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Unmanageable GP workload threatens safety of patient care, warns GP leader

Pressures on general practice have ‘sunk to new depths’ in past year

Caroline White

Wednesday, 22 June 2016

Unmanageable workload, too few doctors, and too little resource are threatening the delivery of safe, quality care to patients, the leader of the UK’s GPs will warn today.

Dr Chaand Nagpaul, BMA GP committee chair, will make his comments in his address to delegates at the BMA’s annual representative meeting in Belfast this afternoon.

He will outline how pressures have just increased over the past year.

“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,” he will say.

“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.

Referring to the record number of surgery closures last year—201—he will emphasise that 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,” he will say.

Describing the typical case of a 75-year-old with heart failure, diabetes and severe knee arthritis whose ongoing care is in the hands of her GP, he will say how much care she needs.

“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 10 minutes. It's not possible. Not sustainable. Unsafe.

“If you were seriously ill, would you want to be the sixtieth patient to see an exhausted GP at the end of the day, a GP who has worked non-stop, skipped lunch, squeezing in home visits and dizzy reading hundreds of hospital letters and test results before seeing you beginning to end in ten minutes?”

The “unmanageable” workload was driving GPs to part time work, with one in five saying that they intend to reduce clinical sessions, he will say, and only by making the job “doable” would this trend be reversed.

“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 benefits 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.

“GPs will play their part in this fight and we’ll fight every day until we resurrect our proud profession. Because if general practice fails, the NHS fails.”

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