GPs must offer face-to-face Saturday appointments, under a new NHS contract which is opposed by doctors’ leaders.
Health officials have issued terms which say patients must be able to access in-person appointments six days a week.
The contract also promises to boost access for patients, with online booking for all types of appointment, including screening checks, and same-day appointments.
Family doctors have been told that routine appointments must be available between 9am and 5pm on Saturdays in their local area, as well as on weekdays.
It means patients should be able to access such appointments locally, though not necessarily at their own practice.
But the British Medical Association (BMA) has reacted with fury to the new contract, saying it has been imposed without their agreement, and with too little funding.
The rows follow long wrangles over access to face-to-face appointments.
Latest figures show the proportion of GP appointments held in person fell for the third month in a row to 60.3 per cent in January.
Before the pandemic the figure was about 80 per cent.
The new contract says Primary Care Networks (PCNs), which are responsible for GP services, must “ensure a reasonable number of appointments for in person face-to-face consultations are available” in their area – including on Saturdays.
Each PCN covers a population of up to 50,000.
The arrangements, for 2022/23, call on GPs to increase diagnosis of cancer, which has fallen during the pandemic, with a particular focus on prostate disease.
Ramping up cancer checks
Extra funds have been allocated for increases in checks for bowel cancer, and heart conditions.
Officials say too many patients with symptoms that should have been checked have not been seen since the pandemic, because they struggled to access care, or feared being a burden on services.
Dr Nikki Kanani, NHS medical director for primary care said: “The NHS is focused on recovering services and tackling the covid-19 backlogs that have inevitably built up over the pandemic and so as part of the contract for General Practice in 2022/23, extra funding will be given to primary care teams to increase checks for cancer and heart conditions for our patients.”
Estimates suggest that 14,000 men with prostate cancer have yet to be diagnosed, along with more than 12,000 women with breast cancer.
But the BMA said it was “bitterly disappointed” by the terms – saying there was too little funding attached.
The union said it had called for extra funding to cover increased employers national insurance contributions, due in April, as well as for a recovery plan for general practice, and more flexibility to hire a range of support workers.
Dr Farah Jameel, BMA England GP committee chairman, said: “We are bitterly disappointed that NHS England has chosen to ignore the appeals from the profession and the needs of patients in today’s letter.
“Despite our best efforts to outline a number of positive and constructive solutions that would make a difference to practices’ ability to improve care for patients, NHS England has instead decided to follow a path laid out three years ago, long before the arrival of Covid-19, and roll over a contract that fails to address the current pressures faced by general practice.
“Failing to offer practices something as simple as reimbursement to cover additional costs for national insurance contributions means they are losing funding that should be going towards looking after patients.
“Therefore, a tax aimed at funding the NHS, has become a tax on the NHS itself. The result will be fewer members of staff to care for the growing needs of patients.”
She said patient care would suffer – with longer waits to see a GP – unless surgeries were given “an emergency rescue package”.
The union said it began negotiations with NHS England in January over annual amendments to the five-year contract deal, which was agreed in 2019, but said the terms had now been agreed without their agreement or endorsement.
“We approached this year’s negotiations in good faith, recognising the need to uphold previous agreements but striving for improvements in patient care.
“Today’s letter, presented to us with only a few hours’ notice, defies everything we were aiming to achieve in building a constructive relationship and sits at odds with positive conversations with government,” Dr Jameel said.