Patients must get an appointment or referral when they first contact their GP practice under the terms of a new NHS contract.
Heath bosses want to end the daily 8am battle by getting patients to book more consultations in advance.
Some practices tell people seeking the same daycare to call back the next day once they are fully booked, rather than giving them the option to book ahead.
Now they should be able to reserve a place in the conversation or be referred to another appropriate service, such as a pharmacist or physiotherapist.
However, GPs have threatened to strike over the ‘offensive’ new contract, which they say has been forced on them by NHS England and does not offer enough money.
Growing populations and a shrinking workforce have exacerbated the workforce crisis in all but one of England’s 106 health districts. In Blackburn with Darwen there are 2,915 patients per fully qualified GP making it the worst served area. The number has increased by a quarter since 2016. Portsmouth is second with 2,821 and Hull third with 2,805
There were just 27,558 full-time equivalent fully qualified GPs employed in England last month, 1.6 per cent fewer than the 18,000 registered in June 2021. It was 5.3 per cent fewer than the more than 29,000 employed in June 2017
While the number of fully qualified GPs in England has fallen overall, the patient population has risen to 62 million meaning more Britons are competing for fewer doctors
It comes after surveys showed that public satisfaction with GPs has reached an all-time low, with patients particularly frustrated by the difficulties they face in accessing a doctor or even getting through on the phone.
A letter sent to all GP practices today by NHS England read: ‘To ensure consistency in the access patients can expect, the GP contract will be updated to make it clear that patients should be given an assessment of need or sent to a suitable service should be referred. , at the first contact with the practice.
‘Practices can therefore no longer request patients to contact the practice at a later time.’
The ‘needs assessment’ can be done over the phone, with some patients treated remotely and others invited to meet with a doctor face-to-face.
Those with minor illnesses may be referred to a pharmacist and those with muscle pain may be told to see a physiotherapist.
People with very urgent problems are referred to A&E, 999 or 111. The number of patients per fully qualified GP has reached an all-time high, with some GPs now caring for nearly 3,000 people in the worst served areas.
The new contract, which starts next month, reduces the number of goals GPs have to meet, so they have less bureaucracy and can focus more on patient care.
But it says practices should use a modern phone system when their current contract ends so that callers are queued and not greeted with an annoying busy signal.
They must also ensure that patients have online access to their medical records by the end of October.
About 1,400 surgeries, for 6.5 million patients, have already done so.
GPs are being instructed to offer statins to millions of patients and promote the benefits of exercise in an effort to prevent thousands of heart attacks and strokes.
The drug watchdog, Nice, effectively scrapped eligibility criteria for the pills in January after a major study found they are safe and rarely cause side effects.
Fewer than seven in ten GP appointments in England (68.3 per cent) were held face-to-face in December. It is the second month in a row that the figure has fallen after a peak of 71.3 percent in October. Eight out of 10 consultations were in-person before the pandemic. But the figure hasn’t bounced back so far
In England in 2015, there were over 1,000 GPs outnumbering receptionists in primary care in England. But by the end of 2022, that had completely changed with 3,000 receptionists more than GPs. Source: NHS Digital. Some data for reception numbers in 2016 and 2017 are incomplete and have been left as a straight line in the graph
According to the latest data, GPs now account for only a quarter of the primary care workforce, outnumbered 2-to-1 by administrative staff, more than half of whom are receptionists
Professor Aruna Garcea, Chair of the Primary Care Network Advisory Group at the NHS Confederation, said: ‘There is much to welcome in the new GP contract, including the significant reduction in national targets. “Frontline leaders support the contract’s ambitions and increased focus on improving patient access.”
Dennis Reed, director of Silver Voices, which campaigns for the elderly, welcomed the development but urged the NHS and government to move forward.
He said: ‘The end of the frustration of getting a call back, after queuing to make an appointment, certainly represents progress, but it doesn’t guarantee a timely in-person appointment with a GP.
“Receptionists can still decline a request to see a GP and instead schedule a telephone consultation or decide that another practice worker is appropriate, despite the patient’s wishes.”
Dr. Ursula Montgomery, director of primary care at NHS England, said: ‘GP teams have worked hard to deliver a record number of appointments with half a million more appointments a week last year compared to pre-pandemic, and this new contract is intended to build on this further with more access for patients.
“As well as providing same-day care to more than two-fifths of patients, GP teams will also step up preventive action against heart attacks and strokes over the coming year, encouraging health professionals to prescribe statins alongside other preventative measures such as exercise to a much larger number of patients with heart disease, arterial disease, and those who have had a stroke or have high cholesterol.
“Millions more patients will also be able to access their own health records on their smartphones so they can check their test results without contacting their practice.
“Frontline teams will be supported by more funding to expand their teams, with more mental health practitioners, advanced practitioners and trainee doctors joining the workforce, combined with changes to ensure staff spend less time on paperwork and more time with patients.
‘This contract supports GP teams to provide patients with what matters, and later this spring the NHS will publish the GP recovery plan on how to expand access to care even further.’