I’m a GP (not in Sheffield, although we have the same issues everywhere) and while in principle I welcome any additional funding, I really don’t think getting an appointment will get a lot easier following this announcement. The devil is in the detail.
The majority of Primary Care Networks have already used/committed the majority of their ARRS budget at this stage. The additional £82m announced translates to less than £1.50 per patient across England. The average size of PCNs is 30-50k patients so we are talking about an extra £45k to £75k per average sized PCN.
I haven’t seen detail on what the salary for GPs under the scheme is but that funding has to cover both salary and on costs, so it’s highly unlikely to fund a full time GP.
Now say a PCN had a surplus of ARRS funding and manages to employ a full time GP. My PCN has 9 practices. Let’s say this GP offers 25 appointments per day for 4 days (optimistic as you’d have to factor in a lot of travel between sites). 100 appointments across 9 practices… that’s 11 additional appointments at each a practice per week. It’s a drop in the ocean unfortunately. More likely they’d work in a hub or be recruited to support care home ward rounds, which would free up a small amount of capacity at practices.
I have some concerns about the addition of GPs to a scheme designed for Additional Roles. These doctors won’t be employed directly by practices and the move continues a trend of funding moving from practices to Primary Care Networks. This is in line with Labour’s talk of Neighbourhood Health Teams. My preference would have been more core funding for practices (even if ring-fenced for staffing) so we can employ and invest in our own staff.
But my critical point is that this won’t make a significant difference to patient access and it won’t create enough jobs for all the newly qualified GPs who are desperately looking for work.
If all GPs were salaried NHS employees rather than self-employed small business owners, there would be no need for them to chase profits, compete for lucrative contracts, or waste time with the 'worried well'.
Thanks for another thoughtful and in depth piece of journalism about the GP crisis. Only yesterday I received this text from my GP:
“ Due to a significant increase in unforeseen clinical absences and annual leave, we have had to implement a restricted triage service. This may mean that we reach capacity before the usual 12pm cut off time. We apologise for any inconvenience this may cause. XXXX Medical Centre” and this shows that it only takes one GP to go off sick or take some leave and the whole system falls over for patients. The Government clearly needs to go further that releasing the ARRS payments to fund GP appointments. I don’t think the majority of the public realise that many GP’s are not employed by the NHS but rather employed by a Health Care Federation or an incorporated GP Group which contracts for their services in a district or local area and which can decide what to pay its GP’s
It could also be waiting lists. I had to go back to my gp when an abscess returned with a vengeance. I had already been referred to a surgical consultation, because said antibiotics will only temporarily help, but the waiting list is more than 6 months. I expect I will be back at the gp many more times for antibiotics before I get seen by the consultant.
I was astonished to be offered an appointment with a paramedic at my local practice. This to discuss a long standing back problem. The alternative was an ‘advanced nurse’. I eventually got to see a trainee doctor, whose work was supervised remotely by my GP. Truly appalling that qualified doctors can’t get work.
I’m a GP (not in Sheffield, although we have the same issues everywhere) and while in principle I welcome any additional funding, I really don’t think getting an appointment will get a lot easier following this announcement. The devil is in the detail.
The majority of Primary Care Networks have already used/committed the majority of their ARRS budget at this stage. The additional £82m announced translates to less than £1.50 per patient across England. The average size of PCNs is 30-50k patients so we are talking about an extra £45k to £75k per average sized PCN.
I haven’t seen detail on what the salary for GPs under the scheme is but that funding has to cover both salary and on costs, so it’s highly unlikely to fund a full time GP.
Now say a PCN had a surplus of ARRS funding and manages to employ a full time GP. My PCN has 9 practices. Let’s say this GP offers 25 appointments per day for 4 days (optimistic as you’d have to factor in a lot of travel between sites). 100 appointments across 9 practices… that’s 11 additional appointments at each a practice per week. It’s a drop in the ocean unfortunately. More likely they’d work in a hub or be recruited to support care home ward rounds, which would free up a small amount of capacity at practices.
I have some concerns about the addition of GPs to a scheme designed for Additional Roles. These doctors won’t be employed directly by practices and the move continues a trend of funding moving from practices to Primary Care Networks. This is in line with Labour’s talk of Neighbourhood Health Teams. My preference would have been more core funding for practices (even if ring-fenced for staffing) so we can employ and invest in our own staff.
But my critical point is that this won’t make a significant difference to patient access and it won’t create enough jobs for all the newly qualified GPs who are desperately looking for work.
If all GPs were salaried NHS employees rather than self-employed small business owners, there would be no need for them to chase profits, compete for lucrative contracts, or waste time with the 'worried well'.
Thanks for another thoughtful and in depth piece of journalism about the GP crisis. Only yesterday I received this text from my GP:
“ Due to a significant increase in unforeseen clinical absences and annual leave, we have had to implement a restricted triage service. This may mean that we reach capacity before the usual 12pm cut off time. We apologise for any inconvenience this may cause. XXXX Medical Centre” and this shows that it only takes one GP to go off sick or take some leave and the whole system falls over for patients. The Government clearly needs to go further that releasing the ARRS payments to fund GP appointments. I don’t think the majority of the public realise that many GP’s are not employed by the NHS but rather employed by a Health Care Federation or an incorporated GP Group which contracts for their services in a district or local area and which can decide what to pay its GP’s
If the newly qualified GPs simply replace Physician Associates, I’m unable to see how the number of appointments will increase.
“The number of people who want a GP appointment is rising every year, for reasons he isn’t quite clear on”
An aging population and immigration, surely?
It could also be waiting lists. I had to go back to my gp when an abscess returned with a vengeance. I had already been referred to a surgical consultation, because said antibiotics will only temporarily help, but the waiting list is more than 6 months. I expect I will be back at the gp many more times for antibiotics before I get seen by the consultant.
OK. Victoria: please would you diary this one for a year hence, and report back to us? Thank you 💕
Interesting article that explains quite a lot.
I was astonished to be offered an appointment with a paramedic at my local practice. This to discuss a long standing back problem. The alternative was an ‘advanced nurse’. I eventually got to see a trainee doctor, whose work was supervised remotely by my GP. Truly appalling that qualified doctors can’t get work.
Now I read GPs are going to work to rule.
What a shambles…