Supporting people to access the care they need

It’s been more than a year since the NHS introduced remote triage as the default for accessing general practice, in response to the pandemic, to keep patients and staff safe. We are very grateful to everyone who adapted rapidly to new ways of working, and your continued delivery of the largest vaccination programme we have ever carried out.

Your dedication and hard work has not gone unnoticed, and we are now managing higher levels of demand than ever before. As we ease out of the pandemic we must build on the innovation and achievements, focussing on a primary care service which is right for patients and staff both now and in the future. It is a key ambition of the NHS Long Term Plan that we provide a digital option for every patient, improving fast access to convenient primary care and navigating people to the most appropriate member of the general practice team. 14 new roles have been introduced into primary care networks and utilising this expansion of the workforce is critical to the sustainability of primary care. For many of you, this blended approach has been part of your patient offering for a long time.

However, we need to bring patients with us, and although we know over 50% of appointments are now face to face, and as GP teams you have been working constantly throughout, some patients have still struggled to get access to their GP. Both Healthwatch and the Patients Association have reported challenges which we cannot ignore.

The message that primary care continues to be open is an important one, because we know that many people over the course of the pandemic have put off seeking medical attention, including for symptoms which could be cancer or other serious conditions. But this message can only be effective if it is matched by people’s experience when they do then try to come forward, or the experience of their family and friends.

With restrictions across wider society easing, we need to keep in step and be accessible, while adhering to infection prevention and control guidelines, ensuring the remote triage offer facilitates a balance of online and face to face care. We know that this for some means more change, but this is important for ensuring that patients who do not have easy access to phones or other devices are not disadvantaged in their ability to access care.

Both the British Medical Association and the Royal College of General Practitioners have recently called for clarity on next steps in terms of access, and our latest GP Standard Operating Procedure (SOP) provides that, making clear that practices should continue to engage with local populations regarding access models and you should actively adapt your processes as appropriate, in response to feedback. We know that many practices are already providing an excellent balance, offering face-to-face services and making best use of remote working for those patients for whom this works well, and keeping people safe. This update to the SOP has been welcomed by patient groups including the Patients Association.

We know this is a complex issue and one size does not fit all, as we discussed in a recent article for Pulse. We hear you when you describe the changing and increasing workload and we want to work with you as the General Practice operating model evolves, to ensure we are supporting our patients and staff in the best possible way, making the best possible use of the skills and expertise of the wider primary care workforce.

As GP teams, working with patients, you are best placed to ensure the best balance for the communities you serve, and we will do all we can to support you through the most difficult time you have experienced.

GPs and every part of the primary care team have responded amazingly to be there for patients during the greatest challenge the NHS has ever faced. Our challenge now is to build on all of that good work and together continue improving primary care for the future, with the mix of remote and face-to-face appointments we know our patients want and need.

Dr Nikki Kanani is a GP in south-east London and is Medical Director of Primary Care for NHS England and NHS Improvement. Prior to joining NHS England she was Chief Clinical Officer of NHS Bexley Clinical Commissioning Group (CCG).

Nikki has held a range of positions within healthcare to support the development of innovative models of care, highly engaged clinical, patient and public leadership and is passionate about supporting primary care, improving service provision and population wellbeing.

She is a member of The King’s Fund General Advisory Council and holds a MSc in health care commissioning. With her sister she co-founded STEMMsisters, a social enterprise supporting young people to study science, technology, engineering, maths and medicine. She has two young children.