When the British Medical Association's England GP committee passes a motion of no confidence in the leadership of NHS England, it is clear that something has gone very wrong. A ‘woefully badly judged’ letter from NHS England (2021) to GPs caused anger after it demanded that all patients should be offered face-to-face appointments if they choose, adding fuel to the fire in sections of the media that have suggested GP practices have been closed during the pandemic, and hitting the already low morale of those working in general practice.
NHS England medical director for primary care Nikki Kanani, subsequently clarified in a blog post (Kanani, 2021): ‘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’. Following on with ‘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.’
As we all know, most practice nurses have been seeing patients face-to-face throughout the pandemic for many different reasons, and most practices are offering a hybrid model of telephone or e-consults, with patients invited in to the surgery based on clinical need to reduce the risk of COVID-19 exposure for the patient and the practice staff.
Regardless of the intention, the reaction of GPs and practice nurses to the NHS England letter suggests a profession that is at crisis point. The latest NHS Digital (2021) data show that general practice is busier than ever – conducting almost 3 million more appointments in March 2021 than March 2019 – with an overwhelming workload and a lack of staff. Let us not forget that the 5000 extra GPs that were promised within 5 years back in 2015 never materialised. The number of GPs actually decreased.
NHS leaders need to look at how to improve morale, and consider more thoroughly how communications might be construed by a workforce under extreme pressure.
‘Practice Nursing provides nurses working in general practice with the tools to reach their full potential and deliver the best possible care to their patients. Our monthly journal informs and inspires by providing up-to-date, evidence-based clinical articles, highlighting key professional issues and promoting the latest research in general practice.’