Editor’s response

I thank Dr Needham and Dr Perkins for their letters. I agree that practices need to adopt appointment systems that can allow for continuity of care. There has been intense political pressure to prioritise access and it has certainly been mandated through past policy initiatives. I’ve no doubt that this is felt keenly by practices and, of course, access is a matter of great concern to patients, particularly when resources are scarce. I have considerable sympathy for any practice and partners trying to balance such competing demands at a time where demand significantly outstrips capacity.

The cover photo of the November issue used a stock photo that we understand shows a consultation in French general practice with an employee of a municipal health centre. Research in the BJGP showed, against expectations perhaps, that overall locum use in England has changed little in recent years though there was considerable variability in regions.¹ I would be deeply reluctant to attribute any blame to GP colleagues, whether partners, salaried, or locum, for the current crisis in general practice.