those 5th March changes

What was the climbdown from North West London Itegrated Care Board on 5th March?

In a letter to GP Surgeries in North West London on 5th March, the ICB has announced that the planned “new ways of working” will now be made part of GP Surgery contracts only from April 2025.

This means “at-scale” area hubs to replace you and your family’s care by your doctors surgery will now be delayed for a year. And the ICB promises now some kind of engagement with patients and doctors.

This appears to mean a delay rather than, as yet, an offer to revisit or negotiate the heart of the ICB’s scheme.

Specifically, the ICB have clarified nothing on continuity of care for all or clinical assessment by doctors.

The ICB has given no indication that the nine “Key Principles” of its proposed new “Same Day Access Model of Care” may now be up for discussion, change or replacement.

The ICB’s continuing ‘Key Principles’ summarised in brief:

“Same day” telephone appointment demand will be clinically assessed “at scale” in area operations no smaller than the local Primary Care Network (that is: at least 6 GP Surgeries but in most places 8 or more).

Assessments at these hubs will done by a range of non-doctor staff taken from the area’s GP Surgeries, supervised by at least one GP “senior clinical decision maker”.

Patients needing face-to-face appointments via this route should be offered these at any of the GP surgeries in the hub area, or at other sites possibly opened for the purpose.

In time, online consultation requests to GP Surgeries will also get similarly re-routed, once the telephone version is running first.

The new call centres/hubs should eventually merge with and take over local NHS 111 demand.

The new hubs should handle all prescribing and referrals – including to mental health services – independently of patients’ own GP Surgeries.

Patients found having “complex needs” will be referred back to their registered GP Surgeries.

At an online meeting with GPs and Surgeries on 6th March, the ICB could not say what action – if any – it is now going to take to review and strengthen its governance, to ensure that its approaches to managing change will be different in the future.

At the same meeting, ICB representatives also warned GPs who had been making “noise” about the proposals that General Medical Council guidelines could leave them culpable should their actions “make patients anxious”.

ICB representatives have been trying to suggest that their plans have been “misinterpreted” – for example, that “access hubs were never the things that had been mandated”

But “triage same day demand at scale” clearly means working via area-level call-centres or hubs remote from people’s own Doctors Surgeries.

It seems evident that patients and most GPs understand the ICB’s proposals more clearly than some of those who are proposing them.

If you haven’t already, please sign and share our petition’s ongoing call for the North West London ICB to support the preservation and strengthening of GP Surgeries, rather than their dissolution and replacement.