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GPs asked to report patient harm after trust failed to send over 14k discharge letters

A hospital trust has failed to send over 14,000 discharge letters to GPs due to ‘a failure’ in the process, Pulse has learnt.

University Hospitals of Leicester (UHL) told Pulse it discovered that 14,443 discharge letters were not digitally sent to GP practices between March 2023 and March 2024.  

The trust said that an audit of a ‘random selection’ of 120 patient records covering the period has been conducted to ‘check for any potential patient harm’.

GPs were not asked to go through the backlog but they were asked to contact the trust if they have ‘any concerns’ that patients have ‘come to harm as a result’ of the practice not receiving a hospital letter during the affected period.

GPs with concerns have been sent information on how to get in touch with the trust, UHL said.

This is the latest in a series of similar incidents uncovered by Pulse during the past two years, which led to chaos for GP practices having to deal with backlogs and to anxiety for patients whose clinical information could have been missed.

Leicester, Leicestershire and Rutland (LLR) LMC chief executive officer Dr Grant Ingrams said that the LMC and the trust agreed that the additional workload of having to check thousands of letters ‘would be disproportionate for practices’.

He said: ‘For example, it would not just be reconciliation of medication, but the practice would then need to look through every clinical interaction since the date of discharge (within and external to the practice) to check if there had been any subsequent changes.’

He said that the backlog ‘could cause some issues with patients’, mainly because the practice would not have received a final message to say why a patient had been in hospital.

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Source: Pulse, 26 September 2025

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GPs asked to keep doors open after ‘significant incidents’ warning

New guidance requires GPs to offer at least some face-to-face appointments, amid reports that some had completely eliminated them, sparking ‘significant incidents’.

NHS England’s instructions for the third phase of the NHS response to COVID-19 were issued on Friday, including the call that “all GP practices must offer face to face appointments at their surgeries” along with remote triage and remote consultations.

Most appointments in primary care have been carried out remotely since the NHS instituted new operating procedures in response to covid, with practices offering a mix of remote consultations over the telephone or video, with a diminished number face-to-face. 

However, there have been reports of some GP practices not offering any face-to-face appointments at all, and continuing this approach following the peak of cases in the spring.

A letter to GPs last month told them they must offer appointments in person “where clinically appropriate”, now reiterated in the phase three guidance.

The letter added: “It should be clear to patients that all practice premises are open to provide care, with adjustments to the mode of delivery. No practice should be communicating to patients that their premises are closed.”

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Source: HSJ, 4 August 2020

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GPs asked to find undiagnosed infected blood victims

GPs will be asked to find undiagnosed infected blood victims, following a national inquiry’s concern that hundreds affected by the scandal could be living unaware.

Around 400,000 new patients registering at GP practices each year will be asked if they had a blood transfusion before 1996 and offered tests for Hepatitis C, under new rules from NHS England.

The drive comes in response to recommendations from the Infected Blood Inquiry into the scandal that left 30,000 patients infected with HIV and hepatitis, and killed more than 3,000 people from the 1970s to the 1990s.

The inquiry, led by Sir Brian Langstaff, suggested hundreds of people infected during childbirth may still be living undiagnosed and unaware.

The scandal has been dubbed the “biggest disaster in the history of the NHS”, and earlier this month, the government admitted some patients will die before they get compensation.

In the final inquiry report, published in May 2024, Sir Langstaff recommended that patients who might have had blood transfusions before 1996 should be tested for Hepatitis C.

NHS England has said around 400,000 people born before 1996 will now be asked if they received a historic blood transfusion, with those who did then being offered a test for Hepatitis C.

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Source: The Independent, 19 May 2025

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GPs asked to contact ADHD patients to discuss medicines shortage

Prescribers should not start any new patients on some ADHD medicines because of a national shortage, the Department for Health and Social Care has warned.

GPs are also being asked to identify and contact all patients currently prescribed the medicines to ensure they have supplies to last.

A national patient safety alert said there were ‘supply disruptions’ of various strengths of methylphenidate, lisdexamfetamine and guanfacine.

It follows a previous alert about shortages of atomoxetine capsules in August which is set to resolve next month, DHSC said.

The shortages are due to a combination of manufacturing issues and an increased global demand, the alert explained.

With the latest issues expected to continue to December for some medicines, new patients should not be started on the products affected by shortages until the supply issue resolves, the guidance sent to healthcare professionals said.

Where patients do not have enough to last until the re-supply date – which differs depending on the medicine in question – GPs are being asked to contact pharmacies to find out about stocks and reach out to the patient’s specialist team for advice if a product cannot be sourced.

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Source: Pulse, 28 September 2023

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GPs asked for further support to care providers

NHS England has been asked for a “clear plan and timescale” for development during covid of its controversial scheme which aims to provide extra support for care homes.

In its adult social care winter plan the government has advised NHS England to push forward with the rollout of the “enhanced health in care homes” programme, ensuring that all care homes are assigned to primary care networks by 1 October.

The scheme requires GP practices to provide extra clinical support and advice to homes.

PCNs should also nominate a clinical lead for the care homes and work with other providers, such as social prescribing link workers, health and wellbeing coaches and care co-ordinators, to provide personalised care. 

The winter plan responds to a number of recommendations published by the COVID-19 support taskforce, after reviewing the management of the virus in the sector. It asks NHSE to provide a clear plan and timetable for its “enhanced health in care homes” programme. 

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Source: HSJ, 23 September 2020

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GPs are misdiagnosing patients because appointments are too short

GPs say they are misdiagnosing patients because appointment slots are too short. A survey of family doctors found more than one in three said they had failed to properly diagnose cases because they did not have enough time to fully assess them. Typically, the time slot to see a patient is around 10 minutes. The poll of 200 GPs found that 95 per cent of those surveyed said such slots were too short to do their jobs safely.

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Source: The Telegraph, 25 July 2019

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GPs are at “breaking point” and in need of respite, leaders warn

General practices are “reaching breaking point” because of the “intense” workload pressure facing doctors and staff, the country’s most senior GP leaders have warned.

The warning came as new figures from NHS Digital showed that practices in England delivered almost five million more appointments in March 2021 than the month before and nearly three million more than in March 2019.

Richard Vautrey, chair of the BMA General Practitioners Committee, said that the figures underlined the huge efforts practices were going to and the workload pressure on staff. He said, “GPs and their teams are consistently telling us they’re busier now than they have ever been, and this data—which does not include a large proportion of the vaccine programme undertaken by practices, nor a vast amount of other daily tasks—backs this up.”

Last week the Ivy Grove Surgery in Derbyshire provided an example of the strain facing some practices in a 16 page open letter to its patients about the huge demand it was facing and the resulting risk of staff burnout. The surgery said it would be reducing its use of the video consultation tool eConsult, as it had seen a doubling of demand over recent months, with some patients submitting several requests a day.

In a statement the practice told The BMJ, “We are aware of the stir our letter has caused but have also been overwhelmed by the kind feedback from our own patients, and the many encouraging messages of support we have received from GP surgeries all around the country. We therefore know that many of our GP colleagues are experiencing the same issues, but they may be fearful of articulating what is happening."

“We feel that open and honest debate about demand and workload in general practice is vital. If this letter goes even a little way towards sparking some much needed discussion then it will have been a good thing.”

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Source: BMJ, 4 May 2021

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GPs and patients invited to share views on legal ‘duty of candour’

The Government is inviting views on how well GP practices and other NHS organisations are complying with their legal duty of candour when things go wrong.

Patients and health professionals are being asked whether the statutory duty is well understood and adequately regulated by the CQC.

Under the statutory duty of candour, introduced for all CQC-registered providers in 2015, GP practices must be open and honest with their patients when something goes wrong and has caused harm. 

In December, the Department of Health and Social Care (DHSC) announced a review into whether healthcare providers are following the duty of candour rules.

This was in response to concerns that the duty is not always being met and that there is variation in how the rules are being applied. 

The DHSC has published its ‘call for evidence’ to gather views on how well the duty of candour obligation is working for both patients and health professionals. 

Patients have been asked whether GP practices and other providers ‘demonstrate meaningful and compassionate engagement’ with patients who have been affected by an incident. 

The call for evidence also asks for views on whether the criteria for triggering the duty are appropriate and well understood by staff.

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Source: Pulse, 16 April 2024

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GPs and hospitals in England to be required to share data to create single patient records

GPs and hospitals will be required to share patient data under legislation to be announced in the king’s speech on Wednesday.

Legislation to create a single patient record (SPR) for each person, which would be used across all healthcare providers, is part of a £10bn digitisation of the health service.

The health secretary, Wes Streeting, said making the data accessible in one place would be a “gamechanger” that would save lives.

The legislation aims to spare patients from constantly having to repeat their medical history when turning up at hospital or being discharged back to their GP.

“As patients, there’s nothing more frustrating than having to repeat your medical history at every appointment,” Streeting said. “When paramedics arrive to heart attack and stroke patients, they can’t see the patients’ medical records, putting them in even greater danger.

“For the first time ever, the single patient record will mean patients are given real control over their care through a single, secure and authoritative account of their data.

“It will be a gamechanger that means NHS staff can see patients’ medical records, allowing them to deliver better care faster and more conveniently, and even saving lives.”

Although some emergency information is already available – such as current medicines and known allergies – hospitals often cannot access the full medical history of a patient. GPs have to wait for letters, sent by email, from consultants to be informed of what happened to their patient in the hospital.

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Source: The Guardian, 10 May 2026

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GPs allowed to close on day of Queen's funeral

NHS bosses have been told to make sure patients can access care if GPs close on the day of the Queen's funeral.

NHS England has written to local bosses saying while GP services will be able to close on the bank holiday there needs to be enough out-of-hours care. The letter also asked for scheduled Covid booster care home visits to be carried out as planned.

In another letter to hospitals NHS England said it expected a rise in patients not turning up for clinics.

There have been reports of some hospitals in England and other parts of the UK cancelling routine treatments due to take place on the day of the funeral too.

The letter addressing GP access, signed by NHS England's director of primary care Dr Ursula Montgomery, said GP practices would be contractually able to close their core services on Monday as its a confirmed bank holiday.

But it added local health boards would need to "urgently work to ensure sufficient out-of-hours services capacity is in place".

The letter also said areas must make up for cancelled appointments by offering patients another appointment within two weeks and make sure patients can pick up prescriptions in advance.

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Source: BBC News, 12 September 2022

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GPs ‘should perform minor surgery’ to cut waiting lists

GPs should be empowered to perform minor surgery to help the thousands of Scottish patients who are waiting years for treatment, one of the country’s leading family doctors has said.

Despite pledges by SNP ministers to tackle the backlog of patients waiting for care, the latest data shows more than 10,000 Scots have been waiting for at least two years for treatment — 100 times higher than the equivalent figure in England.

Doctors have suggested that GPs could perform more services within local surgeries, removing the need for a hospital referral and cutting down waiting times.

Minor treatments which GPs could perform include cutting out skin lesions and cryotherapy (which includes freezing skin lesions with liquid nitrogen), contraceptive coil fittings and joint injections, it has been suggested.

Dr Chris Williams, deputy chairman of the Royal College of General Practitioners in Scotland, said that the Scottish government’s announcement of £13.6 million in extra funding this financial year for general practice “should allow some practices to offer these services should they choose to do so”.

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Source: The Times, 11 December 2024

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GPs ‘in crisis’ as one in four fear surgery is in danger of closing

GPs are facing “insurmountable pressures”, experts have said as they warned that the NHS “will not survive” without general practice.

A new report into GP pressures suggests one in four staff fear their practice is in danger of closing because of unmanageable workloads and rising demand.

The document, from the Royal College of GPs (RCGP), says general practice is “in crisis”, and makes a series of calls to help ease pressures and stop the growing number of GPs from quitting.

The report says GPs are bracing for “winter-style pressures” well into spring and summer.

“The workload pressures in general practice over this winter have been immense, and high levels of patient demand are set to continue for some time,” the report authors wrote.

“General practice is in crisis. We cannot rely on short-term emergency funding pots over winter to try and paper over the cracks."

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Source: The Independent, 10 March 2023

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GPs ‘force the elderly to book online in breach of NHS rules’

GP surgeries are forcing elderly patients to book appointments online, against NHS rules, a survey suggests.

As many as one in three people aged 75 or over surveyed by a charity said they were made to submit online forms to see a doctor.

This is despite the GP contract requiring all practices to allow patients to book over the phone or in person if they prefer.

The NHS says all practices should offer a range of booking methods. There is no evidence that any surgeries have been punished for not following the NHS rules.

Critics warned that practices were operating with impunity and “should lose funding” if they were found to be flouting contract requirements.

The results are part of a report by Re-engage, a charity fighting loneliness in old age, which said older people were being “dehumanised” and “excluded” by the digital-first approach.

The charity’s report, Care On Hold, revealed findings from a survey of 926 older people based on their real-world experiences of accessing GP services. The authors warned that forcing elderly people to book online left them without healthcare appointments.

The report also warned that some patients were instead getting help from emergency services, self-treating, or going untreated.

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Source: The Telegraph, 4 May 2026

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GPs ‘do not face huge complexity’, claims former health minister ahead of PA debate

GPs do not ‘face huge amounts of complexity’ and most of their appointments are ‘incredibly straightforward’, according to a former Conservative health minister.

Speaking to BBC Radio 4 last week, Lord Bethell defended upcoming legislation that will bring physician associates (PAs) under GMC regulation, which could be struck down by the House of Lords this evening.

Both the Doctors’ Association UK and the BMA had previously complained about the lack of debate in Parliament.

Discussing the role of PAs on Friday, Lord Bethell said he had not seen ‘any evidence’ of patients being confused about whether they were seeing a doctor or an associate.

"GPs don’t face huge amounts of complexity. Most interactions are incredibly straightforward. Certainly my own experience over the last 20 years of going to my GP, it really hasn’t required 10 years of training to deal with my small problems," he said.

Lord Bethell added: ‘When they are complex, they should be escalated. But there’s a much wider group of people who have professional training who should be respected, celebrated – they shouldn’t be denigrated, they shouldn’t be in any way patronised by other professionals.’

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Source: Pulse, 26 February 2024

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GP’s ethnicity ‘affects level of support they get’

A GP’s ethnicity has an impact on the level of leadership support it gets from regulators and external bodies, a new Care Quality Commission (CQC) report has suggested.

In 2021, the CQC conducted research looking at concerns raised by some doctors that ethnic minority-led GP practices were “more likely to have a poorer experience or outcomes” from regulation.

In a final report, the CQC has admitted ethnic minority-led practices are “not operating on a level playing field”, due to several factors including the fact they are more likely to care for populations with higher levels of socio-economic deprivation and poorer health.

This can affect their ability to achieve some national targets used in assessments of quality, and increase challenges around recruitment and funding.

The evidence gathered by the CQC also suggested that practices led by ethnic minority doctors “often lacked leadership support from other bodies and suffered from low morale”.

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Source: HSJ, 19 January 2022

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GP who downplayed symptoms of boy who died from Addison’s disease is suspended

A GP who gave wrongly dated and misleading medical notes to police inquiring into the death of a 12 year old boy from undiagnosed Addison’s disease has been suspended from the UK medical register for nine months.

Ryan Morse died in the early hours of 8 December 2012, hours after his mother rang the local Blaenau Gwent surgery twice in a day, reporting high temperature, extreme drowsiness, and involuntary bowel movement. The second time, she spoke to GP Joanne Rudling, telling her that the boy’s genitals had turned black.

But Rudling failed to check the notes of the first call or give adequate weight to the fact that the mother was calling again, the tribunal found. She failed to obtain an adequate history or reach an appropriate conclusion about the change in genital colour.

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Source: BMJ, 25 November 2019

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GP who dishonestly recorded patients’ vital signs without measuring them is struck off

A GP has been struck off the UK medical register after a tribunal found that she dishonestly recorded patients’ temperature, pulse, and other key variables without ever actually measuring them or carrying out a proper examination.

Kathleen Bilton was an out-of-hours GP at Royal Glamorgan Hospital in south Wales in early 2018 when two complaints arose from patients she had sent home with antibiotic prescriptions. Both were admitted to hospital soon after and diagnosed with sepsis.

Their medical records showed that Bilton had entered specific figures for their pulse, temperature, respiration, and other variables, but both complainants denied that she had taken such measurements.

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Source: BMJ, 15 October 2019

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GP upgrades ‘stuck in layers of approval’

A string of bureaucratic barriers are still holding up development of buildings for primary and community care, multiple NHS and industry organisations have warned.

Concerns were raised in written evidence to the health and social care committee’s ongoing inquiry into what is needed from the NHS estate to deliver the government’s vision of a neighbourhood health service.

Primary Health Properties PLC, the UK’s largest primary care property investor, said it has 19 planned developments of new health centres and around 20 upgrades to existing buildings serving more than 500,000 patients that are “currently stuck due to challenges with local NHS decision-making and agreeing a viable rent”.

Rugby Primary Care Network also said the “health on the high street” concept had “completely stalled” in Rugby and was “costing thousands due to acquisition from private landlords”.

Warwickshire District Council, meanwhile, said local community estate, including GP surgeries, was “antiquated and out of date”, adding: “What you have got for the most part isn’t good enough to do the job.”

NHS organisations and industry sources have raised concerns in recent years over barriers to upgrading primary care premises. HSJ  reported  how debate over rent prices was contributing to an “untenable stalemate” back in 2024.  

The government is now seeking to develop and expand hundreds of primary and community facilities to create “neighbourhood health centres”, with some funded publicly and some by a new private finance programme. It issued guidance last week that asked ICBs to set out their planned schemes.

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Source: HSJ, 23 April 2026

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GP training to be overhauled to meet ‘ever-shifting’ needs of patients

Health Education England (HEE) has outlined a new vision for general practice training which it says will better prepare GPs for future models of care.

The programme will have greater focus on areas such as addressing health inequalities and managing the growing proportion of patients with mental health care needs seen in general practice, HEE said.

Innovative placements, perhaps with charities, third sector organisations and services such as CAHMS will be explored, the Training the Future GP report said.

And it should include educational opportunities around improving cancer detection and referral, the report said, as well as training in the harms of overdiagnosis.

Overall the goal is to move to a flexible model of training that meets the needs, skills and experiences of the trainee as well as the area they are working in.

HEE said it would also continue to work to address issues of discrimination, prejudice, bias and specifically racism at individual, institutional and systemic levels, and to reduce differential attainment.

It will include plans to ensure patients in deprived areas are able to access care, with the development of specific training offers on these issues and prioritising expansion of training capacity to areas in need.

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Source: Pulse, 17 March 2023

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GP trainers among those at highest risk of burnout, GMC warns

GP trainers are more at risk of burnout than the average for all specialties, according to the GMC’s annual training survey results. 

The survey of over 70,000 doctors who are trainees or trainers found that 15% of GP trainers are at high risk of burnout, which is higher than the average of 12% and ranked second only to emergency medicine at 24%.

The results also showed that 24% of GP trainers said that every working hour is tiring for them, compared to 11% of public health trainers. 

Last month, GP leaders raised concerns about how trainers and experienced GPs will handle the long-term workforce plan’s expansion of training places, especially given the existing pressures and lack of retention measures.

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Source: Pulse, 11 July 2023

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GP test result confusion puts patients at risk

Patients are being put at risk because GPs wrongly assume they will actively seek their test results, a study says.

Researchers from the University of Bristol said the mismatched expectations could harm patients, with delayed diagnosis a likely result.

The study found: “Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety.”

Dr Jessica Watson, a GP and doctoral research fellow at the Centre for Academic Primary Care at the university, who led the study, said: “GPs have a medico-legal and ethical responsibility to ensure they have clear, robust systems for communicating test results.” 

Watson added: “Relying on patients to get in contact and making assumptions about their knowledge of how to do so were particular risks highlighted.”

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Source: The Times, 12 July 2022

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GP telephone first system 'here to stay' in Northern Ireland

A phone first system adopted by most GP surgeries at the start of the pandemic is "here to stay", the Royal College of GPs (RCGPs) in Northern Ireland has said.

However, the RCGP has also accepted patient access needs to improve.

The system was introduced in spring 2020. According to GPs, the move, which came without either consultation or prior information, was necessary to minimise the risk of infection of Covid-19.

Two years on, there is concern among some members of the public that the system is not working.

Speaking to BBC News NI, Dr Ursula Mason accepted that the system wasn't working but said there were not enough GPs to see people.

She added that the telephone system, which was being "refined" and "improved" was the best way to manage "growing demand" and to "prioritise the sickest patients to be seen first".

"The telephone system allows us to see many more patients, to deal with demand in a better way so I think the telephone system is here to stay," added Dr Mason.

"There will be some changes to upgrade it, but it will form a significant part of how we manage demand."

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GP surgeries offered £1,000 to cancel second dose Covid jab appointments in roll-out chaos

GPs are being paid £1,000 to cancel second dose appointments for Covid jabs and given a script to follow to deal with angry patients amid growing chaos in the roll-out of the vaccine programme.

Practices have been offered the payments to cover the workload of postponing hundreds of patients who were set to have their second dose and booking new ones in their place.

NHS sources said the shift has contributed to delays in rolling out the programme. Some GPs have refused to postpone the appointments, with practice managers saying it was "too cruel" to dash the hopes of those who were booked for a second jab.

In December, everyone given a first vaccine by Pfizer was told to come back for their second dose three weeks later. But the strategy was changed 10 days ago in a bid to get a first dose to more of the population more quickly.

Patients are now being told they will have to wait 12 weeks for the second dose, with a reassurance from health officials that the longer gap could strengthen its effectiveness.

By the time the plan was changed, around one million people had already been booked in for their second dose. GPs are now under orders to postpone such appointments and instead give the slots to those awaiting a first dose. 

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Source: The Telegraph, 8 January 2021

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GP surgeries are told to open late and at weekends

GP surgeries must open for routine appointments between 9am and 5pm on Saturdays and during weekday evenings, NHS bosses have said.

From October, patients will be able to book weekend and evening slots with “the full multi-disciplinary team” in a local practice, including for services such as screening, vaccinations and health checks.

The British Medical Association said it was “bitterly disappointed” by the changes, which had been imposed without its agreement. 

A letter tells GPs the appointments must be made available at least two weeks in advance. Same-day online booking should be possible “up until as close to the time slot as possible”. Any unused slots should be available for NHS111 to allocate to callers.

Some may be remote appointments, but networks are told to “ensure a reasonable number” of appointments are face-to-face consultations. 

Rachel Power, chief executive of the Patients Association, said: “There’s a great deal in this letter that patients will welcome, given the struggles they have had since the start of the pandemic to see their GPs face-to-face or even get through to their surgeries.”

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Source: The Times, 2 March 2022

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GP staff facing abuse from patients over cancelled blood tests

GP surgery staff are facing abuse from patients who are “angry and upset” that their blood test has been cancelled because of the NHS-wide chronic shortage of sample bottles.

“Patients are angry when we ring them up and say, ‘Sorry we can’t do your blood test after all’. A lot of people are quite angry and concerned about their own health,” Dr David Wrigley, the deputy chair of council at the British Medical Association, said.

“Patients are quite rightly upset and some get quite aggressive as well. They are worried because they don’t know what the implications of their cancelled test are for their health.”

GP practices in England had begun cancelling appointments because the NHS’s main supplier could not deliver stocks as planned for one to two weeks because of “unforeseen road freight challenges”. 

NHS England has responded to the shortage of blood sample bottles by telling GPs to cancel all but clinically urgent blood tests and hospitals to cut back the tests they do by at least 25%. 

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Source: The Guardian, 6 September 2021

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