Backlash over NHS rescue plan: Ex-Health Secretary Jeremy Hunt says service needs more staff NOT targets – as Therese Coffey promises to meet four-hour A&E target, introduce two-week maximum wait for GP appointment and free-up 7,000 more beds this winter
The new Health Secretary announced an ‘ABCD’ strategy in the Commons to fix the crises plaguing ambulances, backlogs, care homes, doctors and dentists.
It includes an ‘expectation’ for every patient to be offered a GP appointment in two weeks and a £500million social care package to help free up 7,000 hospital beds.
Ms Coffey also promised to keep the four-hour A&E wait target that the NHS has not been met since 2015 – despite studies showing it is a life-saver.
She also wants to hire 8,000 999 and 111 call handlers to speed up ambulance discharges and open 31,000 more GP hotlines to end the phone call lottery for appointments.
But critiquing Ms Coffey’s plan from the backbenches, Jeremy Hunt, one of her predecessors, said ‘it is not more targets the NHS needs, it is more doctors.’
There are currently 160,000 vacancies across the NHS in England and the health service is short of at least 6,000 doctors.
Mr Hunt urged Ms Coffey to publish the NHS workforce plan before Christmas so demoralised staff ‘can at least go into winter knowing there is a plan for the future’.
But the current Health Secretary could not be pinned down on a date. The Liberal Democrats described Ms Coffey’s plan as an ‘A, B, C of failure’.
Therese Coffey, the new Health Secretary, announced an ‘ABCD’ strategy in the Commons to fix the crises plaguing ambulances, backlogs, care homes, doctors and dentists
Almost half of GP appointments are done on the same day but there is massive variation around the country
NHS data published today show 1.14 million Britons spent at least half a day stuck in waiting rooms or corridors between April 2021 and March 2022
Daisy Cooper MP said: ‘We were promised an extra 6,000 GPs by 2024, instead we’ve lost almost 2,000.
‘People are now struggling to get appointments because there simply aren’t enough GPs to go around, a new phone system cannot fix this.
‘Even when patients do manage to get an appointment, one in five are being rushed through in less than five minutes.
‘It’s all they have to give, but it’s nowhere near enough time to explain complex symptoms, get a confident diagnosis or to talk through treatment options.
Therese Coffey reveals she was told to go home after enduring a NINE HOUR A&E wait
Therese Coffey today revealed how she was forced to wait nine hours in A&E this summer only to be told to go home.
The Health Secretary’s own experience, told in the House of Commons, illustrates the scale of the NHS‘s emergency care crisis.
Tens of thousands of Britons face 12-hour casualty waits every month.
Detailing her own horrifying A&E delay, Dr Coffey told MPs she was treated swiftly after visiting a different, nearby hospital the next day.
Her account came as she unveiled her NHS rescue plan, including her main pledge for patients to be able to see a GP within two weeks.
It comes after damning figures last week revealed that more than a million patients faced 12-hour waits in busy A&E units between April 2021 and March 2022.
NHS statistics showed the toll was three times higher than during the same period the year before.
It made last year the busiest ever in A&E, as casualty units battled Covid as well as the knock-on effects of the pandemic and day-to-day pressures.
The NHS says the current crisis is being driven by so-called ‘bed blockers’, which Dr Coffey has also vowed to clamp down on.
Another of her immediate priorities is access issues with GPs, which leading experts have suggested is adding to A&E pressures, with patients resorting to casualty units because they can’t get their ailments checked by a doctor.
‘Patients are being forced to pay a dangerous price for years of chronic underfunding and broken Conservative promises.’
The King’s Fund said doctors were struggling with demand and ‘setting new expectations and targets will not suddenly increase the capacity in general practice’.
Helen Buckingham, director of strategy at the Nuffield Trust think tank, said: ‘The truth is that we are chronically short of GPs, with the number of GPs per person in England falling year after year.
‘Targets don’t create any more doctors.’
Ms Coffey promised a ‘laser-like’ focus on addressing the NHS crisis as she laid out her ‘Plan for Patients’.
She told the Commons: ‘My priorities are patients priorities, I will endeavor through powerful partnerships with the NHS and local authorities to level up care and match expectations that the public rightly have.
‘Whether you live in a city or town, in the countryside or on the coast, this Government will be on your side when you need care the most.’
Her plan includes a demand for patients to be able to see how well their GP practice performs compared with others.
It will also give them the option to book an appointment at a less busy surgery if their usual family doctor cannot see them in two weeks.
Labour said the message being Dr Coffey delivered to patients effectively amounted to ‘get on your bike’ and find treatment elsewhere.
Under the new plan, the sickest patients will be offered a same-day GP appointment and non-urgent cases should be seen within a fortnight.
But these are only ‘expectations’ rather than firm targets.
The Health Secretary said a range of workers – such as pharmacists, GP assistants and advanced nurse practitioners – will be used to ease the burden on GPs and free up their time.
Ms Coffey will also change funding rules so practices can recruit extra staff, allowing GPs to focus on care and freeing up 1million extra appointments a year.
And pharmacies will be empowered to manage more medicines without a prescription, which could free up an additional 2million GP consultations.
Ms Coffey also pledged her commitment to the four-hour A&E target for people to be admitted, transferred or discharged.
There were just 27,558 full-time equivalent, fully-qualified GPs working in England last month, down 1.6 per cent on the 18,000 recorded in June 2021. It was down 5.3 per cent on the more than 29,000 working in June 2017
Map shows: The proportion of GP appointments made in-person in July across England’s integrated care boards
Meanwhile, the figures also showed fewer than half of appointments across the country were with a fully-qualified GP
Under current guidelines, 95 per cent of patients should be admitted, transferred or discharged within the 240 minutes.
COFFEY’S ABCD PLAN TO RESCUE NHS THIS WINTER
1. Every hospital and ambulance trust having a plan to reduce long ambulance handover delays so they can get back on the road more quickly, alongside improvements to the directory of services so 111 and ambulance services can direct people to the most appropriate service and ensure only those with an emergency attend A&E.
2. The NHS will deliver on their winter plan with 4,800 call handlers in NHS 111 and 2,500 in 999 so 111 calls can be answered more quickly and ambulances can be dispatched as fast as possible. There will also be the equivalent of 7,000 more beds across the country – including 2,500 beds with remote monitoring from patients’ homes, to reduce pressure on hospitals and speed up ambulance handovers.
1. Delivering up to 160 community diagnostic centres, with 92 currently operating, to help deliver 9 million additional tests, scans and checks a year by March 2025.
2. Trusts will continue to prioritise patients who have been waiting longest and those needing treatment most urgently, including for cancer.
1. The government will invest £500 million to support discharge from hospital into the community and bolster the social care workforce, to free up beds for patients who need them. Ahead of this winter the government will also launch the next phase of the national adult social care recruitment campaign.
2. Funding of £15 million this year will help increase international recruitment of care workers. The funding will help support local areas with visa processing, accommodation and pastoral support.
1. Changes to NHS pension rules will retain more experienced NHS staff and remove the barriers to staff returning from retirement. New retirement flexibilities will include a partial retirement option for staff to draw on their pension and continue building it while working more flexibly, allowing retired staff to build more pension if returning to service. The government will fix the unintended impacts of inflation, so senior clinicians aren’t taxed more than is necessary – it will amend the revaluation date in the NHS Pension Scheme to reduce the risk that NHS staff face annual allowance tax charges as a result of high inflation.
2. The Government also intend to allow retired and partially retired staff to continue to return to work or increase their working commitments, without having the payment of their pension benefits reduced or suspended. To do so, ministers will extend the temporary retire and return easements to 31 March 2025.
3. By 2023 all Trusts will also be required to offer pensions recycling, meaning employer pension contributions can be offered in cash instead of as an addition to pension funds, helping retain senior staff who have reached the lifetime allowance for tax-free pension saving.
1. The government will address variation in dental care, including ‘dental deserts’, through working with the General Dental Council to make it easier for dentists who trained overseas to practice in the NHS, requiring practices to publicly state whether they are taking new patients. Further changes will enable those contractors that can deliver more NHS care to do so by releasing funding from contractors that consistently underdeliver.
The target has not been met since 2015, in which time there have been four prime ministers.
Ms Coffey said she recently endured a wait of nearly nine hours in A&E, adding: ‘I can absolutely say there will be no changes to the target for a four-hour wait in A&E.
‘I believe it matters, and I’ll give you a personal experience recently.
‘Just in July I went to A&E, I waited nearly nine hours myself to see a doctor and I still didn’t get any treatment.
‘I was asked to go back the next day, so I went to a different hospital just three miles away and I was seen and treated appropriately.
‘That’s the sort of variation that we’re seeing across the NHS.’
On ambulance wait times, Ms Coffey said there was ‘too much variation in the access and care people receive across the country’.
She said 45 per cent of ambulance handover delays are occurring in 15 NHS hospital trusts.
A lack of staff in social care has created a logjam in hospitals because elderly patients cannot be discharged into care homes.
Ms Coffey promised to create the equivalent of 7,000 more beds at the worst affected trusts this winter to improve handover times.
Ms Coffey said a £500 million fund would enable medically fit people to be discharged from hospital more quickly, supporting them to receive care in the community or their own homes instead.
And hospitals will be encouraged to monitor patients from home using mobile apps and devices that take blood pressure and other vitals.
Meanwhile, the number of 999 and NHS 111 call handlers will also be increased to answer calls more quickly.
Ms Coffey said the NHS ‘will need a true national endeavour’, adding that she wanted to draw on the ‘energy and enthusiasm’ of the 1million people who volunteered during the pandemic.
Various bodies including the Royal College of Nursing, Unison and the TUC have all criticised the Government for leaning on volunteers rather than focusing on recruiting full-time staff.
Asked about such criticism, Ms Coffey said: ‘I’m standing up here for patients. I’m focused on my A, B, C, D because that’s what most people experience.
‘Getting access to a doctor, getting access to a dentist, having an ambulance turn up on time rather than be stuck in terms of being stuck outside a hospital. Those are the things that matter when people need care the most and that’s what I’ll keep my focus on.’
Asked if the health service has enough doctors, Ms Coffey said: ‘As I said, that’s what I’ll keep my focus on, and I’ve talked about how we’ll be freeing up appointments as well.’
On whether she has concerns about how the scrapping of the planned Health and Social Care Levy might impact her plans, Ms Coffey said: ‘We will still be getting the same level of funding for health and social care. It will just come from the public purse more broadly rather than a specific levy.’
Mr Hunt ‘welcomed’ her plan broadly but criticised the decision to add more targets to GPs’ workloads.
He said: ‘When it comes to the workforce plan that she recommitted to – and I welcome her commitment to publishing it – could she tell the House will it have hard numbers so that we know how many doctors we are going to need in 10, 15, 20 years’ time, and whether we are actually training them?
‘Will she publish it before Christmas so staff can at least go into winter knowing there is a plan for the future?’
Ms Coffey replied: ‘I want to assure him now I have spent time focusing on the plan for priorities, there is already work ongoing about the workforce plan and I will be hoping to make elements today, working alongside my new ministerial team so that we can maximise that.’
She added the Government planned to ‘make it more straightforward for people wherever they are in the world’ to practice medicine in England.
But Ms Coffey said she would not apologise for setting a two-week appointment target.
She was given a tour of The Marven Surgery in Pimlico, south London, this afternoon following her speech.
She visited the surgery after setting out plans in Parliament for patients to see a GP within two weeks and committing to keeping the four-hour A&E target.
She told reporters: ‘I’m very keen that patients are seen. The ones that need an appointment should get an appointment.
‘Understandably it’s up to clinicians how they prioritise their patients but I think we have been encouraging people to come forward in order to, if they’ve got symptoms of something or something that’s particularly concerning them, because that’s the way they can get diagnosed and get, if necessary, care and treatment.
‘So I have not apologised at all for saying it’s my expectation that when somebody phones up and they need an appointment that they get that appointment at least within a fortnight.’