Hospital Dr News

Chronic disease management by GPs disappearing due to pressure of demand

Primary care is “skating on thin ice” according to the Chair of the Royal College of General Practitioners, Professor Helen Stokes-Lampard.

GPs are struggling to keep the NHS afloat with rising numbers of patients with illnesses brought on by winter pressures, she explains.

It is not just hospitals bearing the impact of winter pressures, she says, with hard pressed GPs “firefighting” peaking demand.

Dr Chaand Nagpaul, BMA GP committee chair, agreed and pointed to severe GP shortages – with one in three practices having unfilled vacancies.

Nagpaul said: “GPs are working flat-out to keep up with rising demand, and are often forced to squeeze care into an insufficient time frame and deliver an unsafe number of consultations, in some cases seeing 40-60 patients a day.

“General practice cannot be allowed to continue being run into the ground: it’s time for positive change that gives patients the care they deserve.”

Professor Stokes-Lampard, a practising GP in the Midlands, is very concerned about the unintended consequences of patients not being able to see a doctor promptly this winter. In some areas of the country already having to wait up to three weeks to get a GP appointment for ‘non-urgent but worrying’ symptoms.

Stokes-Lampard is calling for NHS England to honour the pledges made in its GP Forward View – including a bigger share of the NHS budget and more GPs – as a matter of urgency.

She said: “It’s not just A&E that sees peaks in workload. Every peak that you see in A&E is magnified in primary care just through the scale.

“As a service that is already skating on thin ice – a service that is stretched incredibly thinly – something has to give.

“If you’re dealing with people who are acutely sick on the day because people need help, then chronic disease management will disappear.

“Chronic disease management is the most phenomenal success story of the NHS – every day tens of thousands of people do not die who would have died 20 to 30 years ago because we are quietly saving them from having heart attacks, we are saving them from having strokes, we are saving them from complications of diabetes.

“My worry, the big fear, is that if GPs and other healthcare professionals working in the community rein back on preventative care and chronic disease management because we are too busy firefighting the urgent issues, the knock-on consequences could take years to manifest but they will be very serious.”

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