PATIENTS could lose the automatic right so see their their doctor in a major rescue plan that aims to cut 'avoidable' face-to-face appointments.

Health bosses yesterday approved sweeping plans to address Oxfordshire's GP crisis that have already been criticised as 'cuts in disguise'.

It follows the closure of a number of GP practices in the last year, with more than a dozen others warning they could go the same way.

The plans agreed yesterday will also mean:

• Patients will not have an 'automatic right' to see a doctor or receive a home visit. Instead a 'triage' will be done to assess patients before same-day or urgent appointments are given

• More people will be told to 'self-care' and manage their own conditions

• Frail elderly patients will have a '24/7 care plan co-ordinated by their GP' with a 24/7 telephone support line

• Hubs to be created for patients to get health and lifestyle advice such as smoking cessation and weight management

• Patients needing significant medical care to get 15-minute appointments but with GPs limited to 13 a day. These patients make up about four per cent of all those seen at a given time.

Agreed by Oxfordshire Clinical Commissioning Group (CCG) the plan cites a national survey which stated that 27 per cent of GP consultations are 'potentially avoidable'.

Eddie Duller, chairman of Healthwatch Oxfordshire, said: "One of the great dangers is that people might slip through the net completely and don't go when they should."

Instead, the CCG hopes that nurses and social workers, pharmacists, optometrists and dentists, will have a role to play in improving health.

Pharmacists are cited as an option to potentially triage, treat and refer patients.

But Pupinder Ghatora, of Woodlands Pharmacy in Botley Road, said: "GPs are under pressure but pharmacists are no better.

"We are supposed to be the first line of defence and we are treated like the doormat of the NHS."

Some weekend access will be available and the CCG wants patients to be able to book a routine appointment within seven days.

At the same time GPs are being urged to combine their resources and form 'super-practices' with up to 20,000 patients.

Groups of two to five practices will be jointly responsible for the health of populations of 30,000 to 50,000 - the size of an Oxford suburb.

Prit Buttar, chairman of the Oxfordshire Local Medical Committee, said: "The bottom line is that resources and demand don't match. Anything that sounds like 'sustainability' is a cut in disguise."

Julie Dandridge, deputy director of the CCG, said: "Our vision is to provide enhanced primary care, extended primary care teams, and more specialised care closer to home delivered in partnership with community, acute and social care colleagues.

"Future work will now take place in each locality to develop local plans for primary care. Patient involvement in this process will be paramount.”

* A legal challenge was launched by Cherwell District Council yesterday following a 'confusing and flawed' consultation process regarding plans to shake-up NHS services in Oxfordshire which includes the permanent closure of 200 hospital beds. The council, alongside others, has applied for a judicial review into how the CCG consulted with the public over changes to services including maternity, critical care and hospital bed use at Banbury's Horton Hospital.