Patients are to lose the “automatic right” to see a doctor as part of a rescue plan to ease pressure on a dwindling workforce of GPs.
Health bosses at Oxfordshire Clinical Commissioning Group are understood to be the first in the UK to introduce the measures county-wide as part of a care plan overhaul.
Patients who call up asking for a same-day appointment with a doctor will not “automatically” get one, under the plans approved this week.
Instead, callers to Oxfordshire’s 78 surgeries will be “triaged” – and only 13 a day who need “urgent” care will get a long 15-minute appointment with a GP.
Those who do get urgent same-day appointments might have to go to another surgery or see a different member of the care team, other than a GP.
People asking for more routine appointments MIGHT be permitted to see a medic within a week if deemed appropriate – but this might not be face-to-face or with a GP.
The report added technology such as Skype or FaceTime could play a “key role in releasing GP time”.
NHS bosses said the changes are needed to cope with a shortage of GPs, admin burdens, and an increase in patient and “avoidable” consultations.
But critics fear the changes will trigger an increase in patients turning up at A&E departments, and have labelled the plan “cuts in disguise”.
Health bosses admit staff such as receptionists will need to be “skilled up” to make it work – prompting fears non-medically trained staff will be deciding who sees GPs.
Detailing the plan, report author CCG deputy director Julie Dandridge, wrote: “All patients requesting an urgent appointment will be seen or clinically triaged
by a high skilled health care professional (not a protocol based system) and seen the same day if urgent need is thought to be appropriate.
“Patients will not have an automatic right either to same day appointments or home visits.
“Same day urgent appointments will not necessarily be at the patient’s own general practice or by the patient’s own GP and the patient will see an appropriate member of the Primary Care Health care team.
“Patients will see the most appropriate health professional first time as defined
by the expert triage.
“All patients requesting a routine appointment will be able to book one within one week if clinically appropriate.
“This appointment may not need to be face to face, but if the patient would prefer this then all efforts must be made to provide this.
“The appointment will be with the most appropriate health care professional.”
Health bosses said the new plan was drawn up after the closure of a GP surgery, and more than a dozen in the area declared themselves “vulnerable”.
The CCG blamed the fact Oxfordshire has the lowest ratio of average income to house price in the UK – as well as a decline in funding, an ageing population and declining state of GP premises.