From April 2022 to March 2023 the 182 General Practices across Kent & Medway provided 10.5 million appointments an increase of 6% from the previous year. This is for a population 1.9 million, which equates to every person having the equivalent of  5.5 appointments a year, an astonishing achievement. All this work in the context of the lowest numbers of GP’s per 1000 population compared to any other area in England.

In the last few weeks there have been several directives released by the NHS; some are guidance, and some are mandated.  Here we explain what the recently mandated changes to the GP contract means for patients accessing their General Practice. These recent changes were not agreed by the profession and have not been accompanied by additional funding to support increased capacity.

When a patient contacts a practice, what should they now expect?

A patient can expect a response based on an assessment of their need and the finite capacity within General Practice.  The contract now states that following a patient contact (in-person, phone or on-line) the General Practice must take steps to provide an ‘appropriate response’ the same day or the next day if contact is after 6.30pm.

 An ‘appropriate response’ includes one of the below options:-

• Invite the patient for an appointment (in-person / phone or video) at a time which is appropriate and reasonable having regard to all circumstances.
• Provide appropriate advice to the patient – this could include emailing / texting advice or signpost to on-line resources.
• Invite the patient to make use of appropriate services - this could include where suitable directing patients to community pharmacies, urgent treatment centres or A&E departments.
• Communicating with the patient:-
  • asking for further information to make an adequate assessment
  • if suitable the practice can let the patient know they will receive further information about their options at a future date

Following patient contact can my General Practice ask a patient to seek help from another service?

The latest changes make it clearer that an appropriate response to a patient query can include signposting patients to other sources of help that may include attending a pharmacy for advice, refer to self-care advice on a website or even suggest attendance at an urgent treatment centre, A&E or referral to the Community Pharmacy Consultation Service

Does my GP or other member of the GP team have to see me within 2 weeks?

There is no mandated requirement for General Practices to offer appointments within 14 days. There is an aspiration payment that practices working in groups called Primary Care Networks (PCNs) can work towards an offer of appointments in 2 weeks. The new contract can allow for much longer waiting times for routine appointments as long as the patient is made aware of the likely waiting time.

How is New Dover Road Surgery responding to these changes?

From June 2023, to fulfil the requirements of the new contract, we will be operating a more comprehensive triage system on first contact. When you call the Practice for an appointment, you will be asked to provide an outline of the reason. This will help our reception staff signpost you to the most appropriate point of care, which may be:

• an on-the-day appointment with a GP, 
• a routine appointment with a GP,
• an appointment with a Practice Nurse,
• an appointment with a physiotherapist,
• direction to mental health support services to which you can self-refer,
• an appointment with a pharmacist, either in a community pharmacy or with a clinical pharmacist who works with our PCN,
• direction to the community pharmacy services for advice,
• an Accident & Emergency, Out of Hours service, Urgent Treatment Centre or Minor Injuries Unit,
• an optician or audiologist,
• providing guidance on how to order repeat medication (although they cannot take orders over the phone,
• giving administrative advice
• other

We are providing our staff with additional signposting training, and this will be overseen on a daily basis by a supervisor.

It may be, particularly if our list is getting full for the day, that we have to get back to you with a solution. In this case, your request will go to a secondary triage list to be looked at by a senior member of staff, who will in turn refer to a GP if they need a clinical opinion on how best to help you. This may mean we may not be able to give you an answer or an appointment when you first call, but you will hear back from us by the end of the working day, and you will not be advised to call back another day. 

To help us, please be prepared to tell your call handler an overview of the problem you are calling with. If you are offered an option other than a GP appointment, this will be because it is a more direct and better option for you, and will help us reserve urgent GP appointments for those who really need them. We hope that by implementing this system, we may be able to release more routine GP appointments, which will improve access for everybody.

As with any change, this will take a little time to embed, and we will be reviewing the changes on a frequent basis, looking to make improvements wherever we can. We thank you for your patience during this period of change.

Published: May 15, 2023