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Our new Health Secretary, Wes Streeting, visited my surgery in London last week – on his first day on the job.
He decided to come to us first on the advice of NHS director Amanda Pritchard, who I had previously invited to come and see the good work we were doing.
Mr Streeting gave a clear signal that he intends to, as he put it, ‘fix the front door of the NHS’.
He said billions of pounds would be transferred from hospitals to GP surgeries to solve the crisis, with patients struggling to get appointments.
Despite record demand, we are only receiving ten percent of the £165 billion NHS budget, so this was welcome news.
I liked Mr Streeting. But it takes more than money and words of encouragement to solve the monumental problems facing patients in primary care.
Now that I’ve had a few days to think about our meeting, I’ve come up with my own five-point plan that, if he decides to listen, could help resolve the crisis.
Good luck, Wes…
Wes Streeting with Dr. Ellie and her colleagues outside their practice in London
Health Secretary Wes Streeting (left) with NHS England Chief Executive Amanda Pritchard on July 8
Put an end to the hectic rush of 8am appointments
It has been the biggest complaint from Mail on Sunday readers in recent years: the obligation to call the GP at 8am to make an appointment.
Many don’t get through, or are put on hold for hours only to find there are no more appointments and have to try again the next day. This delays crucial treatment for those who need it – and some people just give up altogether.
This flawed system needs to stop. And some practices, like mine, have managed to get rid of those frustrating queues.
When our patients want to be seen, they call and our receptionist will put their details on a list. One of our GPs will go through the list and decide who needs to be seen that day and who can wait – for example, a patient with chest pain, which could be a sign of a heart problem, versus someone with a chronic skin rash.
Our support team sends text messages to patients to let them know when they will be seen. Crucially, it means that seriously ill patients are put at the front of the queue.
Some people find it annoying that they cannot be seen immediately, but it is an effective system that protects most patients from harm.
The problem is that, despite the clear evidence that systems like ours work well, not every practice operates in this way, leaving us with a two-tier NHS where some patients benefit and others struggle.
That’s not fair. We need to streamline it so that all patients have equal access to their GP, not just those lucky enough to live close to a good practice.
How a 50p fee could tackle no-shows
This was my controversial recommendation five years ago, and I stand by it.
I say this with a heavy heart, as I believe that healthcare should be free at the point of delivery, but that small 50p surcharge is a token gesture to change people’s mindset about wasting GPs’ time.
The latest figures, from May 2023, show that there were 1.2 million DNA samples – not returned – in general practices.
The latest figures, from May 2023, show that there were 1.2 million DNA tests – not shown up at the practice – in the GP practice (stock photo)
That’s 14.4 million appointments in a year. Each ten-minute appointment with a GP costs the NHS around £30, meaning £432 million is wasted.
Charging 50p is enough to make people think twice about wasting doctors’ time, but not to abandon them. Think of the plastic bag levy, the use of which has fallen by more than 90 per cent. Potentially, we could save millions and reduce waiting times. And it’s cheaper than the £10 Rishi Sunak proposed last year.
Put an end to the drug shortage nightmare quickly
Every day we hear from patients that they cannot get the medications we prescribe.
That’s why this newspaper has launched a campaign to end drug shortages, with four key demands: give pharmacists the authority to make substitutions if drugs are out of stock; force manufacturers to provide advance warning of shortages; create a public database where patients can check where drugs are in stock; and allow patients to go to hospital pharmacies that are better equipped to obtain medications.
Mr Streeting knew about the problems but didn’t give anything away. He needs to make this a priority before it takes up more of the GP’s time and puts more patients at risk.
Use the NHS app to replace time-consuming administration
It may not sound like a priority, but GPs are faced with a lot of administrative hassle, which means we are unable to see more patients.
We have to write letters to patients letting them know about their health needs, letters explaining their absences from school, and even letters canceling a gym membership.
It is extremely frustrating and it is not the job of a GP.
If the NHS app worked better, patients could use it to download their diagnoses and the medications they are taking, and this information could then be passed on if necessary.
And if the app were even better, patients could even make an appointment with a specialist at the hospital themselves.
Every day patients tell their GP that they cannot get the medications they have been prescribed (stock photo)
Make first aid part of the national curriculum
Young people have much less capacity to care for themselves. Research suggests that many people under 25 go to the GP for a minor medical problem, such as a cut.
Handling these visits takes up a lot of the GP’s time, while this can easily be done by a pharmacist – or even by the patient themselves.
That’s why I think schools need to teach first aid. And I’m not just talking about CPR. Kids need to know basic medical tasks, like how to bandage a wound or what to do if they twist their ankle.
I understand that schools are under pressure, but by offering these skills, many more agreements can be made.
Pharmacy First, which allows pharmacists to treat seven conditions such as sinusitis, earache and sore throat, is a start, but we need to enable more people to help themselves when they can.
