Does the new NHS plan mean I'll finally get to see a GP? Doctors answer your key questions

Telegraph

2 days ago

The 10-year plan for the NHS revealed by the Government yesterday might be the single biggest health announcement made since Labour took over a year ago. At its core is a plan to make our health service 'digital by default', with an app where people can access same-day GP appointments, as well as receive tips on healthy living and preventing illnesses like cancer and cardiovascular disease.
It's a massive document, coming in at a full 168 pages, and it's certainly an ambitious plan. What's clear from the announcement is that it will pivot the NHS into a prevention-first organisation, and that the Government will rely on tech like AI and genetic screening to do it. So we asked our trusted experts, the doctors and GPs who are working with patients every day – to tell you exactly what it all means for your health – and whether it's really enough to fix a system that has been letting many in Britain down for years.
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Will this mean I can get a same-day GP appointment?
The promise:
All patients who need one will be able to get a same-day GP appointment through the NHS App by 2028, according to the 10-year plan. As it stands, 44 per cent of consultations are same-day, while 31 per cent occur a week or longer after booking, according to the latest GP appointment data for England.
To help achieve this, a 'My NHS GP' section will be built into the NHS App. This will be an AI-powered advice tool that offers around-the-clock information, directs patients to the care they need and helps them book a remote or face-to-face consultation, if they need one.
Additionally, thousands more GPs will be trained to increase the number of appointments available and digital phone systems will be used so that patients who call their GP practice get through faster.
The doctors' verdict:
'All patients who need same-day appointments have been getting them for many decades,' says Dr Carter Singh MBE, a GP in Nottingham and spokesperson for the Rebuild General Practice campaign.
'This is just another route by which they can get one. We need to intelligently and accurately differentiate the 'wants' from the 'needs', as on many occasions, the patient is going to want a same-day appointment. We live in an 'Amazon-Prime' culture where expectations are such that we expect everything right now, at the push of a button.'
On the use of AI within the app to direct patients to GP appointments, Dr Singh is less confident. He doesn't believe AI currently is 'intuitive or intelligent enough to sensitively or specifically direct patients based on their reported symptoms and severity of illness to the right part of the NHS within the right timeframe'.
'A person who didn't need to be seen today for their ingrown toenail or runny nose could deny a same-day appointment for an elderly, vulnerable patient who has diarrhoea, vomiting, dehydration and is at risk of falling and breaking their hip,' he says. Without extra funding and more doctors in general practice, it's simply 'rearranging the deck chairs and ignoring the elephant in the room', Dr Singh adds.
However, Dr Amos Ogunkoya, a GP in north London and resident doctor in sports medicine, believes the NHS App will be an 'excellent solution' for helping patients book appointments.
'I think we have to embrace AI and technology which allows patients greater access. In theory, it should work out really well but in practice there will need to be some oversight,' he says.
'It's going to give people another way they can access appointments. It essentially gives people an option and people will naturally go to the one that's easier for them. Some patients might prefer explaining their symptoms over the phone – it's not getting rid of that option. I think it's really important we move from an analogue system to a digital one.'
Do I need to be tech-savvy to benefit from the changes?
The promise:
The NHS App – which can be accessed through a smartphone or tablet – is at the centre of the plan to modernise the health service. It will act as a 'front door' to the NHS, with the Prime Minister saying it will become an 'indispensable part of life'.
The app will offer patients advice, allow them to access their GP, book tests, hold consultations, manage their medicines and oversee the care of their children or people they care for.
The doctors' verdict:
The focus on the NHS App for accessing the health service risks creating 'winners and losers', according to Dr Singh. 'I think the people without that tech may be left behind, whether that's older adults, people in deprived areas or individuals with learning disabilities.'
'For example, in my area, where we've got massive levels of deprivation, digital illiteracy follows,' he says. There will also be patients who live in areas with poor internet connectivity who may struggle to use it, Dr Singh adds. 'They might be uncertain whether hitting their 'submit' button has really sent through their request.'
Additionally, many patients prefer to receive health advice from a doctor directly, rather than from AI, he notes. 'You come to the doctor for more than just medicine – it's the sensitive nature of that doctor-patient relationship, which may be lacking through chat bots and apps.'
However, the option of using the app rather than phoning a GP could be beneficial for patients who are not tech savvy, according to Professor Kamila Hawthorne, chair of the Royal College of GPs.
'Ideally, what we will see is that with more people using the app to access services, it will actually free up capacity for other, more traditional methods of access – such as phonelines – so that those who are less tech-savvy have a better chance of getting through that way,' she says. 'So in that sense, if things are implemented correctly, it should be a win-win.'
Dr Ogunkoya is also more optimistic. 'This isn't going to be a complete replacement of the processes we already have in place – it is something we'll see happen slowly and responsibly.
'It's not about replacing, it's about accessibility and giving people the option and allowing things to become more efficient. People are normally sceptical of new technologies and we need to be understanding of that but also actually have an open forum so people can discuss their concerns and we have to be listening to voices that do say that.'
Will my cancer get treated more quickly?
The promise:
Currently, the median wait time for patients to begin treatment after a screening or urgent GP referral is over 90 days. This falls far short of NHS targets which state that 85 per cent of patients should start treatment within 62 days. The Government's 10-year plan states that 'advances in technology continue to change the way hospital care is delivered' and highlights that AI is already used to allow for quicker diagnosis (and therefore treatment) of skin cancer. The plan does not mention an updated target time for cancer treatment.
The doctors' verdict:
Aside from promoting new technologies, the 10-year plan 'puts a lot of focus on prevention through lifestyle issues like obesity and tobacco use,' says Prof Richard Sullivan, director of the Institute of Cancer Policy and a medical doctor who qualified through work on the NHS. Between the two improvements, which could lower the number of cancer cases that occur in the first place, 'there's some indication that this might lead to greater resources in treatment and therefore quicker treatment overall,' he explains.
However, he isn't convinced that this will translate to faster or better-quality care for most patients. 'There's also an emphasis on patients being able to shop around the country for where they want to be treated. In theory, that's a good thing, but in practice, people with cancer would get treatment more quickly if everyone had access to good care on their own doorstep,' he says. 'Using AI and targeted prevention can't replace the need for more doctors and more actual space in operating theatres to treat people. Cancer is a very complicated disease and this idea of shopping around could actually hold things up.'
What is really needed is 'more joined up thinking so that people with cancer are cared for effectively and quickly through their journeys,' says Prof Sullivan. 'For that to become quicker, care needs to be more integrated in cases where people are visiting multiple hospitals.' The plan does not adequately address this need, he believes.
Will I get more preventative screenings?
The promise:
The 10-year plan sets out how the Government will 'transition the NHS from a sickness service to a prevention service, powered by the new engine of genomic science'. Genetic screening will be used more widely to test for the inherited causes of different diseases like cancer (such as the BRCA genes, which have been linked to breast and prostate cancer) and cardiovascular disease (such as familial hypocholesteraemia, which causes high levels of 'bad' cholesterol even when people eat healthily and exercise). These tests could be offered at local hubs.
There will also be more targeted screening rolled out to some groups. There are plans to roll out lung cancer screening to everyone with a history of smoking, and women who haven't taken up cervical screenings will be sent home sample kits. It is also hoped that the new NHS app will lead more people to take up the screenings they are already offered. In practice, this might mean that people are offered many more kinds of screening for different diseases or risk factors throughout their lifetimes.
The doctors' verdict:
'Only four percent of cancers are picked up through screening, and a lot of the analytical uses of AI that are discussed in this plan are only speculative at this point,' says Prof Sullivan. There are also plans to screen people for risk of different illnesses on the basis of characteristics like being overweight, and target help towards them to support lifestyle change.
This might seem like a good plan, but Prof Sullivan is not optimistic that it will work. 'We know from research that it's incredibly difficult to get people to change their habits in this way,' he says. 'A real boost to NHS resources would require engineering at a social, cultural and economic level, rather than telling individuals to change their behaviour.'
Will there be more NHS dentist appointments available?
The promise:
NHS dentistry is in crisis – satisfaction levels are at a record low, with over one in four adults struggling to source public dental care, according to the British Dental Association. More people are turning to private treatment, whilst those who can't afford it are left unable to eat or work properly, or tragically forced to resort to DIY dentistry.
The NHS pledges to 'fix the foundations in dentistry' by focusing on prevention to improve children's oral health, overhauling the dental contract to increase the number of dentists in the system, and integrating care in neighbourhood health teams. By 2035, the dental system will be 'transformed'.
The doctors' verdict:
'There's a specific target within the plan to help with urgent appointments which is going to be incredibly impactful,' says Dr Deepak Aulak, a dentist who has worked both in the NHS and privately. One of the ways that the NHS plans to increase the number of appointments is by ensuring new dentists work in the system for a minimum of three years. Dr Aulak says this change offers 'hope' for both patients and dentists. 'For the first time, there's [...] real recognition that the contract isn't operable and the current state of dental care isn't a workable model.'
Overall, he believes the plan is promising for NHS dental patients. 'They want to make dentistry more prevention-focused and they want it to be integrated in our local communities, with hygienists, therapists, and nurses. I think it's a sensible and viable plan rather than sound bites.'
Patients should benefit through more appointments and improved accessibility via new technologies, however Dr Aulak says that '[they] should keep putting the pressure on, because a lot of the successes in this report have come not just from dentists, but from the patients themselves speaking up.
'The key question many patients will still have is: when will they start to see meaningful improvements in the service? This is where a concrete, actionable plan from the Government, with clear milestones and deliverables, would be greatly welcomed.'
Will I be rewarded for being healthier?
The promise:
'Citizens clearly have a role to play in managing their weight and diet,' the 10-year plan states. 'Incentives are embedded in many other parts of our lives, from supermarket shops, to buying a morning coffee, or choosing who to bank with. Evidence shows that incentives can also help people make healthier choices.'
The NHS will therefore implement a similar model by introducing 'NHS points' that rewards healthy behaviours. While the exact way this scheme will work is yet to be finalised, the plan cites a recent NHS pilot which gave cinema tickets, clothes and food vouchers to people in Wolverhampton who increased their step count and ate more fruit and vegetables. It also mentions a similar initiative in Singapore, which sent e-vouchers to people who improved their diet, sleep and exercise levels.
The doctors' verdict:
'I've got a degree in psychology and we studied this token economy approach 25 years ago,' Dr Singh says. 'Positive reinforcement can be quite effective in the short-term, whether that's giving people cash for physical activity, smoking cessation or improving their diet and weight management.
'However, as soon as you remove those tokens or points, then the health behaviours revert back to baseline and sometimes become even worse. So, in terms of sustainability of positive health behaviours, I don't think it's that effective. You have to have it as part of an integrated approach where patients are supposed to live healthier lifestyles because they want to, rather than knowing they can press a button and get a token.
'Without a strategy addressing the wider determinants of health and adequate funding and continued support and motivation, these kinds of schemes usually do fail – that's what all the research and evidence points towards.'
However, Dr Ogunkoya notes that there are some examples of health incentives working. 'If it didn't work, Vitality wouldn't use a point system for their insurance. People stay healthier for longer when they are incentivised to move and exercise more.
'I'm a sports and exercise medicine specialist as well as a GP and I know that there's nothing worse for our health than sedation, so not moving. Even if it only encourages a little bit more every day, that will improve the health of our population.'
Prof Hawthorne believes schemes that aim to tackle obesity, change patients' behaviour and encourage them to live healthier lives 'have to be a good thing'.
'It's good to see the 10-year plan not only rely on weight loss medication, which has a lot of potential, but shouldn't be seen as a silver bullet to tackling rising levels of obesity,' she says. 'The focus on some quite innovative schemes to support healthy living is encouraging to see.'