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GP services reach point of ‘emergency’ warning

BMA says patient safety is being compromised regularly

Adrian O'Dowd

Monday, 01 February 2016

Staff shortages and growing demand has pushed general practices to the point of an “emergency” situation with patient safety regularly being compromised, according to doctors’ leaders.

The BMA issued a stark warning at the weekend about the perilous state of pressure on general practice.

Dr Chaand Nagpaul, BMA GP committee chair, issued the warning during his keynote speech on Saturday at a special conference of BMA’s Local Medical Committees held in London.

The BMA said poor workforce planning had resulted in the proportion of NHS doctors who were GPs falling from 36% to 25% in two decades and with fewer GPs per head today than in 2010, despite the fact that GPs were now seeing a record 370m patients annually in general practice.

Dr Nagpaul, said: “Patients are being short-changed on a daily basis, with nine in ten GPs stating that workload pressures are damaging the quality of care to patients.

“This is a disgrace in a system in which the government promotes quality and safety as central to the NHS.”

It was neither safe nor sustainable for GPs to continue seeing patients with complex multiple morbidity in 10 minutes, many of whom would be on more than 10 different medications and with a heightened risk of medical error.

“It’s not safe for GPs to have up to 70 patient contacts daily in the style of a conveyor belt, and on top of that plough through hundreds of clinic letters, pathology results and reams of repeat prescriptions,” he told the audience.

“It’s not safe for GPs to be examining patients while simultaneously having to take urgent calls from hospitals, district nurses and social workers, and also be called for an emergency home visit at the same time.

“It is not safe for practices struggling with unfilled vacancies to be forced to carry on registering patients when they haven’t the doctors or nurses.

“And it’s not safe to fuel the political hyperbole of routine seven days services, taking GPs away from ill elderly housebound patients in greater need. To put it simply, it is not safe to carry on the way we are, and which is why this conference is highlighting that general practice is quite literally in a state of emergency.”

Dr Nagpaul also criticised the problems being caused by the Care Quality Commission (CQC), which the BMA believed was adding further stress to general practice.

“It’s tragic that GPs and practices live in a climate of fear, in which the CQC takes no account of your circumstances, and blames, names and shames you even if you’re running on empty with skeleton staff, or locked into inadequate premises not of your own choosing,” he told the audience.

A survey carried out by the BMA had shown that the CQC had refused to reschedule inspections even in extenuating circumstances when the lead partner or practice manager was off sick, he said, which added further stress and unfairly judged them.

Yet CQC had the “double standard” of unilaterally cancelling inspections at a moment’s notice, he added.

The BMA wanted the government to act now to stop the crisis overwhelming general practice, said Dr Nagpaul.

“What we need to know is what the government is going to now do to enable one million patients daily to receive a safe and sustainable GP service today,” he said.

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