'Plans for GPs creating unachievable expectations'

A Shropshire GP has said she believes the government is creating an "unachievable expectation for patients" by asking practices to guarantee same-day appointments for people with urgent health needs.

The change is part of a new contract for GPs in England.

Spending on GP services will increase by nearly £500m, which the government said would be used to help recruit more doctors.

"There's a big thing not being acknowledged here in terms of NHS estates. I know numbers of practices are unable to have clinicians in the building because they haven't got a space for them to work," said Dr Jess Harvey, from Much Wenlock and Cressage Medical Practice.

"We want our patients to get the service they deserve but that needs to be appropriately funded," she said.

Separately, nearly £300m of existing funding will be ring-fenced and diverted into practices as part of plans to recruit additional GPs, or increase sessions undertaken by GPs already in post.

Harvey said this was not new money, and that before the announcement, it was going to practices in a "flexible way to be used in the way we need".

However she said it was now going to be given "in a very specific way and relies on us meeting very specific criteria."

"To try and say that we are going to see every urgent patient on that day requires a real significant uptick in funding for the clinical ability to do that," she added.

GPs already set aside a proportion of their appointments to try to ensure patients who need immediate treatment can be seen.

Currently, there is no requirement to measure how many patients who need a same-day appointment get one.

From April, it will become a contractual requirement to monitor this and achieve it in 90% of cases.

The 10% leeway is being built in to reflect that some patients may not be able to make a same-day appointment or may call too late in the day to be realistically given one.

Urgent cases are being defined as any patient whose symptoms suggest they need treatment to start the same day or where there is a risk of deterioration if they aren't assessed, such as a child with a high fever and a rash, or a frail older person who has suddenly become confused.

Health Secretary Wes Streeting said: "We are fixing the front door to the NHS. Many more patients with urgent needs will be able to get an appointment the day they contact their practice."

But Harvey said: "The definition of urgent needs to be considered because… one person's urgent could be someone else's routine."

She added that if those most in need were to be seen on the day, there needed to be "some acceptance that there has to be a clinical triage from the professionals".

"I genuinely believe that general practice offers an incredible service given the funding that we get.

"What we need is appropriate resource and also recognition of the hard work that's going on in general practice recognised."

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