Hospital Dr News

“GPs working in an environment that prevents delivery of safe care to patients”

GPs are working in an environment where unmanageable workload is preventing the delivery of safe, quality care to patients.

That’s the message from Dr Chaand Nagpaul, BMA GP committee chair, to the BMA’s annual representative meeting.

He said: “Since last year sadly the pressures on general practice have sunk to new depths. Demand escalates relentlessly, with a growing, ageing population with expanding, multiple complex needs.

“Meanwhile, the explicit wholesale transfer of care out of hospital continues unabated. It’s GPs who’re absorbing this burgeoning workload, with 70 million more patients seeing us annually compared to seven years ago and with fewer GPs per head which is drowning our capacity to cope. A record 201 surgeries closed last year.

“Unfilled GP vacancies are at their highest, with half of practices struggling to recruit locums to provide essential services. This has led to a toxic mix from which existing GPs can’t wait to escape, and which many young doctors will not join.

“Let’s step into a GP’s shoes for a moment, to understand how we care for Doris, aged 75. Doris has heart failure, diabetes and severe knee arthritis. Her entire ongoing care has been transferred from hospital to her GP. She’s on 10 different drugs, and today asks her GP to change the large blue tablet she can’t swallow to a smaller one, how to obtain a disabled car badge, complains her hearing aid needs repair but the clinic insists on a new GP referral, and that she hasn’t received a date for her knee replacement and on calling hospital was told to see her GP to write a letter.

“And that’s before the whole point of her appointment which was to review her uncontrolled diabetes and heart failure. Her four conditions would previously have taken four hospital appointments totalling an hour and a half, yet GPs are forced to juggle this multiple complexity in ten minutes. It’s not possible. Not sustainable. Unsafe.

He said that unmanageable workload is fuelling GPs turning to part-time work, with one in five intending to reduce clinical sessions further.

Looking to solutions for the future, Dr Nagpaul said: “The elephant in the room is of course money. As a supposedly rich nation it’s shameful we spend less of our GDP on health than most of the developed world, where we have a fraction of the hospital beds of France and Germany and lag behind most other OECD countries in our doctor and nurse numbers.

“General practice desperately needs more resources, not by robbing Peter to pay Paul, but from a larger NHS pot that provides the level of care that befits a civilised state. This is everyone’s fight, from doctors to patients and the public as taxpayers, to challenge politicians who are irresponsibly trying to squeeze a quart into a pint, while savagely slashing NHS funds under self-proclaimed austerity.”

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