Will the ‘Plan for Patients’ make any tangible difference to the NHS?

The British Medical Association (BMA) has criticised the health secretary’s new ‘Plan for Patients’, which aims to improve NHS care ahead of the expected winter pressures, describing it as “tone-deaf”.

The BMA says the plan will make “no tangible difference to patients struggling to access care”, as it offers no concrete proposals to tackle the workforce crisis.

A  Plan for Patients

As part of the plan, the government is calling on the one million volunteers who stepped up during the pandemic to come forward once again to support the NHS, as part of plans to ensure patients have timely access to care.

The new plan, Our Plan for Patients, developed by the new health and social care secretary Thérèse Coffey, says the public should “do their bit” and take part in a “national endeavour” to support the NHS and social care.

The NHS Volunteer Responders Programme was set up at the start of the pandemic to free up nurses, doctors and other NHS staff to deliver patient care. It saw nearly a million volunteers step forward to carry out tasks such as delivering medicines, making phone calls and stewarding vaccination sites.

While full details of the plan are yet to be confirmed, it seems that these volunteers would take on similar roles to help free up healthcare professionals’ time.

Pat Cullen, General Secretary and Chief Executive of the Royal College of Nursing, has criticised the announcement for “lacking” any real plans to make “care safer”. She added that another call-out for volunteers looks “panicked and ill-considered”.

The RCN say that the plans do not address the staffing crisis, and call for “urgent investment” to boost the domestic workforce and ensure nurses are paid fairly.

Ensuring patients can access GP appointments quickly and easily

Improving access to GP appointments is also a key priority for the new health secretary. Under the new plans, everyone who requires a GP appointment should get one within two weeks, with patients with the most urgent needs being seen within the same day.

To achieve this, the government will change funding rules to recruit extra support staff so GPs can focus on treating patients – freeing up over one million appointments per year. This includes GP assistants and advanced nurse practitioners, as well as pharmacists, mental health practitioners and nursing associates.

Ms Coffey says the government will provide more telephone systems for general practices to make it easier for patients to get through to their GP surgeries, and publish appointments data at a practice level so that patients can access more information about their local surgery.

Pharmacies will also be permitted to manage and supply more medicines, so that patients can access their prescriptions directly from pharmacies, rather than having to make a GP appointment. They will also take referrals from emergency care for minor illnesses or symptoms, such as a cough, headache or sore throat.

85% of GP appointments already happen within two weeks of being booked

However, the Royal College of GPs (RCGP) have highlighted that around 85% of GP appointments already happen within two weeks of being booked, with nearly half (44%) happening on the same day as booking. “Those taking longer than two weeks after booking may be routine or regular appointments for which the timing is therefore appropriate,” they add.

Prof Martin Marshall, Chair of the RCGP also criticised the Health Secretary for failing to consult the College or its members before the announcement, saying they “could have informed her of what is really needed to ensure a GP service that meets the needs of patients and is fit for the future”.

The College is concerned that the scheme simply piles on further expectations from GPs, without a plan on how to deliver the care that patients so desperately need.

He said: “[The plan] will only serve to add to the intense workload and workforce pressures GPs and our teams are facing, whilst having minimal impact on the care our patients receive.”

What general practice really needs, he says, is “the implementation of a new recruitment and retention strategy that goes beyond the target of 6,000 GPs pledged by the Government in its election manifesto, funding for general practice returned to 11% of the total health spend, investment in our IT systems and premises, and steps to cut bureaucracy so that we can spend more time delivering the care our patients need and deserve.”

A “tone-deaf” plan that will make “no tangible difference”

The British Medical Association have similarly called for government to put a greater focus on fixing the staffing crisis.

Dr Farah Jameel, chair of the BMA’s GP committee for England, said the plan was “tone-deaf”, and in reality, only offers “minor tweaks that will make no tangible difference to patients struggling to access care”.

The Association is concerned that introducing two-week targets is “simply another addition to a tick-box culture”, and note that timely access to care cannot be achieved without more GPs and staff to deliver it.

“Many practices already use cloud-based telephone systems, but we simply don’t have the staff to answer more phone lines, nor more clinical staff to offer more appointments,” Dr Jameel added.

“The first step” in bolstering NHS and social care services

Ms Coffey said the plans are “just the first step in our work to bolster our valued NHS and social care services so people can get the care they need.”

She said: “I will put a laser-like focus on the needs of patients, making their priorities my priorities and being a champion for them on the issues that affect them most.

“Our Plan for Patients will make it easier to get a general practice appointment and we will work tirelessly to deliver that, alongside supporting our hardworking GP teams.”

Will the plan tackle the persistent problems in social care?

In a follow-up announcement (22 September) the government announced that it would provide £500 million of additional funding into adult social care to help people get out of hospitals and into social care support.

There are currently around 13,000 patients in hospital beds who should be receiving care in the community. The government says that the Adult Social Care Discharge Fund will help speed up the safe discharge of patients from hospital this winter to free up these beds, as well as helping to retain and recruit more care workers.

Of this package, £15 million will be dedicated to helping increase the international recruitment of care workers. This will enable local areas to support care providers with activities such as visa processing, accommodation and pastoral support for international recruits.

The government says that this a national domestic recruitment campaign will also be launched in the coming weeks.

The announcement comes following calls from the NHS Confederation, who asked the government to reinstate the dedicated central funding for social care. Its absence, the Confederation say, has contributed to bottlenecks in the numbers of patients stuck in hospital when they do not need to be.

Matthew Taylor, chief executive of the NHS Confederation, said: “Failure to address the lack of capacity in social care is a big reason why we have seen ambulances queued up outside hospitals all summer.

“The government must grip this problem and invest in extra social care capacity. We have days and weeks to get this right or risk a health emergency this winter.”

Allowing retired and partially retired staff to continue to return to work

The Confederation also called on the government to address ‘the pensions crisis’, which is preventing many senior medical staff from taking on additional shift work, which is in turn hampering efforts to bring down waiting times.

In response, the government has announced that it will extend retirement flexibilities to allow retired and partially retired staff to continue to return to work or increase their working commitments without having payment of their pension benefits reduced or suspended.

The government will also fix the unintended impacts of inflation, so senior clinicians aren’t taxed more than is necessary.

Prime Minister Liz Truss said: “These measures are the first part of that plan and will help the country through the winter and beyond. Ultimately my mission in government is to grow our economy, because that is the best way to support the NHS and social care system and ensure patients are receiving the frontline services they deserve.”