Health

GPs win ‘significant concessions’ from NHS England over in-person appointments

GPs have secured “significant concessions” from NHS England in an apparent climbdown over patient access and face-to-face appointments.

Family doctors in England have threatened industrial action in protest against the government’s attempt to force them to see any patient who demands an appointment in person.

The British Medical Association (BMA) GPs committee voted unanimously to reject plans by the health secretary, Sajid Javid, which included “naming and shaming” surgeries that see too few patients in person, setting up what could be the first big clash between the medical profession and ministers in more than five years.

However, in private talks to resolve the crisis on Wednesday evening, NHS England told the BMA there were no longer any plans to publish monthly “league table” data showing what proportion of surgery appointments occur in person or virtually, according to sources. Separate plans to create specific targets for what proportion of appointments must be conducted in person have also been abandoned.

An NHS source claimed “naming and shaming” GPs responsible for low levels of face-to-face appointments had never been included in the plans; they only included the guidance saying “appropriate levels of face-to-face appointments for patients based on local need must be delivered”. The NHS source added that “while more localised access data will be published, the plan does not include ‘naming and shaming’”.

Amid concern about rising levels of abuse aimed at family doctors, senior NHS officials have also agreed to a “zero tolerance to abuse” campaign, which will be backed by Javid, sources said.

The BMA is still talking to its members about possible industrial action, which could lead to family doctors at the 6,600 practices in England reducing the work they undertake. However, senior officials on both sides will hope the concessions offered go some way to de-escalating the threat of industrial action this autumn.

A BMA spokesperson said: “These are significant concessions from what the government was talking about just two weeks ago, so we will need to give them serious consideration.”

The talks came as figures published on Thursday revealed a jump in the number of appointments offered by GPs in England, and a rise in face-to-face appointments.

Figures from NHS Digital show that an estimated 28.5m appointments took place in September – about 8% higher than for the same month in 2019, and more than 3m on the figure for August.

Of the appointments made in September 43.2% took place on the same day they were booked and 61% were in person. This 17.3m total for face-to-face contacts was the highest figure recorded since February 2020 and was up by about 3.5m on the figure for August, when 58% of appointments were face-to-face, the data suggests.

Before the pandemic about 80% of general practice appointments were conducted face-to-face. GPs have come under fire over allegations that they are not offering enough in-person appointments, which prompted last week’s threat of industrial action.

Prof Martin Marshall, chair of the Royal College of General Practitioners, said: “Today’s figures highlight just how extremely hard GPs and our teams are working, caring for patients in their communities and alleviating pressures elsewhere in the NHS.”

An NHS spokesperson said: “These latest figures show that general practice is working hard to ensure that patients get the care they need with over 17m face-to-face appointments in September – the highest number since the start of the pandemic – and over 3.5m more than in August.”

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.’

Health

433 Foreign-Trained Doctors Fail MDCN Qualifying Exams

No fewer than 433 out of the 836 foreign-trained medical graduates who sat the qualifying examination organised by the Medical and Dental Council of Nigeria (MDCN) failed

The qualifying examination was held at the Aminu Kano Teaching Hospital between 22 and 23 November 2023.

The assessment for the foreign-trained medical graduates was in a Computer Based Test format with the graduates taking the examination in four different centres, namely: BMG Institute of Information Technology; JAMB Professional Test Centre; Kano Cooperative CBT Centre and Treztech, all in Kano State.

The examination comprises a computer-based test, a picture-based test, and an objective structural clinical examination.

Findings showed that most of the medical and dental graduates performed poorly in the CBT.

A list of shortlisted candidates in Abuja showed that a total of 836 candidates with medical degrees from foreign universities were selected for the examination initially. However, only 403 candidates passed, according to the results obtained on Monday.

Every year, thousands of Nigerians aspiring to become medical doctors and dentists enrol in foreign universities, spend a fortune on tuition and accommodation fees, and dedicate between four and seven years to pursuing the Bachelor of Medicine, Bachelor of Surgery course.

Among the favourite destinations for Nigerians studying medicine are Ukraine, Sudan, Cyprus, Egypt, The Caribbean, Russia, Belarus, India, Hungary, Guyana, Niger Republic, and Benin Republic. But on completion of their studies abroad, to get a licence to practise in Nigeria, they are required to pass the MDCN assessment.

The MDCN is the body that regulates the practice of Medicine, Dentistry, and Alternative Medicine in the country to safeguard the nation’s health care system.

The MDCN conducts the assessment twice a year.

The examination tests the candidates’ ability to apply their basic medical sciences and clinical skills in a healthcare setting.

Health

UK Confirms Never- Seen- Before Strain Of Swine Flu in Human

The UK’s first human case of swine flu strain H1N2, very similar to what has been circulating in pigs, has been detected, the UK Health Security Agency said on Monday.

Routine surveillance in general practitioner surgeries picked up the case after the person suffered a mild illness.

The UKHSA said it is now carrying out contact tracing to prevent further spread of the virus.

It is not known at this stage how transmissible the strain is or if there could be other cases in the UK.

It is also too early to say if the strain could have pandemic potential.

The UKHSA has notified the World Health Organisation of the latest case.

There have been about 50 reported human cases worldwide of the H1N2 virus since 2005, none of them related genetically to this strain.

The person involved is not known to have worked with pigs and has fully recovered.

The case was detected as part of routine national flu surveillance undertaken by UKHSA and the Royal College of GPs, which was in place even before the COVID-19 pandemic.

The patient was tested by their GP in North Yorkshire after experiencing respiratory symptoms.

The strain was identified via Polymerase Chain Reaction testing and genome sequencing.

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The UKHSA said people with respiratory symptoms should continue to follow the existing guidance, avoiding contact with other people while suffering symptoms and taking particular care around vulnerable people and the elderly.

It said it was “monitoring the situation closely and is taking steps to increase surveillance within existing programmes involving GP surgeries and hospitals in parts of North Yorkshire.

“To assist in the detection of cases and assessment of transmission, those people who are contacted and asked to do the test are encouraged to do so.’’

Meera Chand, incident director at the UKHSA, said, “It is thanks to routine flu surveillance and genome sequencing that we have been able to detect this virus.

“This is the first time we have detected this virus in humans in the UK, though it is very similar to viruses that have been detected in pigs.

“We are working rapidly to trace close contacts and reduce any potential spread.

“In accordance with established protocols, investigations are underway to learn how the individual acquired the infection and to assess whether there are any further associated cases.’’

Chief veterinary officer, Christine Middlemiss, said, “We know that some diseases of animals can be transferred to humans, which is why high standards of animal health, welfare and biosecurity are so important.

Based on early information, the UKHSA said the strain detected in the UK differs from recent human cases of H1N2 elsewhere in the world but is similar to viruses in UK pigs.

In 2009, there was a pandemic in humans caused by flu strain H1N1, commonly referred to as swine flu.

NAN