Access to health services has become politicised in recent years

23 July 2021

Good access to health services is a defining feature of effective primary care. The Alma Ata declaration told us this in 1978 and few clinicians would disagree. Ensuring good access is particularly important for people with a quiet voice or no voice. But it’s also important for those who have no problem being heard, because it maintains the social compact which underpins the NHS.

But access has become politicised in recent years. Patient complaints about poor access to GP services - difficulties in making an appointment, or having to wait to see a clinician, or not getting a face-to-face appointment - are being used by some politicians and some parts of the media as a stick to beat GPs. And take my word for it, for the foreseeable future this is a problem which is going to escalate rather than go away.

The latest GP Patient Survey results show that 59% of respondents saw or spoke to someone at a time that they wanted to or sooner, 60% who wanted a same-day appointment got one and 71% say they had a good experience of making an appointment. If you’re a GP working under intense pressure these figures are a remarkable reflection of our ability to keep a stressed system running. But nevertheless, there’s no shortage of disgruntled patients to take their complaints to the newspapers or their MP.

We are doing everything we can to maintain access for our patients, introducing new ways of working, highlighting alternative care pathways, greater use of technology and, of course, working harder. But the fundamental problem is that need and demand far outstrips supply.

I know I’ve said this before and I’ll keep on saying it - we need a larger general practice workforce.


Latest updates from your College

COVID-19 update

The College has been vocal about the need for people to remain cautious - and that restrictions must remain in primary care settings. This week, we’ve supported the NHS Confederation’s clever #NotTooMuchToMask campaign calling for people to take simple steps to keep safe as we move into the next stage of the pandemic. You can find out more and download resources to share on social media, if you wish.

We’re pleased that mask wearing has been accepted and have heard a number of important updates from NHS England and Public Health England this week on service delivery now that most restrictions have been lifted in England. This includes guidance about what to do when a staff member has been 'pinged'. Please let us know if you have any questions about the application of this guidance.

Public Health England have developed resources for you to print off and display in your practices, or display on your practice websites, to encourage patients to continue following restrictions in surgeries. The BMA have also produced a COVID safety poster (714 KB PDF).

There was also the news over the weekend about the expanded flu programme being repeated for another year. As a public health measure, we’re supportive of this - but there are lots of unanswered questions, particularly in terms of how this will work alongside the possible COVID booster campaign, and we’ll continue to ask these at the highest levels on your behalf.

GP Data update

The College has been engaging consistently with NHS Digital, NHSX and the Department for Health and Social Care to set out the areas that needed to be addressed prior to data being collected under the GP Data for Planning and Research Programme (GPDPR).

We are pleased that this feedback was taken on board in the letter sent from Health Minister Jo Churchill to all GPs on Monday. Data collection will no longer begin on 1 September and instead the GPDPR programme will not commence until key criteria around public awareness, opt-outs and data security are met.

We will continue to represent your views and concerns as the programme develops. You can read our statement.

Reinvigorating relationship-based care

Reinvigorating relationship-based care in general practice was a key priority of mine when I became Chair (before anyone knew COVID was coming) and every time we discuss this at College Council it sparks a tremendous response. At our last Council meeting, during a discussion about our latest report on the issue, one member remarked "now that’s what I call general practice".

We’ve made the case to the profession - and we know our patients value the relationships they have with us. Making the case to politicians and policy-makers, however, always proves trickier.

I’ve written this editorial in the BMJ outlining our case: just why relationship-based care is so important in general practice, and why we should strive to reinvigorate it. Please do discuss it with your colleagues and circulate the link widely - getting conversations going is the start of change.

TARGET Antibiotics - how one practice improved UTI management

The College has a longstanding partnership with Public Health England to bring you a dedicated UTI Resource Suite of materials as part of the TARGET Antibiotics project. 

Read the new TARGET blog from Linda Strettle, GP and TARGET Antibiotics trainer. Linda used TARGET resources - including flowcharts, audit documents and a workshop - to successfully change policies and processes surrounding diagnosis and management of UTIs at her practice in Rotherham.

South Asian Heritage Month

From 18 July to 17 August join us to celebrate South Asian Heritage Month 2021, recognising the continued contributions of GPs from South Asian backgrounds to our health service and celebrating shared culture and heritage. 

We've got a packed programme of events and activities in store, along with member blogs and podcasts. Keep an eye on Twitter and Instagram throughout the month to hear stories from our diverse community of members.

See what's on.


Post written by

Professor Martin Marshall, Chair of RCGP Council

Professor Martin Marshall is Chair of the Royal College of General Practitioners and a GP in Newham, East London. He is also Professor of Healthcare Improvement at UCL in the Department of Primary Care and Population Health. Previously he was Programme Director for Population Health and Primary Care at UCLPartners (2014-2019), Director of Research & Development at the Health Foundation (2007-2012), Deputy Chief Medical Officer for England and Director General in the Department of Health (2006-2007), Professor of General Practice at the University of Manchester (2000-2006) and a Harkness Fellow in Healthcare Policy. 

He is a Fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012. He has advised governments in Singapore, Egypt, Canada and New Zealand, has over 230 publications in the field of quality improvement and health service redesign and his primary academic interest is in maximising the impact of research on practice. In 2005 he was awarded a CBE in the Queen’s Birthday Honours for Services to Health Care. 

A co-founder and driving force of the Rethinking Medicine movement, Martin has a passionate commitment to the values of the NHS, patient care and ensuring the GP voice is central in a time of great change. When he’s not working, he likes being outside, preferably on a mountain or a coastal path with his wife Sue and their puppy. 

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