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England GPs will receive £ 250million to improve their services, but only if they increase the number of patients seen face to face as part of a new government and NHS action plan.

The move follows a growing public war of words between GPs and Health Secretary Sajid Javid, who has called on family doctors to step up in-person consultations.

As part of the ‘master plan’, GP practices in England will be able to share a new £ 250million ‘winter access fund’ to hire more staff, such as locum GPs, physiotherapists and chiropodists . However, the money will be conditional on the increase in the number of patients who get an in-person appointment.

In the future, GPs should ask patients if they would like to come to the office to be seen or if they are willing to speak to a doctor or nurse practitioner by phone or video conference and arrange a face-to-face consultation. to face if that’s what the patient wants.

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

Ministers and NHS England have made it clear to GP organizations in recent discussions on the new package of measures that surgeries will also need to provide more same-day appointments, especially for those in urgent need. The difficulty of seeing a general practitioner has been proven to be one of the factors behind the recent increase in the number of people seeking care in an A&E unit.

Only surgeries that provide “appropriate levels of face-to-face care” will be able to apply for money from the new fund to expand access to care. Those who do not expand in-person treatment will be “offered support to improve” as part of a more rigorous regime of scrutiny of their functioning.

Starting next spring, data will be released each month showing what proportion of appointments for each surgery took place in person or virtually, in what general practitioners may consider a “name and shame” exercise.

The government is also on the verge of abolishing the 2-meter social distancing rule in general surgeries to pave the way for more patients to be able to enter, bringing them into what is already the policy enforced by hospitals. This decision will be outlined in new guidelines on infection control procedures developed by the UK Health Safety Agency, which are due to be released shortly.

Javid heeded some suggestions made by general practitioner executives by agreeing to have them write fewer “adjustment notes” for people on sick leave and also perform fewer DVLA checks.

But he disappointed the British Medical Association and the Royal College of GPs by rejecting other ideas they came up with to reduce their workload. They included the suspension of the Quality Outcomes Framework, under which general practitioners are paid for the follow-up of patients with conditions such as asthma and diabetes; creation of a new national hotline to answer patients’ questions about the Covid vaccination; and ensure that hospitals have systems in place to inform patients of the date of their planned surgery, in order to reduce calls to general practitioners about this.

The BMA has warned that the reshuffle will make it harder than easier for patients to get appointments.

“After weeks of pledging an ’emergency package’ to save general medicine, we are extremely dismayed that, although additional funds have been pledged, the package as a whole offers very little and shows a government completely disconnected from the world. ‘magnitude of the crisis on the ground,’ said Dr Richard Vautrey, chairman of the BMA’s general practitioner committee.

“General practitioners and their teams will now be facing the worst winter in decades and, as a result, patient care will suffer. Appointments will be more difficult to make, wait times will lengthen, more of the profession could leave and general practitioners will find it difficult to cope.

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

“The pandemic has proven that in many other cases, phone or video appointments are very appropriate and valued by patients, and a crude focus on percentages or goals is totally unnecessary. “