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26 Sept 2022

Health Secretary pledges to tackle GP access and keep A&E target

Health Secretary pledges to tackle GP access and keep A&E target

The Health Secretary has promised a “laser-like” focus on NHS problems as she set out plans for patients to see a GP within two weeks and committed to keeping the four hour A&E target.

Therese Coffey told MPs that “most of the time patients have a great experience but we must not paper over the problems we face”, as she noted “too much variation in the access and care people receive across the country”.

The Our Plan for Patients laid before Parliament means patients will be able to see how well their GP practice performs compared with others, potentially allowing them to join a different one.

The Health Secretary said a range of workers – such as pharmacists, GP assistants and advanced nurse practitioners – will be used to ease the burden on GPs, while urgent cases should be seen on the same day.

In her speech to MPs, Ms Coffey also pledged her commitment to the four-hour A&E target for people to be admitted, transferred or discharged.

The target has not been met since 2015. There have been four prime ministers in that time.

Ms Coffey said she recently endured a wait of nearly nine hours in A&E, adding: “I can absolutely say there will be no changes to the target for a four-hour wait in A&E.

“I believe it matters, and I’ll give you a personal experience recently.

“Just in July I went to A&E, I waited nearly nine hours myself to see a doctor and I still didn’t get any treatment.

“I was asked to go back the next day, so I went to a different hospital just three miles away and I was seen and treated appropriately.

“That’s the sort of variation that we’re seeing across the NHS.”

On ambulances being stuck outside hospitals for hours because they are unable to hand over patients, she pledged “a laser-like focus on handover delays”.

She said 45% of ambulance handover delays are occurring in 15 NHS hospital trusts.

She said: “The local NHS will be in intensive work with those trusts to create more capacity in hospitals, the equivalent of 7,000 more beds by this winter, through a combination of freeing up beds with a focus on discharge, and people also staying at home and being monitored remotely through the sort of technology that played such an important role during the pandemic.”

Ms Coffey said a £500 million fund would enable medically fit people to be discharged from hospital more quickly, supporting them to receive care in the community or their own homes instead.

The number of 999 and NHS 111 call handlers will also be increased to answer calls more quickly, she told MPs.

Ms Coffey also said the Government will be “exploring the creation of an ambulance auxiliary service”.

She said the NHS “will need a true national endeavour”, adding that she wanted to draw on the “energy and enthusiasm” of people who volunteered during the pandemic.

Shadow health secretary Wes Streeting criticised Ms Coffey’s “Sesame Street” plan as he questioned how the Government will make it easier for patients to see a GP.

He told the House of Commons: “She says patients will be able to get a GP appointment within two weeks – her party scrapped the guarantee of an appointment within two days that Labour introduced when we were in government, and she made it clear this morning that this isn’t a guarantee at all, merely an expectation.

“What is the consequence if GPs don’t meet her expectation? Well, as we heard on the radio this morning, her message to patients is ‘get on your bike and find a new GP’. Are patients supposed to be grateful for this?”

The Royal College of GPs said it had not been consulted on the plans, and league tables will not “improve access or standards of care”.

The King’s Fund said GPs were struggling with demand and “setting new expectations and targets will not suddenly increase the capacity in general practice”.

Helen Buckingham, director of strategy at the Nuffield Trust think tank, said: “The truth is that we are chronically short of GPs, with the number of GPs per person in England falling year after year.

“Targets don’t create any more doctors.”

The Our Plan for Patients document sets out how NHS pension rules will be changed to “retain more experienced NHS staff and remove the barriers to staff returning from retirement”.

It said: “New retirement flexibilities will include a partial retirement option for staff to draw on their pension and continue building it while working more flexibly, allowing retired staff to build more pension if returning to service.”

Work will also be done to reduce the risk of NHS staff facing annual allowance tax charges as a result of high inflation.

Retired or partially retired staff should be able to work without having pension benefits reduced or suspended, it said.

“By 2023 all trusts will also be required to offer pensions recycling, meaning employer pension contributions can be offered in cash instead of as an addition to pension funds, helping retain senior staff who have reached the lifetime allowance for tax-free pension saving,” it said.

The Government has also pledged to address variation in dental care and tackle “dental deserts”, saying it will make it easier for dentists who trained overseas to practice in the NHS.

The number of call handlers will rise to 4,800 on NHS 111 and 2,500 on 999 by December, according to the plan.

Later, during a visit to a surgery, Ms Coffey responded to former health secretary Jeremy Hunt’s comments that while there was “much to welcome” in the new announcement, the “NHS (and GPs) need more targets like a hole in the head”.

Asked directly about the comments, she said: “I’m very conscious that Jeremy was health secretary for many years and of course is well-versed and experienced in this regard.

“I think it’s important to have the priorities for the patients, and getting an appointment is one of the main frustrations that many people have raised with me and the Prime Minister over the summer.”

Asked a similar question on BBC Radio 4’s PM programme, junior health minister Robert Jenrick said that plans for patients to see a GP within two weeks is an “expectation”, not a “target”.

“This isn’t a target in the sense that it is something that is mandated to GPs, but it is an expectation. I think that’s fair to make.”

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