Changes to GP Access in North West London

Plans have been revealed to change GP access across North West London.

Patients wanting same day access to a GP will be referred to a central hub which will be overseen by a GP but will be staffed by care co-ordinators who will decide how to deal with their request.

Only if you have a “complex long-term condition” will you be given the option to consult with and see your doctor in the GP practice where you are registered.

Deborah Unger NWL PPG Forum Chair and Robin Sharp, Chair, Brent Patient Voice; who are both members of QPARA; have written this:

Alarming proposals planned to restrict patients seeing their own GP

Patients of GP practices across NW London have serious reason to be alarmed by
an untested plan being rushed through by the NHS Integrated Care Board that supplies their funding. Doctors’ and patient groups are calling for the Board to delay the plan for “same day access” on safety and clinical grounds.

This plan drawn up by KPMG management consultants has emerged in the last few days without either consultation with the GP practices involved or the people or patient groups of North West London.

From April 1st, all practices are to have a centrally controlled phone system. When a patient calls the practice for an appointment, they will be invited to press the button for option 1 – same-day appointments. Then they will be transferred to a “Same Day Hub” where a care co-ordinator (not a medically trained doctor) will decide how to deal with their request. In this new system you, as a patient, will not have the option to speak to your GP to discuss your condition. Only if you have a “complex long-term condition” will you be given the option to consult with and see your doctor in the GP practice where you are registered.

This plan, not so far publicly announced, is meant to deal with the so-called “8am
rush” – the long phone waits many patients have experienced post-Covid. But there is no assessment of the risks to patients from this major change or guidance on how calls will be dealt with.

The Londonwide Medical Committee, the London doctors’ association, said: “A shift of this magnitude in the way of working requires a safe, effective model of
care…..there is immense concern regarding this model with unrest heightened by
the proposed timescales”. Their 9-page letter of concern to the Board has not so far been answered. GP Helen Salisbury explains in the British Medical Journal why the scheme is “a spectacularly bad idea”.

Six things at least that are wrong with the proposal:

  • It undermines equal access for all patients to be cared for by their GPs,
    a founding principle of the NHS.
  • It risks our health outcomes because care coordinators are not
    clinicians and will have no prior knowledge of patients’ medical
    histories. They are not equipped to carry out “clinical triage” as doctors
  • It artificially divides patients into two categories – and puts the burden
    of taking medical decisions on patients and non-clinical staff.
  • It will be disruptive and expensive to establish at a time when the NHS
    is desperately short of funds and trained people, with no guarantee of
  • Most GPs are unaware of how it would work in practice and those who
    have seen the plan have grave concerns it will lead to medical errors.
  • Feedback from doctors in the limited pilots that have taken place
    shows mixed results and no endorsement for general roll out.

Regrettably this scheme has not been devised by doctors and patients working
together, as we recommended last autumn, but by highly-paid management
” commented Robin Sharp, Chair of Brent Patient Voice. “We want the
Integrated Care Board to pause its introduction for wiser counsels to prevail.

N.B. This statement has been put together for urgent information to the public by
representatives of the NW London PPG Forum and Brent Patient Voice based on
documents issued in the last few days by the NWL ICB.


Date of issue: 14 February 2024

More Information

Letter to NW London Primary Care Networks Clinical Directors and Managers from Local NHS Directors:

Letter to Rob Hurd, CEO NW London Integrated Care Board from Robin Sharp, Chair Brent Patient Voice:

Briefing Pack about NW London Integrated Care System (long & technical):

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Page written 19/02/24