Health

GPs warn face-to-face appointments plan could lead to exodus of doctors

GP leaders have warned that giving patients guaranteed face-to-face appointments could lead to a crippling exodus of family doctors already exhausted by the pandemic and despairing of being “pilloried” by ministers.

The profession’s key bodies said the government’s plan to force them to see in person every patient who asks will exacerbate the already serious shortage of doctors, especially as the proposal includes “naming and shaming” surgeries that do not comply.

Opposition parties also rounded on the government’s blueprint for change, with the former Conservative health secretary Jeremy Hunt saying ministers were taking the wrong approach.

“This is a burnt-out workforce running on empty,” he said.

The increasingly bitter war of words between GPs and the government escalated further when Prof Martin Marshall, the chair of the Royal College of GPs (RCGP), condemned ministers for implying that family doctors are lazy, despite working long hours and dealing with increasingly heavy and complex workloads.

“The last thing GPs are is lazy, and that goes for other members of our team as well,” Marshall told the Guardian.

“GPs have worked to their limits over the last 18 months, caring for patients in as safe a way as possible,” he added.

He also accused minsters of spreading dangerous myths that telephone or video appointments are inferior to in-person interactions. “The narrative being peddled that remote consultations are substandard to those delivered in person is dangerous. Face to face appointments will always be an essential part of general practice, but good and safe care can also be delivered remotely.”

The British Medical Association said Javid’s failure to push through major changes it suggested to reduce GPs’ workloads “will force many GPs to hang up their stethoscopes and leave the profession for the last time.”

Dr Richard Vautrey, the chair of the BMA’s GP committee, told the Guardian: “This new performance management messaging and potential public naming and shaming will do little to persuade wavering GPs to remain in the NHS, and the constant criticism will do nothing to persuade new recruits to choose general practice.

“After pulling out all the stops, working all hours to provide for patients over the last 20 months, delivering world class Covid and flu vaccination programmes, these latest insults will leave many asking why they bother.”

Javid’s plan, under which GPs in England will receive £250m extra funding if they agree to see more patients face-to-face, was criticised by Hunt, the health secretary from 2012-18.

He described the government’s proposals as a poorly thought-out “sticking plaster” that would not work.

The chronic and worsening lack of GPs meant the plan is doomed, Hunt said. “As someone who tried and failed to get 5,000 more GPs into the system, I don’t think this package will turn the tide,” he said. While he recruited more young doctors to train as GPs, that success was nullified by larger numbers of older family doctors going part-time or quitting altogether, he added.

Official workforce figures published by NHS Digital show that the number of full-time equivalent GPs in England has fallen from 29,403 in September 2015 to 28,023 – a fall of 1,380. However, the overall number of family doctors has risen over that same period from 36,120 to 38,792.

“This is a burnt-out workforce running on empty because of a massive mismatch between supply and demand. The only thing that will convince them not to continue retiring or opting for part-time hours in droves is a clear plan to end the unsustainable pressure they face,” added Hunt.

He said Javid should instead focus on a massive recruitment drive that would include persuading retired GPs who came back into the NHS during Covid to stay. Incentives to entice doctors from abroad, especially Canada and Australia, to come and work in Britain, are also needed.

The outpouring of anger from GPs that greeted Javid’s “GP rescue plan” led the health secretary to pull out of a scheduled appearance at the RCGP’s annual conference in Liverpool at the last minute.

The BMA accused him of “running scared of speaking to the profession face-to-face because he knows his plan is, in reality, no plan at all.”

Opposition parties voiced their fears of even more GPs quitting.

“There is now a real risk that GPs already burned out from working overtime during the pandemic will walk away from the profession in frustration at the government’s attitude towards them”, said Munira Wilson, the Liberal Democrats’ health spokesperson.

“We should not forget the sacrifices many GPs have made to keep us safe. It seems the government have a short memory on this.”

Labour’s shadow health secretary, Jonathan Ashworth, said: “Within minutes Sajid Javid’s promise to guarantee face to face appointments with a doctor completely unravelled.

“By failing to put forward a proper solution there is now a real risk that more GPs could quit in frustration. No wonder the health secretary ran away from explaining himself face to face. Rather than picking fights he should deliver the 6,000 extra GPs he promised as Chancellor.”

Prof Chris Whitty, the government’s chief medical officer for England, struck a different tone to Javid when, addressing the RCGP gathering, he praised GPs as “outstanding”, adding: “I’m massively admiring of what you all have done, and continue to do, in the biggest public health challenge in our professional careers.”

After pulling out of the RCGP conference Javid did a round of broadcast interviews to defend his plan and then visited a GP surgery in south-east London where he lavished praise on family doctors.

Health

Sierra Leone reports first case of monkeypox

Sierra Leone has reported its first confirmed case of mpox since the World Health Organization (WHO) raised its highest alert level for the potentially deadly viral disease last year.

According to the National Public Health Agency, the patient is a 27-year-old man from the rural district of the Western Zone, near the capital Freetown.

“Health teams are actively tracing and investigating to identify potentially exposed persons and to prevent further spread,” the agency announced in a social media post.

The confirmed case was detected on January 10, though health officials have not specified the variant affecting the patient.

Mpox, caused by a virus from the same family as smallpox, presents with high fever and skin lesions known as vesicles.

The disease was first identified in the Democratic Republic of Congo in 1970 and had mainly been limited to a dozen African countries before spreading more widely in 2022, including to regions where the virus had not previously circulated. The WHO declared its highest alert level for the disease in 2024.

In response, Sierra Leonean health authorities have swiftly activated containment measures. The infected patient has been placed in isolation while contacts will be monitored for 21 days. Surveillance efforts have been increased in all areas visited by the patient.

A public awareness campaign has been launched, and health workers are being equipped with protective gear and trained in prevention techniques to curb further spread.

Sierra Leone was previously one of the hardest-hit countries during the Ebola epidemic, which claimed around 4,000 lives, including nearly seven percent of the nation’s health workers, between 2014 and 2016.

Health

Risk of HMPV infection in Nigeria moderate- NCDC

The Nigeria Centre for Disease Control (NCDC) says the risk of the human metapneumovirus (HMPV) in the country is moderate.

HMPV, which was first reported in 2001 in the Netherlands, is a single-stranded ribonucleic acid (RNA) virus that causes symptoms similar to the common cold and influenza including cough, fever, nasal congestion, and fatigue, with an incubation period of three to six days.

It causes severe complications like pneumonia in infants, the elderly, and those with weakened immune systems and spreads through respiratory droplets or contact with contaminated surfaces.

China is currently experiencing an outbreak of the virus, sparking global concern. India has also reported at least two cases of the virus.

In an advisory issued, the NCDC said the agency, in collaboration with the ministry of health, is closely monitoring global developments. The agency said as of January 6, 2025, data from surveillance does not indicate any unusual increase in respiratory infections, including those caused by HMPV.

“However, given the global trends in HMPV cases, the Nigeria Centre for Disease Control and Prevention (NCDC) is proactively implementing measures to strengthen the country’s preparedness and response capacity.

In collaboration with the Federal Ministry of Health and partners such as the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (USCDC), and the UK Health Security Agency (UKHSA), conducted a dynamic risk assessment for Human Metapneumovirus (HMPV).

The assessment classified the risk of HMPV for Nigeria as moderate. This evaluation will inform and guide preparedness efforts, decision-making, and response strategies to mitigate potential impacts.”

The NCDC said it is also collaborating with port health authorities to ensure robust preparedness at all international points of entry (PoEs).

“In addition, quarantine facilities are being identified and prepared to manage any suspected or confirmed cases if required. Infection Prevention and Control (IPC) materials are being deployed to PoEs to ensure adherence to hygiene and safety protocols. Information, Education, and Communication (IEC) materials are being developed and distributed to raise awareness and provide clear guidelines for frontline staff and travelers at PoEs.

The National Influenza Sentinel Surveillance (NISS) sites across the six geopolitical zones monitor Influenza-like Illness (ILI) and Severe Acute Respiratory Infections (SARI) which is already testing for COVID-19, will now also start testing for HMPV. Provisions will be made to increase the number of tests conducted. Additionally, laboratories in states with international airports will be supported to enable them to test for HMPV.”

Health

WHO declares new COVID outbreak in China global health emergency

The World Health Organization, WHO, has declared the outbreak of a new coronavirus in China, a global health emergency.

The WHO Director-General Tedros Ghebreyesus made the announcement at a press conference in Geneva.

WHO’s emergency committee on the epidemic had reportedly met Thursday afternoon and recommended designating the outbreak a Public Health Emergency of International Concern, PHEIC.

The decision had been “almost unanimous,” Didier Houssin, chair of the emergency committee, said at the press conference.

“The main reason for this declaration is not because of what is happening in China, but because of what is happening in other countries,” Tedros said at the press conference.

“Our greatest concern is the potential for the virus to spread to countries with weaker health systems and which are ill-prepared to deal with it. Let me be clear, this declaration is not a vote of no confidence in China. On the contrary, WHO continues to have confidence in China’s capacity to control the outbreak.”

Tedros also outlined recommendations made by the emergency committee to control the outbreak, including accelerating the development of vaccines and drugs and combatting the spread of misinformation.

This is the sixth time WHO has used that label, Public Health Emergency of International Concern, PHEIC. since the designation was introduced 15 years ago.