New GP service proposed to end ‘8am scramble’ for appointments

A new GP service to end the 8am “scramble” for appointments has been proposed by experts in a “rescue package” for primary care.

A report from the think-tank Policy Exchange says there is a need to improve access to GPs by creating a “first contact” service that also works with the NHS app.

The aim would be to roll out the “smart” new NHS Gateway service across GP surgeries and NHS 111, utilising machine learning and artificial intelligence.

It would allow a new way of booking appointments and checking symptoms, reducing the “8am scramble to book appointments by telephone – currently 86 per cent of GP appointments (are) booked this way”, the study said.

People would be asked about their symptoms and would be able to do things like order at-home blood tests and kits, such as for urinary tract infections, which account for up to 10 million GP appointments every year.

The report said NHS Gateway would also be a portal for NHS-approved health apps to manage mental health and other chronic illnesses such as musculoskeletal pain (which account for 30 per cent of GP consultations).

Furthermore, patients would be able to manage their bookings and request “high-quality video consultations” with staff other than GPs, including community pharmacists.

The report said that, in the longer term, NHS Gateway would be driven by artificial intelligence and machine learning so that at-risk patients can be flagged and public health trends monitored.

Of the current GP model, the report said: “Access remains too variable, producing unacceptable levels of unmet demand, necessitating an approach which provides greater consistency and coherence to the ‘front door’.”

In other recommendations, the report said that private health firms will “continue to have a central role in primary care” and “should be essential to primary care service provision”.

The GP contract should also be overhauled to “reduce bureaucracy and free up GPs to help the patients with the most complex needs”.

There are also proposals to “level up” the system with “a massive boost in high-quality video consultations in areas where there are not enough doctors”, and by using overseas doctors in videos after they have completed NHS training.

In a foreword to the report, Health Secretary Sajid Javid praised NHS staff, adding: “There is an exciting future for primary care and we need to think deeply about how services are designed and planned – not just within general practice but across pharmacy and dentistry too.

“To provide a 21st century offer to patients, we must give the frontline innovators the right tools to evolve to meet the needs of patients in the future.”

Lead author Dr Sean Phillips said: “There have been growing pressures on general practice for years, but the current situation just isn’t sustainable for GPs or their patients.

“GPs are doing their best, but dissatisfaction is increasing among patients. We need to find ways to work smarter, rather than just demanding that stretched GPs work harder.

“By expanding high-quality digital healthcare, such as video consultation, we can ‘level up’ areas that have fewer GPs and enable GPs to conduct more appointments face to face – particularly those with complex needs.

“Optimising the use of the NHS app can help reduce missed GP appointments, which cost the NHS £216 million every year, through simple reminders, and signpost patients to the place their needs are best met.”

Earlier this week, NHS England announced changes to the GP contract to ensure patients can see a doctor on Saturdays and in the evenings.

GP appointments will be available until 8pm on weekdays and from 9am to 5pm on Saturdays, according to the new plans, which have attracted huge criticism from the British Medical Association (BMA) and others.

Dr Farah Jameel, BMA GP committee England chairwoman, said modernising services needs to take into account the needs of patients, but added: “The problem is that there are simply not enough GPs, and those that remain are being stretched thinner by the day.

“Every month, more and more GPs leave the service and the public are understandably horrified when they lose their local practice.

“A radical approach is necessary to address staff shortages, unbalanced investment and misaligned incentives.”