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After the accompaniment of “that” letter from NHS England alongside the most recent Standard Operating Procedure, general practice has reacted. Anger, frustration, sadness, shock, and depression are all words permeating through the primary care world at the moment. With workload and demand at an all-time high and staffing numbers stagnating or in decline across many areas, and a (so far, highly successful) vaccination programme to deliver, the general feeling is that this is a slap in the face from central government and the mainstream media alike. There has also been a direct (and much darker) impact on the ground with cases of abuse from patients directed at staff on the rise. Against this depressing backdrop, our joint Practice Index, Practice Manager panel return and are joined by GP and Clinical Director Dr Hussain Gandhi, to reflect on the detail of the letter, the implications of it, the impact on digital evolution in primary care, workload, capacity, patient education and most importantly, how we move forward from here.

Introductions (0:45)

Nicola’s reaction the letter (1:19)

From Robyn’s perspective (2:02)

Gandhi’s view (2:46)

Why was the letter issued? (3:53)

Long term issues with access (4:49)

Diverting attention from the bigger, more long-term challenges (5:38)

The impact on staffing capacity (and turnover) (5:56)

Crunching the staffing numbers (6:36)

Effect on Whole Time Equivalents (WTE) and clinical sessions (7:29)

Can the additional roles make a positive difference? (8:36)

Patient education is key (9:29)

Digital evolution (10:13)

Signposting patients to the most appropriate care provider (11:20)

What happens now re. remote consultations? (12:35)

Online consultations; help or hindrance when considering total demand (14:29)

Balancing telephone, online and face to face consults (16:20)

Why is demand at an all-time high? (17:16)

Patient appreciation and understanding (19:19)

The impact of the NHSE letter for practices on the ground (19:57)

How do we respond? (22:12)

The Institute of General Practice Management (IGPM) view (22:45)

Final thoughts from Gandhi (23:26)

The IGPM are currently running a campaign to raise awareness of the abuse suffered by general practice staff right now. View and promote here: (short clip) and (long clip)