"Exhausted" GPs are doing everything to keep Hertfordshire residents in good health despite "ridiculous" NHS England demands for same-day assessments, a meeting heard.

Doctors, pharmacists and other health professionals met with leaders from Herts and West Essex Integrated Care Board (ICB) during a meeting of its primary care transformation committee on Thursday.

Clinicians responded to a 'system-level access improvement plan' outlining the ICB's strategy to keep high standards of healthcare across the county.

One goal was to fulfil NHS England's ambition to carry out same-day assessments when a clinical need was identified.

GP Dr Alice Baldock, Local Medical Committees representative, spoke up for "exhausted" frontline staff already working hand in hand with other practices in order to keep patients safe.

Her comments were echoed by Dr Robert Mayson, of Hailey View Surgery in Hoddesdon.

He told the meeting: "I just wanted to add that you're trying to fit too many potatoes in this poor, heaving, breaking sack. To just go along and agree with the direction of NHS England is actually not helpful.

"It makes the GPs feel more undervalued and we feel like we're just not doing a good enough job, because access is broken. It's not our fault, we're seeing more patients because of issues that are creeping in from other parts of the system.

"We have patient expectations and for NHS England, to have those comments on expectation and ambitions, it means the Department of Health has it and and the Government has it. They say one thing one on the news and patients say, 'Oh, you've got to assess me within 24 hours'.

"This is what is actually really fundamentally wrong, given the resources in primary care which have gone down. We've reduced our staff cost because we can't afford them anymore, but we're being expected to increase our appointments and access. It's utterly ridiculous.

"Actually, we need our system to start supporting the real issue, not just the political machinations. I'm afraid two weeks for a routine appointment is utterly ridiculous in this climate.

"Plus most people don't need a routine appointment in two weeks, if it's routine it can be anything from a month to three months."

The report stated: "General Practice, like many parts of the NHS, is under tremendous pressure – nationally one in five people report they did not get through or get a reply when they last attempted to contact their practice.

"The Fuller Stocktake report [commissioned by NHS England] stated, "there are real signs of growing discontent with primary care – both from the public who use it and the professionals who work within it". The Fuller Stocktake also provides valuable insights on the preferences of people waiting for and choosing appointments.

"People waiting for an appointment with their GP prioritise different things. Some need to be seen straightaway while others are happy to get an appointment in a week's time.

"Equally, for some patients it is important to be seen face to face while others want faster, more convenient ways of accessing treatment and there is emerging evidence of a growing appetite (even before COVID-19) for patients to access care digitally.

"The NHSE 'Delivery Plan for Recovering Access to Primary Care' (NHSE May 2023) has two central ambitions:

• To tackle the 8am rush and reduce the number of people struggling to contact their practice. Patients should no longer be asked to call back another day to book an appointment, and we will invest in general practice to enable this.
• For patients to know on the day they contact their practice how their request will be managed.

"If their need is clinically urgent it should be assessed on the same day by a telephone or face-to-face appointment. If the patient contacts their practice in the afternoon they may be assessed on the next day, where clinically appropriate.

"If their need is not urgent, but it requires a telephone or face-to-face appointment, this should be scheduled within two weeks.

"Where appropriate, patients will be signposted to self-care or other local services (e.g., community pharmacy or self-referral services)."