NHS GP england hospital
© RayArt Graphics/AlamyDenis Campbell and agenciesGPs will spend less time monitoring patients and do fewer health checks on over-75s.
Ministers have given GPs in England the green light to provide less care to millions of patients for the next four months so they can join the "national mission" to urgently deliver Covid booster jabs.

Comment: Rather Orwellian: providing 'less care' is now dubbed a "national mission".

Family doctors will spend less time monitoring people with conditions such as diabetes and heart problems, do fewer health checks on the over-75s and stop performing minor surgery until April.

Comment: This comes amidst the winter season when hospitals are usually in higher demand, particularly by people with comorbidities who need more regular health checks.

Sajid Javid, the health secretary, and NHS bosses have approved the controversial changes so that GPs and practice nurses can join the drive to administer top-up shots as quickly as possible.

Doctors' leaders sought to reassure the public that anyone falling ill or worried about their health would still be seen and assessed.

Comment: We know that these are empty assurances because the NHS has also admitted that they have an unprecedented backlog caused by the rolling, nearly two year long lockdowns; that thousands of doctors are threatening to quit due to 'burnout'; and, unsurprisingly, the NHS is predicting that this convergence of preventable problems could will result in the early deaths of tens of thousands of people.

However, the Patients Association immediately warned that the reduction in routine checks will lead to signs of illness being missed and disrupt the relationship between patients and GPs.

Family doctors will experience a substantial lifting of the requirements set out in the Quality Outcomes Framework (QOF) to monitor patients and help tackle public health problems such as smoking and obesity - lifting their workloads so they can help administer booster shots.

Comment: One wonders whether doctors are aware that they're being given the choice between four months of relatively routine Covid 'booster' jabs, over significantly more stressful days trying to firefight the backlog of primary care appointments?

One could be forgive for thinking that, people who feel they're under so much stress that they're threatening to quit, would be more inclined to choose the more glorified and easier 'national mission' option, despite the deadly fall out that will produce.

Javid and NHS England have given them permission to undertake far fewer checks on people with a wide range of serious ailments, including high blood pressure, asthma, chronic kidney disease and obesity. GPs will also undertake fewer medication reviews with people who are taking drugs on a long-term basis to help manage their condition and reduce the danger of their health deteriorating, for example blood pressure tablets to reduce the risk of a heart attack or stroke.

For the next four months family doctors will continue to carry out only a limited amount of these checks. Javid and NHS England have agreed to leave it to GPs' clinical judgment which patients still need to be monitored.

Comment: As we've seen throughout this contrived crisis even medical staff have been so hystericised by government fearmongering, evidencd by the 'dancing nurses' craze, and the dystopian, multiple mass Do Not Resucitate orders, that lapses of judgement amongst the medical profession have become more frequent and it's likely that GPs judgement is likely to be just as compromised now.

"This is a necessary temporary emergency measure because the booster rollout is now the NHS's top priority," a source said. "National GP bodies have assured the government and NHS leadership that most of the services should still go ahead, but based on clinical need."

However, GPs will still have to comply as usual with a few QOF duties, including administering non-Covid vaccinations, especially in children, and undertaking cervical cancer screening.

The NHS has to ramp up the daily total of boosters delivered from 350,000 to 500,000 as soon as it can to help deliver Boris Johnson's pledge on Tuesday that every adult in England will have been offered one by the end of January.

The deal was hammered out during several days of complicated and protracted talks this week involving GP leaders, NHS England and the Department of Health and Social Care. The Guardian revealed on Wednesday that moves to set aside QOF obligations on GPs were under way after the emergence of the new Omicron variant of coronavirus left ministers, NHS leaders and scientists worried about a potential new surge in infections.

Comment: Meaning that this decision wasn't simply yet another dystopian order from government, doctors actually agreed to this. Note that these are the same doctors that, over a decade ago voted against training more medical staff because the competition would mean they'd be on a lower salary.

Rachel Power, chief executive of the Patients Association, welcomed the fact that "the NHS is undoubtedly mobilising resources on an impressive scale for the booster programme."

But, in a sign that NHS England will have difficulty explaining the rationale behind the move, Power added: "Withdrawing some regular GP services will further disrupt the relationship between patients and the NHS. The decision also risks building up future ill-health that would have been picked up in routine health checks, which will have to be dealt with at some point."

Comment: As with the removal of primary care at the begining of the lockdowns, it's well known that this decision threatens the lives of patients.

The changes were outlined in a letter which NHS England chief executive Amanda Pritchard and three senior colleagues sent on Friday to local leaders across England outlining how the health service will push forward with the booster programme.

The suspension of so many of the QOF duties is a major victory for the British Medical Association (BMA). Javid has ignored the doctors' union's pleas in recent months to relax or scrap QOF altogether as a way of reducing their "unsustainable and impossible" workloads and angered them when he did not include it in his "GP support package" in October. That plan caused fury and consternation in the profession by insisting that GPs see any patient who wants it face to face, despite the threat posed by persistently high levels of Covid infection.

Comment: When doctors are rejecting face to face appointments, despite knowing that it's essential to providing optimal care, it's clear that something has seriously gone awry.

The BMA GP committee chair, Dr Farah Jameel, said the nationwide shortage of family doctors meant that, while GPs intend to aid the boosters push as much as they can, "there must be a recognition that they cannot do everything for everyone all of the time.

"Today's changes begin to recognise this, and we hope that, by removing some of the more bureaucratic and target-based requirements within practices' contracts, that staff's time can be freed up to get more jabs into arms, while allowing practices to focus on patients who need their attention the most."

Comment: It's a simple as that...

She added: "Patients need to know that if they are unwell or have concerning symptoms and need to receive care from their practice they will continue to be prioritised and GP teams will continue doing their very best to keep their sickest patients safe in every way they can and know how."

Ruth Rankine, director of primary care at the NHS Confederation, said: "Hopefully this guidance will free up much-needed time for primary care teams to vaccinate at speed and to prioritise patients with the greatest clinical need."