Kamis, 14 Oktober 2021

League tables for surgeries do not 'make any sense whatsoever', says head of Royal College of GPs - Sky News

Government plans to publish league tables for GP surgeries and allow patients to rate their performance via text message do not "make any sense to me whatsoever", the head of the Royal College of GPs has told Sky News.

Professor Martin Marshall said a new package of support for GP surgeries in England, which ministers say will help them "see more people face-to-face and more promptly", fails to "address the fundamental problems" facing practices.

Under the plan to improve access, practices which fail to provide an "appropriate" level of appointments in person will not be eligible for new NHS England funding worth £250m, with league tables ranking how much access surgeries are providing.

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'I believe in choice' for patients to see GPs

Patients will also be able to rate their practice's performance via text message.

Reacting to the proposals, Prof Marshall said: "Of course any money, even short-term funding over the winter period, is welcome. But it doesn't address the fundamental problems. The fundamental problems are deep-seated.

"For more than a decade, general practice has been under-invested in, we've had an increasing workload and more consultations, more complex consultations, more things that we can do, but the number of GPs is actually dropping.

"This offer from the government doesn't address that fundamental problem."

More on Nhs

Asked for his take on league tables and text ratings, he said: "GPs have always been receptive to patient feedback.

"There are many different ways, established ways now, of patients being able to feed back their experience of general practice.

"I think the idea as part of this so-called offer, that GPs should be in some way or other held to even greater account, put under even more of an administrative burden, in order in some ways to improve care, just doesn't make any sense to me whatsoever."

Prof Marshall said GP practices are already struggling under a "massive burden" and "struggling to deliver what we're trained to deliver and what we know our patients want and need".

He was speaking to Sky News after telling the RCGP conference that some politicians and sections of the media were engaging in "abuse" of medics, describing it as "demoralising and indefensible".

Prof Marshall said GPs have been engulfed in a "public storm over face-to-face appointments".

"The malicious criticism of the profession by certain sections of the media and by some politicians as a result of the shift towards remote working - introduced to keep our patients and our team safe and keep the service operating - has been the worst that I can remember in over 30 years as a GP," he said.

"This widespread vilification of hard-working GPs and our teams is unfair, it's demoralising, and it's indefensible. No-one working in general practice deserves this abuse."

Speaking to delegates, Professor Chris Whitty, England's chief medical officer, said the issue of face-to-face appointments had received "rather more heat than it needs".

He did suggest that there could be more in-person consultations, but urged GPs to pay no mind to negative media coverage.

"I would stick to the advice that is an old saying, but it's completely right, which is never worry about criticism from somebody you wouldn't take advice from," Prof Whitty said.

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NHS backlog leaves GP surgeries struggling

Dr Michael Mulholland, vice chair for professional development at the RCGP, told the conference there had been a "change" to the line-up and Health Secretary Sajid Javid would not be addressing them as previously planned.

"Unfortunately we do have one change to the programme. The Secretary of State for Health for England is unable to join us today either in person or by video link," he said, prompting laughter in the audience.

"This is because, and I need to get this right, he had to 'clear his diary to ensure he can fight for the NHS in the spending review, or be anywhere else you may have seen or heard him this morning'."

Speaking to Sky News earlier on Thursday, Mr Javid said providing "more data, more transparency" would help raise standards.

"It is important that patients have this information because I want to see a levelling up of healthcare throughout the country," he said. "We do need to understand what the differences are in healthcare provision across the country."

Mr Javid added that GPs had done "phenomenal work" during the COVID-19 pandemic and added: "We want to support them to do what they do best, which is to see patients and to see more patients properly and in a way that the patient chooses."

The health secretary said the measures will "help GPs to see more people face-to-face and more promptly".

He stressed patients should have a choice between in-person appointments and remote consultations, saying: "I believe in choice, I think that's what patients want to see.

"The vast majority of GPs I talk to say that if you can help us to increase capacity, if you can provide us the support, that's also what we want to do.

"I think patients should have a choice, and if some choose that they prefer remote or online versus face-to-face then that absolutely can be right for them."

Mr Javid visited a GP surgery in southeast London on Thursday.

Dr Jai Israel, principal GP at The Vale Medical Centre in Forest Hill, told Sky News afterwards that the surgery does not "have the bodies" to increase the number of face-to-face appointments.

"It's not about the funding or injecting the millions into the service," he said.

"If the GPs aren't available, we can't provide the appointments that they need. The problem that's happening now is individual GPs are having extra patients on top of their fully-booked sessions.

"This is creating a lot of pressure mentally on GPs, but also it's unsafe. Because with too many clinical contacts in a day for an individual, there's a very high risk of clinical error occurring.

"GPs are consistently watching their back, afraid that they may make such a mistake."

The Great Debate

The NHS said the "winter access fund" will allow GPs to improve the availability of appointments and increase the number of face-to-face appointments and same-day care.

Other healthcare workers will be given new powers to provide patients with medical documents like fit-to-work notes or DVLA checks in a bid to free up GPs.

The NHS said GP practices must "respect preferences for face-to-face care unless there are good clinical reasons to the contrary".

People will be able to compare GP practices thanks to appointment data which will be published at practice level by spring to "enhance transparency and accountability", the health service said.

It is not clear how "appropriate levels" of face-to-face care will be defined, but those who do not meet the standard will be offered support to improve.

"Walk-in consultations" could be one of the ways in which practices choose to address the problem.

GP telephone systems will be upgraded to reduce long waits over the phone, social distancing in practices could be changed or reduced, and patients will be able to see nurses, pharmacists, and paramedics at GP practices.

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2021-10-14 13:52:30Z
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North Yorkshire crime commissioner quits after 'streetwise' comments in wake of Sarah Everard murder - Daily Mail

North Yorkshire crime commissioner quits after coming under fire for saying women should be 'street-wise' in wake of Sarah Everard murder

  • Philip Allott steps down from North Yorkshire PCC role following his comments
  • The crime commissioner said women 'need to be streetwise' about arrests
  • Critics branded his comments as 'horrifically insensitive' and 'victim blaming' 

The head of North Yorkshire's policing has quit after coming under fire for his comments on women's safety in the wake of Sarah Everard's murder. 

Philip Allott, who oversaw police and fire services in North Yorkshire, was widely condemned for suggesting Ms Everard 'never should have submitted' to the arrest by killer Wayne Couzens.

Couzens, a Metropolitan Police officer, used his position to falsely arrest the 33-year-old for breaking lockdown rules in order to kidnap her before raping and murdering her. 

In an open letter, Mr Allott apologised 'unreservedly' for his remarks and claimed he 'misspoke' on the topic of women's safety in the wake of Ms Everard's high profile murder. 

Despite being married and having a daughter himself, Mr Allott suggested women needed to be more 'streetwise' and 'learn a bit' about powers of arrest.

His resignation comes after the North Yorkshire’s Police and Crime Commissioner unanimously voted in favour of a vote of no confidence in him earlier today.

The North Yorkshire Police, Fire and Crime panel met on Thursday with discussion of Mr Allott’s comments, for which he subsequently apologised, forming part of the agenda. 

Former police commissioner for North Yorkshire, Philip Allott, (pictured) resigned after suggesting women 'need to be streetwise' about arrests in the wake of the Sarah Everard case

Former police commissioner for North Yorkshire, Philip Allott, (pictured) resigned after suggesting women 'need to be streetwise' about arrests in the wake of the Sarah Everard case

Wayne Couzens was jailed for the rest of his life after using his position as a Metropolitan Police officer to falsely arrest Miss Everard, 33, for breaking Covid rules before raping and murdering her

Wayne Couzens was jailed for the rest of his life after using his position as a Metropolitan Police officer to falsely arrest Miss Everard, 33, for breaking Covid rules before raping and murdering her

Former Police Commissioner Phillip Allott's resignation statement in full

 'Over the past two weeks I have tried to rebuild trust and confidence in my work as York and North Yorkshire’s Police, Fire and Crime Commissioner. 

'I needed to do that following comments I made on an interview with Radio York regarding the horrific abduction, rape and murder of Sarah Everard.

'I need to be clear. I apologise unreservedly for my remarks. They do not reflect my views.

'I misspoke and I am devastated at the effect that this has had on victims of crime and the groups that support them. I have tried to say this again and again but I recognise that what I have said has not always been heard as I intended.

'I had hoped I could rebuild trust, to restore confidence. I was pleased that so many victims groups had accepted that I was genuinely sorry and were willing to work with me to help me in the mammoth task I had ahead.

'Following this morning’s meeting of the Police and Crime Panel it seems clear to me that the task will be exceptionally difficult, if it is possible at all. It would take a long time and a lot of resources of my office and the many groups who do excellent work supporting victims.

'This is time victims do not have. There are women and girls in York and North Yorkshire today suffering at the hands of men. Victims and the groups who support them need to be heard. They cannot be heard if the airwaves are filled with discussion about my future.

'That is why I am doing the honourable thing and resigning as Police, Fire and Crime Commissioner – to restore confidence in the office which I believe will be almost impossible for me to do, and to enable victims’ voices to be heard clearly without the distraction of the continued furore which surrounds me.

'I entered public life because I wanted to make a difference. I still do. So, I am committing myself to doing all I can as a private individual to support victims groups. The pledge I made as Police, Fire and Crime Commissioner was genuine. It is one I will keep.

'I would like to thank my office and especially my Chief Executive for his help and support, especially during the last two weeks which has been a challenging time for everyone at the OPFCC.

'Whoever the new Police, Fire and Crime Commissioner will be I wish them every success in what is one of the most demanding but rewarding jobs in the UK.

 

After working for IT company Schneider, he founded his own PR and B2B marketing agency, Allott and Associates Ltd in 1993. 

Mr Allott began his political career at 25 when he became a Harrogate District Councillor.

Over nine years, he chaired a number of committees including Leisure, Environmental Health and became leader of the town council's Conservative Group.

He also stood for Parliament as a Conservative candidate in Halifax in 2010 and 2015. 

Elections are now set to take place in the coming months to determine Mr Allott's successor.

Simon Dennis, Chief Executive of the Office of the North Yorkshire Police, Fire and Crime Commissioner, added: 'The North Yorkshire Police, Fire and Crime Panel will now arrange the appointment of an acting Police, Fire and Crime Commissioner to be chosen in accordance with the law, from amongst the staff of the Office of the Police, Fire and Crime Commissioner.

'Further announcements will be made by the Panel in due course.

'In the meantime, the staff of the Office of the Police, Fire and Crime Commissioner for North Yorkshire and York will continue to work to protect communities, support victims and keep residents safe and feeling safe.' 

Julian Smith, MP for Skipton and Ripon and a former cabinet minister, tweeted: 'Recent comments of the NY Police & Crime Commissioner were completely unacceptable.

'Prior to Thursday’s Police & Crime Panel meeting to discuss the PCC’s future I believe the PCC has lost trust of women and victims groups & should go - I have communicated this to the PCC & panel Chair.'

Mr Allott made the comments during an interview on BBC Radio York and were branded 'horrifically offensive' by critics.

During the interview, host Georgey Spanswick asked: 'How on earth do my stepdaughters, me, my friends, how do we protect ourselves now?’

Mr Allot said: 'A police officer can’t just arrest you. There has to be a reason.

'So, Covid for example I would classify as a summary offence, it’s not an indictable i.e. sent to prison or potentially go to a Crown Court.

'So women, first of all, need to be streetwise about when they can be arrested and when they can't be arrested.

'She should never have been arrested and submitted to that.

'Perhaps women need to consider in terms of the legal process, to just learn a bit about that legal process.'

His comments were challenged by host Spanswick, who said: 'Why is it down to me Philip? Why is it down to women because actually, this is down to one man in the police force and there are serious doubts about this man's conduct?'

He later issued an apology for his remarks.

On Twitter, he said: 'I would like to wholeheartedly apologise for my comments on BBC Radio York earlier today, which I realise have been insensitive and wish to retract them in full.'

Tory chairman Oliver Dowden said he and Boris Johnson had been 'outraged' by the comments from Mr Allott.

Asked about the comments last week Mr Dowden told Sky News: 'The Prime Minister and I were outraged by what he said. It was completely unacceptable. 

'I have been very clear in condemning it but I know the Prime Minister shares that view.

'He (Allott) did immediately apologise and I think that's appropriate for him to do so.'

Asked whether Mr Allott would be able to stand again for election to the role, Mr Dowden said 'I'm not going to pre-empt the selection process.

'The Prime Minister and I profoundly disagreed with what he said, it was a stupid thing to have said and he has rightly apologised for it.' 

North Yorkshire crime commissioner Mr Allot said Miss Everard 'never should have been arrested and submitted to that'

North Yorkshire crime commissioner Mr Allot said Miss Everard 'never should have been arrested and submitted to that'

Oliver Dowden blasted North Yorkshire PCC Philip Allott over his 'stupid' comments, which sparked demands for his resignation.

Oliver Dowden blasted North Yorkshire PCC Philip Allott over his 'stupid' comments, which sparked demands for his resignation.

Mr Allott received a furious backlash on social media, with some users calling for him to resign.

Labour MP Barbara Keeley described the comments as 'appalling', tweeting: 'A murder victim like Sarah Everard is not to blame for what happened when she was arrested by a serving Met officer.'

Shadow home secretary Nick Thomas-Symonds said: 'It's absolutely right that Philip Allott resigns following his appalling remarks.

'His awful comments show that misogyny needs tackling, and the community response to them shows it will no longer be tolerated.

'Yet again we've seen a total failure of leadership from the Tories. They should have forced him to leave two weeks ago when Keir Starmer called for it.'

Silkie Carlo, director of Big Brother Watch, said Mr Allott should resign 'for our safety'. 

Before moving to London, 33-year-old Sarah Everard was originally from York, the area covered by Mr Allot's force, and her family still lives there.

Lucy Arnold, of campaign group Reclaim the Streets, who organised a vigil for Ms Everard outside York Minster, was among those angered by Mr Allott's comments.

She said: 'I think frankly that was a horrifically offensive thing to say. Does anyone really feel like they can stand up to a police officer?

'I am very confident I know my rights, I know the law, but no I wouldn't feel confident at all.'

Former chief Julian Smith (pictured) said Mr Allott's recent comments were 'completely unacceptable'

Former chief Julian Smith (pictured) said Mr Allott's recent comments were 'completely unacceptable'

Wayne Couzens used his position as a Metropolitan Police officer to falsely arrest Miss Everard, 33, for breaking lockdown rules before raping and murdering her

Wayne Couzens used his position as a Metropolitan Police officer to falsely arrest Miss Everard, 33, for breaking lockdown rules before raping and murdering her

In his earlier interview, Mr Allot was critical of the Met Police's handling of reports about Couzen's behaviour leading up to the murder.

He said: 'A murderer typically commits seven crimes before going on to murder, that man we know committed at least two crimes.

'The police knew, so what should have happened is that it should have been picked up straight away.' 

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2021-10-14 14:34:12Z
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Insulate Britain to stop road block protests after angry scenes on M25 - ITV News

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  1. Insulate Britain to stop road block protests after angry scenes on M25  ITV News
  2. Insulate Britain announces it's suspending its campaign of 'civil resistance' in letter to PM  Sky News
  3. Eco mob backs down....for now: Insulate Britain SUSPENDS campaign for 12 days  Daily Mail
  4. I should be angry at Insulate Britain blocking motorways – but what choice have they been left with?  The Independent
  5. Insulate Britain says it will suspend its campaign after breaking High Court injunction  Telegraph.co.uk
  6. View Full coverage on Google News

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2021-10-14 11:06:55Z
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Plan to boost face-to-face GP consultations - BBC News

Stock image of a doctor using a phone
Getty Images

GPs in England are being told to see more patients face-to-face as ministers unveil a £250m winter rescue package.

The emergency funding is being handed to GPs so they can recruit extra locum staff with an emphasis on providing more same-day appointments.

Social distancing rules are also expected to be relaxed so that GPs can bring more people into their buildings.

It comes amid mounting criticism about the fall in face-to-face appointments since the start of the pandemic.

Chart showing consultation types

Only 58% of patients were seen face-to-face in August - the first full month following the ending of restrictions.

That compares with 54% in January and more than 80% before the pandemic.

Patients have also complained of long waits on phone lines to book an appointment.

The £250m funding is part of the extra £5bn Covid fund announced last month to help the NHS through to the end of the year, and comes on top of the £12bn set aside for GP services this year.

Alongside locum doctors - doctors who stand in for others temporarily - GP practices will be able to use the money to recruit other temporary staff such as physios and podiatrists.

Funding part of wider plan

The announcement is part of a wider joint government and NHS England plan for GP services, which will be published on Thursday.

It is expected to promise upgrades for telephone systems, ensuring more patients can quickly and easily speak to general practice staff, and a reduction in paperwork by allowing other staff to provide evidence for fitness to work and fit-to-drive checks.

GP surgeries will also be named in league tables if they are judged to have failed to provide an appropriate level of "access".

Health Secretary Sajid Javid said: "I am determined to ensure patients can see their GP in the way they want, no matter where they live. I also want to thank GPs and their teams for their enormous efforts in the most challenging times in living memory.

"Our new plan provides general practice teams with investment and targeted support. This will tackle underperformance, taking pressure off staff so they can spend more time with patients and increase the number of face-to-face appointments."

The health secretary denied a suggestion he was "stirring up anti-GP rhetoric" with the announcement.

But Dr Richard Vautrey, of the British Medical Association, said he was "hugely dismayed" with the package. "It offers very little and shows a government out of touch with the scale of the crisis on the ground."

He said patients would "continue to suffer" and find it harder to book appointments.

"It is disappointing to see there is no end in sight to the preoccupation with face-to-face appointments."

He said in-person appointments were still a key feature of GP care but the pandemic had proven phone or video consultations were "entirely appropriate and appreciated" by many.

Chart showing GP numbers
Presentational white space

The rescue package comes amid the government's ongoing struggle to increase the number of GPs.

Over the past five years the total - in terms of full-time posts - has fallen despite successive government drives to increase numbers.

Lack of access to GPs affecting A&Es

The struggle to access GP services has been highlighted by the Royal College of Emergency Medicine as one of the factors behind the high levels on A&E attendances.

The NHS will publish the latest figures, covering the month of September, for those later.

But during the summer, waiting times reached their worst-ever level since the four-hour target was brought in in 2004 - with nearly one in four people waiting longer.

NHS Providers, which represents health bosses, said its members were particularly worried about A&Es alongside mental health and cancer services.

Deputy chief executive Saffron Cordery said: "The NHS is fighting fires on multiple fronts as they try to recover care backlogs, increased demand for emergency care, treating patients with Covid and preparing for what is likely to be the most challenging winter yet for the NHS.

"In a matter of weeks, we will face our first winter where both flu and Covid are in circulation."

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2021-10-14 08:17:55Z
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Prince William slams Jeff Bezos and Elon Musk after William Shatner ‘space tourism’ saying ‘fix the planet... - The Sun

PRINCE William blasted billionaire "space tourism" on the day Star Trek's William Shatner became the oldest man to be sent into orbit.

The Duke of Cambridge spoke out against the likes of Jeff Bezos and Elon Musk and Richard Branson ahead of his Earthshot Prize this Sunday handing out millions to save the planet.

The Duke called for greater focus on saving the earth, rather than leaving for other planets
The Duke called for greater focus on saving the earth, rather than leaving for other planetsCredit: BBC
Star Trek actor William Shatner experiences weightlessness with three other passengers during the apogee of the Blue Origin New Shepard mission
Star Trek actor William Shatner experiences weightlessness with three other passengers during the apogee of the Blue Origin New Shepard missionCredit: Reuters

It comes as 90-year-old Captain Kirk star Shatner was sent into space in Amazon billionaire Bezos's Blue Origin New Shepard rocket.

Speaking to a BBC Newscast about the new space race, William said: "We need some of the world’s greatest brains and minds fixed on trying to repair this planet, not trying to find the next place to go and live."

Shatner become the oldest person in space and was greeted when he touched back down on earth by the internet shopping tycoon.

When he landed, he said: "Everybody in the world needs to see this".

But space tourism for the rich and famous has been roundly blasted including by the United Nations for being massively environmentally unfriendly.

William spoke out ahead of his Earthshot Prize which is giving out £50million over next decade for initiatives that save the planet.

The awards, hailed as “Nobel Prize of the environmental world”, wants experts and millionaires to spend their time and money saving the planet.

His interview with BBC Newscast’s Adam Fleming filmed at Kensington Palace will be available as a podcast on BBC Sounds.

During the 35-minute chat William watched back clips from his five-part documentary The Earthshot Prize: Repairing our Planet.

He said: "I want the things that I’ve enjoyed - the outdoor life, nature, the environment - I want that to be there for my children, and not just my children but everyone else’s children.

"If we’re not careful we’re robbing from our children’s future through what we do now.’

'NOT ENOUGH ACTION'

The duke will be at COP26 in Glasgow next month as world leaders fight climate change.

He warned against "clever speak, clever words, but not enough action".

And said it was critical for the climate conference to ‘communicate very clearly and very honestly about what the problems are and what the solutions are going to be.

He added: "That's why The Earthshot Prize is so important, because we're trying to create action."

Father-of-three Wills praised his dad the Prince of Wales claiming he experienced a "really rough ride" in his decades of campaigning for green issues saying he has been ‘proven to be well ahead of the curve’.

William added: "It would be an absolute disaster if George is sat here talking to you or your successor, Adam, you know in like 30 years’ time, still saying the same thing, because by then we will be too late."

Shatner and newly minted astronauts Chris Boshuizen, Glen de Vries and Audrey Powers stepped out of their rocket in West Texas yesterday.

They landed following their first mission to the final frontier after spending just three minutes in zero-gravity.

When Shatner emerged from the capsule he was greeted by Blue Origin boss Jeff Bezos and instantly wrapped his arms around him.

The world's rich and famous are queueing up to buy a flight amid a new billionaire space race.

'POINTLESS BILLIONAIRE SPACE RACE'

Virgin Galactic took Richard Branson 86km into the sky two months ago before Jeff Bezos did the same.

Branson said: “We’re here to make space more accessible to all. Welcome to the dawn of a new space age.”

Companies including Elon Musk's SpaceX, Virgin Galactic and Space Adventures want to make space tourism more common.

Critics have called it a “pointless billionaire space race”, a “vanity project” and not a test of the world’s superpowers but “merely the egos of three billionaires”.

The Earthshot Prize wants the brightest minds to put their efforts into saving the planet.

Five inaugural winners of The Earthshot Prize each pocketing £1million will be announced this Sunday at 8pm on the BBC.

The fifteen finalists range from a 14-year-old girl in India who created a solar-powered mobile ironing service and the entire nation of Costa Rica.

BBC Newscast: the Prince William interview airs on Thursday 14th October 2021.

Watch BBC One (at 23:35), BBC News Channel and BBC iPlayer. Listen on BBC Sounds and BBC 5 Live.

Founder and CEO of Amazon Jeff Bezos
Founder and CEO of Amazon Jeff BezosCredit: Reuters
Bezos' Blue Origin\031s New Shepard rocket
Bezos' Blue Origin\031s New Shepard rocketCredit: The Mega Agency
Tesla CEO Elon Musk
Tesla CEO Elon MuskCredit: Reuters
Moment William Shatner, 90, is left awestruck as he floats in Blue Origin capsule saying 'Oh Jesus'

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2021-10-14 05:28:00Z
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Brexit: EU has gone extra mile with Northern Ireland offer - ambassador - BBC News

João Vale de Almeida - who is the EU's ambassador to the UK - on BBC Newsnight

The EU has gone the extra mile by offering a fix to the row about trade in Northern Ireland, a senior EU official has said.

João Vale de Almeida - who is the EU's ambassador to the UK - told the BBC the bloc's proposals were "unprecedented".

The EU has suggested changing part of the Brexit deal that specifically covers Northern Ireland. Both sides agree it has problems.

The UK and EU will now hold three weeks of talks to discuss the suggestions.

When the Brexit deal was agreed less than two years ago, the two sides signed up to the Northern Ireland Protocol - the part that aimed to stop checks along the border between Northern Ireland and the Republic of Ireland.

Instead, the trade checks take place when goods arrive into Northern Ireland from Great Britain.

But two years on, both sides admit there are problems with the protocol. The UK says the current arrangement imposes too many barriers, and the EU recognises it has caused problems for businesses in Northern Ireland.

Their suggested solutions differ, however, with the UK wanting a completely new protocol, while the EU wants to adapt the current one.

On Wednesday, the EU published its plan of how the protocol could be amended - cutting the number of spot checks by 80% and also halving the amount of customs paperwork.

Speaking to BBC Two's Newsnight, Mr Vale de Almeida, who became the ambassador to the UK last year, said: "What we have presented in Brussels today is unprecedented. And I have been working for the EU for almost 40 years now.

"What we have done today goes very far. We went the extra mile to address the problems that were created by Brexit in Northern Ireland, which the protocol tries to mitigate."

He insisted that the EU's suggestions did not represent it giving way to the UK government. "These are not concessions, these are proposals that we make out of our own initiative," he said.

"Why should they be concessions? We're not forced to propose this, we proposed this because we realised that there are problems in Northern Ireland and we care about Northern Ireland, we want the protocol to work."

"We are not renegotiating the protocol, we are adapting the protocol," he said.

After the EU set out its plans on Wednesday, the UK said it would study the detail and the next step should involve rapid and intensive talks to see if a solution could be found.

But disagreements could still remain, including over the role of the European Court of Justice - the EU's highest court - in Northern Ireland.

Both sides previously agreed that the ECJ can police matters of EU law in Northern Ireland, as Northern Ireland will be staying in the EU's single market for goods. So, for example if there was a dispute around complying with applicable EU law, the EU could take the UK to the ECJ.

But the UK's Brexit minister Lord Frost previously said he wants the ECJ's role to be removed.

Mr Vale de Almeida said the EU had gone to the limits of what it could offer.

Asked about the ECJ issue on Newsnight, Mr Vale de Almeida - who is Portuguese - said: "There is no single market without the European Court of Justice.

"It's the referee of the single market.

"So if Northern Ireland wants to have access to single market for goods... and at same time have access to the British market, it's a unique position in the world... there has to be a European Court of Justice. One does not go without the other."

Talks between the EU and UK on the new proposals are now likely to go on for several weeks.

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NI Protocol: The basics

The Northern Ireland Protocol is part of the Brexit deal: It is an agreement that means goods can pass freely across the Irish border. Basically, lorries don't have to stop and prove their goods follow EU rules when they go between Northern Ireland (in the UK) and the Republic of Ireland (in the EU).

It means Northern Ireland still follows some EU rules: As the rest of the UK (England, Scotland, Wales) no longer follow EU trade rules, some goods from there have to be checked when they arrive in Northern Ireland.

But some goods from Britain can't enter Northern Ireland at all: EU rules don't allow certain products, like chilled sausages, to enter its market. A grace period, where the rules don't apply, has been in place since January but no long-term solution has been found.

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2021-10-14 04:28:22Z
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Rabu, 13 Oktober 2021

League tables for GP surgeries as part of £250m package to increase face-to-face appointments - Sky News

League tables for GP surgeries are to be introduced aimed at improving patients' access to face-to-face appointments.

Practices which fail to provide an "appropriate" level of appointments in person will not be eligible for new NHS funding worth £250m.

As part of a new package of measures to improve access, patients will also be able to rate their practice's performance via text message.

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'Tackling huge NHS backlog is a priority'

The NHS said the "winter access fund" will allow GPs to improve the availability of appointments and increase the number of face-to-face appointments and same-day care.

Other healthcare workers will be given new powers to provide patients with medical documents like fit-to-work notes or DVLA checks in a bid to free up GPs.

The NHS said GP practices must "respect preferences for face-to-face care unless there are good clinical reasons to the contrary".

People will be able to compare GP practices thanks to appointment data which will be published at practice level by spring to "enhance transparency and accountability", the health service said.

More on Covid-19

It is not clear how "appropriate levels" of face-to-face care will be defined, but those who do not meet the standard will be offered support to improve.

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'What happens to the NHS is hugely important'

"Walk-in consultations" could be one of the ways in which practices choose to address the problem.

GP telephone systems will be upgraded to reduce long waits over the phone, social distancing in practices could be changed or reduced, and patients will be able to see nurses, pharmacists and paramedics at GP practices.

Health Secretary Sajid Javid said: "I am determined to ensure patients can see their GP in the way they want, no matter where they live."

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COVID: Another winter of strain for the NHS?

He said this will "tackle underperformance, taking pressure off staff so they can spend more time with patients".

Only 58% of GP appointments in England in August were face-to-face, compared with four in five before the pandemic in August 2019.

The British Medical Association said the plans would not help GPs improve care in the way they had hoped and described the government as "ignorant" to the scale of the crisis.

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September: National Insurance rise to fund NHS reform

GP committee chair Dr Richard Vautrey criticised the "preoccupation" with face-to-face appointments and said a hybrid approach was needed.

"GPs across England will be truly horrified that this is being presented as a lifeline to general practice, when in reality it could sink the ship altogether," he said, warning that a "lack of action" would force many GPs to exit the profession.

Professor Martin Marshall, chair of the Royal College of General Practitioners, said "good care can and is being delivered remotely and some patients prefer it".

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September: NHS to get extra £5.4bn, says Javid

The plans mark a significant change from July last year, when then health secretary Matt Hancock said all initial GP appointments "should be teleconsultations unless there's a compelling clinical reason not to".

Campaign group EveryDoctor, which represents 1,700 UK doctors, said earlier on Wednesday that "it's a bit of a shock" GPs have been "blamed" for the amount of telephone consultations offered to patients when they were just following government guidance.

The NHS's Long Term Plan, published in 2019, proposed that all patients be given a "digital-first" option for accessing GP care.

EveryDoctor also expressed concern that "inflammatory" comments about access to GPs was leading to "abuse" of staff - another issue that will be addressed in the new blueprint through the development of a "zero-tolerance campaign".

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2021-10-13 23:48:45Z
52781936841222