Health

England’s GPs to get £250m boost if they see more patients face-to-face

GPs in England will be handed £250m to improve their services but only if they increase the number of patients being seen face-to-face under a new government and NHS action plan.

The move follows an increasingly heated public war of words between GPs and health secretary, Sajid Javid, who has told family doctors to ramp up in-person consultations.

Under the “blueprint” GP practices in England will be able to share in a new £250m “winter access fund” to hire more staff, such as locum GPs, physiotherapists and podiatrists. However, the money will be conditional on increasing the number of patients who get an in-person appointment.

In future, GPs must ask patients if they want to come into the surgery to be seen or are happy to talk to a doctor or practice nurse on the telephone or by videocall instead and arrange a face-to-face consultation if that is what the patient wants.

NHS England made clear that “every GP practice must seek patients’ input and respect preferences for face-to-face care unless there are good clinical reasons to the contrary”. Exhibiting symptoms of Covid-19 will be the most common clinical justification for refusing to see a patient in person, with most others offered a physical interaction, NHS sources said.

Ministers and NHS England have made clear to GP organisations during recent discussions about the new package of measures that surgeries will also have to provide more on-the-day appointments, especially to those in urgent need. There is evidence that the difficulty of getting to see a GP is one of the factors driving the recent rise in people seeking care at an A&E unit.

Only surgeries that provide “appropriate levels of face-to-face care” will be able to apply to the new fund for money to expand access to care. Those that fail to expand in-person treatment will be “offered support to improve” under a more rigorous regime of scrutiny of how they operate.

From next spring data will be published every month showing what proportion of each surgery’s appointments occurred in person or virtually, in what GPs may see as a “name and shame” exercise.

The government is also set to scrap the 2-metre social distancing rule in GP surgeries to pave the way for more patients to be able to come in, bringing them into what is already the policy operated by hospitals. The move will be outlined in new guidance on infection control procedures drawn up by the UK Health Security Agency which is due to be published imminently.

Javid has heeded some suggestions made by GP leaders by agreeing that they should write fewer “fit notes” for people who are off work sick and also undertake fewer DVLA checks.

But he has disappointed the British Medical Association and Royal College of GPs by rejecting other ideas they proposed to reduce their workloads. They included suspension of the Quality Outcomes Framework, under which GPs are paid for monitoring patients with conditions such as asthma and diabetes; creation of a new national helpline to answer patients’ queries about Covid vaccination; and ensuring that hospitals set up systems to let patients know when their planned surgery is happening, to reduce calls to GPs about that.

The BMA warned that the shake-up would make it harder rather than easier for patients to get appointments.

“After weeks of promising an ‘emergency package’ to rescue general practice, we’re hugely dismayed that whilst additional funding has been promised the package as a whole offers very little and shows a government completely out of touch with the scale of the crisis on the ground”, said Dr Richard Vautrey, the chair of the BMA’s GPs committee.

“GPs and their teams will now be facing the worst winter for decades, and as a result, patients’ care will suffer. Appointments will be harder to book, waiting times will get longer, more of the profession could leave and GPs will struggle to cope.

“It is also disappointing to see that there is no end in sight to the preoccupation with face-to-face appointments; a more intelligent conversation about the variety of appointments and care that are available to patients to meet their needs,” Vautrey added.

“The pandemic has proven that in many other cases phone or video appointments are entirely appropriate and appreciated by patients, and a crude focus on percentages or targets is completely unhelpful.”

Health

Kwara approves 100% consolidated health salary structure for nurses

The Kwara State government has approved and implemented a 100% Consolidated Health Salary Structure, (CONHESS) for nurses in the state.

Also, the state government has recruited about 63 nurses to fill the vacuum created by the brain drain in the country to improve the quality and standard of nursing care in line with the global best practices.

The Chairman and Secretary of the Kwara State Council of the National Association of Nigeria Nurses and Midwives, Aminu Shehu and Markus Luka respectively, disclosed this in a statement in Ilorin made available to journalists.

The association appreciated the Executive Secretary of the state Hospital Management Bureau for playing a vital role in the struggle towards ensuring that its demands were met by the government.

The body also commended Governor Abdulrahman Abdulrazaq for the approval and implementation of the 100% CONHESS and the recruitment of more nurses to boost healthcare delivery in the state.

Health

More than 400 consultant anesthetists left Nigeria in 2yrs – Society

More than 400 consultant anesthetists left the shores of Nigeria for greener pastures in the last two years, President of the Nigerian Society of Anesthetists, Dr Olubusola Alagbe-Briggs said in Gombe on Wednesday.

Alagbe-Briggs told newsmen on the side-line of the society’s 31st annual scientific conference that the immigrant anesthetists left Nigeria in search of better practice environment.

She said anesthetists were the most sought-after specialists in foreign lands because of the peculiarity of their services.

“There is a global shortage of anesthetists because of the nature of the job which is intensive, acute and focused.

“We had about 1,200 members in the past, but today we have only 800 members.

“Those countries that are short of anesthetists are pulling those here in Nigeria to their countries.

“Nigerian professionals are the best. They are highly sought-after by other countries.

“Medical practitioners and other professionals will continue to emigrate until their welfare and available equipment are improved upon,’’ she said.

Alagbe-Briggs stressed that availability appropriate equipment and improved welfare were essential to improve medical practice and services.

She said the conference itself sought to ensure continuous enhancement of the knowledge of the society’s members to help to improve their services.

“We are looking at how we can help to improve on cancer care; we are involved in the operational stage, pain relief, emergency care and intensive care.

“We are in Gombe to brainstorm on how to improve our specialty in line with the theme of the conference, learn from one another and share research outcomes,’’ Alagbe-Briggs said.

The conference has: “Anesthesia and the pre-operative care of patients with cancers’’ as its theme.

Health

WHO Demands Fresh Data from China amid Outbreak of Pneumonia in Children

The World Health Organization (WHO) is requesting more data from China amid an outbreak of pneumonia in children.

Dr Maria Van Kerkhove, a WHO epidemiologist, said the agency was ‘following up with China’ as hospitals across the country continue to be overwhelmed.

Face masks and social distancing are again being recommended in the country.

The country is said to be grappling with a spike in pneumonia, dubbed ‘white lung syndrome’ because of the way lung damage shows up on scans, among children that has been attributed to a rebound in respiratory illnesses rather than an entirely new virus.

China had one of the most brutal and longest lockdowns of any country in the world which the WHO says robbed children of vital immunity against seasonal illnesses.

Dr Van Kerkhove told the conference today: ‘Yes, we are seeing an increase in respiratory infections around the world.

‘We’re in autumn and entering winter months, so we are expecting to see rises in respiratory infections regardless.

We are following up with China. They are seeing an increase due a number of different infections

We are following up with our clinical network and following up with clinicians in China.

‘In terms of acute respiratory infections, we are looking at the burden on healthcare systems and looking at the healthcare capacities of systems.’

It comes after Chinese Health Ministry spokesman Mi Feng urged people in the country to again consider wearing face masks and distancing.

Speaking at a press conference on Sunday, he said: ‘Efforts should be made to increase the opening of relevant clinics and treatment areas, extend service hours and increase the supply of medicines.

‘It is necessary to do a good job in epidemic prevention and control in key crowded places.

‘[This includes] in schools, childcare institutions and nursing homes, and to reduce the flow of people and visits.’