🍁Thoughts re yesterday’s Autumn Statement

📱I spent time on the phone to @SKinnock yesterday afternoon. @DrPhilBanfield did the same with @wesstreeting

1/n 💷 We explained quite how concerned GP partners & practices will be about rising employment costs from April

⚖️ Government knows there must be full recompense, so this doesn't add to the financial burden already crippling practices.

2/7

Here’s a snapshot of just 20 letters rec’d this afternoon from hospital & other NHS colleagues

Half need us to do something eg refer, order investigations, send info back

It’s not just GP time, but admin & secretarial too - when 95% staff are in hospitals Look at all the steps from receiving to completing the request (no I’ve never done a serum fluoxetine & I don’t plan to - so it’s also advising pts correctly when they’ve been promised nonsense) each of these tasks could easily take up to 30 mins. 20 x 30 = 500 mins, or 8 hrs.

The @Conservatives, @DHSCgovuk & @NHSEngland have decided, rather than being the ‘stepping stone’ year to signal safety, stability, and hope - 2024 will instead signal reduced patient access to GP services as well as likely closures of GP practices across the country.

🧵👇 The GP business model is now non-viabile despite accrual of 👉£0 👈financial deficit (hospitals c£1.5bn)

Patients & the public need to wake up 👀 & see what this is:

an intentional, predetermined, strategic, non-evidence based, ideological dismantling of NHS general practice.

A word of caution here, folks:

👉1.9% = a disgrace
👉to match 2019/20 we need 8.7% putting this derisory offer into context
👉#FPR for salariedGPs ~ c£450m
👉Total practice income/patient has ⬆️ by only £15 in a decade -
Yes! *£15*

Nice words won’t save General Practice

🧵👇

https://twitter.com/dauk_gp/status/1762536651476160940

We know that @DHSCgovuk & @NHSEngland didn’t even bother to recommend to @VictoriaAtkins or @andrealeadsom to go to @hmtreasury to ⬆️ the £ envelope beyond 1.9% for 2024/25

We can therefore assume that they know this will likely result in
surgery closures & reduced GP access
👇

I was fortunate enough to work with @RSylvesterTimes right at the start, having a small opportunity to frame this Commission, making some key recommendations for the immediate NHS future.

It is great to see a focus on improving integration in technology first and foremost.

1/n

https://twitter.com/thetimes/status/1754407407701102751

GP systems have been ‘paper-free’ for nearly 40 years, yet I was discharged from @uclh this wkd w 7 days’ meds & asked to see my GP for a paper sick note.

@HealthierNWL
@amandadoylegp

An example right here, we could & should be saving millions of appts each month! 🙃

1. Expert generalist GPs over skill-mix

2. Quality over quantity

3. Continuity over access

4. Autonomous patient-advocacy over banal service standardisation

5. Individuality over uniformity

6. Choice over compulsion

7. Human connection over AI

1/x pulsetoday.co.uk/news/breaking-… 8. Relationship-based care over flawed dashboards

9. Senior-led triage over 1000s online consults

10. Face to face over remote

11. Your known family doctor over “working at the top of your license”

12. Valuing your salaried GP colleagues over “adjusting the skill mix”

2/x

GPC England passed this emergency motion in all parts today:

“That GPC England fully endorses the recent statement by UEMO expressing concern over the increasing trend of "Physician Assistants/Associates" (PAs) being used to substitute GPs in English General Practice, &

(1/11) i) asserts that PAs are neither a safe nor an appropriate substitute for a GP

ii) calls for an immediate pause on all recruitment of PAs across PCNs and General Practice until appropriately safe regulatory processes and structures are in place…

(2/11)

🩺 Why is it so difficult to see a GP now? ❓

1: We’ve lost the equivalent of 2,212 full time (60+ hrs a wk) GPs since 2015. 📉 🧑‍⚕️

Assume each GP has a list of 1800 pts (often an underestimate) that’s a whisker below 4 million patients without access to a GP. ⚠️🥼

1/14

https://twitter.com/cyberjennifer/status/1690716265441046528

🩺 Why is it so difficult to see a GP now?❓

2: Those 4 million patients now have to be spread across the remaining GPs. 👩🏾‍⚕️👨🏻‍⚕️

But the population has risen by 2.2 million since then, so it’s more like the equivalent of over

***6 million patients “without a GP” ***

🤷‍♀️🤷‍♂️