despite patients having little of actually seeing a doctor.

Health officials said the plans for almost 3 million residents of north London would boost access to family doctors.

But details seen by The Telegraph show that health officials expect just one in 15 appointments offered under the “same-day access model” to be staffed by GPs.

Patients will be directed to the hub if they select “same-day” care when phoning their GP practice, with artificial intelligence used to help prioritise patients.

Documents drawn up by North West London Integrated Care Board, which is responsible for the health care of around 2.8 million people, suggest that each hub could have just one GP working for it, with most of the work done by less qualified staff, such as physician associates.

The briefing pack, seen by Pulse magazine, suggests that of the 146 appointments every day, just 10 would be staffed by GPs, with the remainder done by pharmacists, physician associates and advanced nurse practitioners.

Role of physician associates extended

The role of physician associate, which requires two years of postgraduate training but no formal medical training, is being extended across the NHS, despite concerns from many doctors.

Officials said patients seeking same-day care may need to travel further for it, while some hubs would be “virtual”, meaning appointments are either carried out remotely, or with patients being sent on to other services.

GPs and patient groups in the area have objected to the plans.

A letter from medical committees across London, which represent GPs in the capital, raises concerns about patient safety.

The letter, seen by The Telegraph, warns that the model will undermine “continuity of care” and suggests that arrangements for one GP to supervise a host of other staff are “unsafe”.

Campaign group Save our NHS Hammersmith and Fulham said the plans “would exclude GPs from almost all provision of ‘same day’ GP care for over 2 million people”.

Dennis Reed, from Silver Voices, a campaign group for the over 60s, said he was concerned that such a shift would end up “abandoning the GP system altogether”.

He said: “It makes the concepts of the family doctor and continuity of care redundant.

“If a patient requests same-day attention it usually means they are very worried about a particular condition, in pain or under acute stress.

“The last thing they need is to be referred to a hub,  interrogated on whether their request is justified, with minimal chance of actually getting to see a GP,” Mr Reed added.

In a website update last week, Dr Genevieve Small, Harrow GP and medical director, Primary Care NHS North West London said: “Patients consistently tell us that getting a GP appointment can be difficult.

“We have developed a plan that will increase same day access to GPs, community pharmacists and other primary care professionals for those patients who need it.

This approach will be introduced gradually across north-west London from April 2024. It will ensure that GPs have more time to proactively care for their patients who most need their expertise, including those with long-term conditions.”

The NHS body said patients might have to travel further for same-day care.

“Where appointments are needed the same day and no slots are available at your local practice, it is possible that you might be referred to a different practice, in much the way patients sometimes see different GPs out of hours.

“You may also be referred to another service such as a community pharmacist if they could better meet your needs.

Dr Small added: “It is for local primary care networks to decide whether their hubs are physical or virtual.”

Prof Kamila Hawthorne, chair of the Royal College of GPs, said family doctors were open to new ways of improving patient access, which could involve new hubs, if implemented appropriately.

But she said: “We do have concerns about how this model could impact continuity of care, which research consistently shows is beneficial for patients and the NHS.

“It’s the trusted relationships between GPs and patients, built over time, that help us to give patients the holistic care they often need.”