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Pressures force GPs to take only emergency patients

Some 17% of practices halt routine bookings

Jo Carlowe

Friday, 25 May 2018

GP practices are halting routine appointment bookings due to increased pressure, a survey shows.

The survey of nearly 800 GPs, carried out by the general practitioners’ magazine Pulse, found that one in six GPs said their practice had to resort to limiting appointments to “emergency” patients only, at some point during the last 12 months. The survey was carried out in April.

With no routine appointments available for the next four weeks, many practices chose to limit bookings to urgent ones only, and resorted to using telephone triage to identify which patients qualified.

Pulse asked the question: “Have you had to stop taking bookings for routine appointments at any point in the past 12 months?”

In response, some 17% said they had rejected patients attempting to see a GP for a routine matter, while nearly 13% of respondents said they did not know.

Commenting, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "GPs up and down the country are fighting fires, delivering care to patients with urgent health needs - but this often means patients whose problems aren't necessarily urgent are having to wait longer and longer. Our concern is that a problem might not be urgent initially, but becomes urgent further down the line if it isn't dealt with - GPs want to identify and treat problems early, so that it doesn't come to that.

"It's a huge testament to the hard work and dedication of GPs and our teams that more than 70% report not having had to turn a patient with a routine issue away, but for others, there simply are not the consultations to offer, or the GPs to deliver them.”

She added, "We're trying our best, and utilising innovative schemes, such as Skype or telephone triage or 'same day' booking systems, to see as many patients as possible, prioritise their needs, and if appropriate, suggest an alternative healthcare professional in the community. But the pressures GPs and our teams are working under are unsustainable - our workload has escalated in volume and complexity in recent years, but investment in our profession is less than it was a decade ago, and GP numbers are actually falling.

"Ultimately, we need to see NHS England's GP Forward View, which promises £2.4bn extra a year for general practice, 5,000 more GPs and 5,000 more members of the practice team by 2020, to be delivered in full and as a matter of urgency.”

British Medical Association GP Committee chair Dr Richard Vautrey described the finding as “further evidence of the pressures practices are under…due to the continuing recruitment and retention crisis in general practice.”

“Over recent years, the number of consultations has been steadily rising while the GP workforce has been declining. Surgeries are now left in the position where telephone triage is the only method by which staff are able to handle this demand in a safe manner – but this can result in increased stress for many GPs as they try to manage so many patients each day,” he said.

He added: “Patient empowerment, better education on public health issues and effective use of social prescribing may go some way to ease demand on general practice. What is urgently needed is proper investment and support from government to solve the workforce crisis.”

An NHS England spokesperson described the survey as “tiny” and representative of less than 3% of GPs, and noted that fewer than a fifth had said this action had been necessary.

“We understand the pressures general practice is facing which is why the NHS is investing £2.4bn extra in GP services, growing the number of new doctors entering general practice, and rolling out evening and weekend appointments to patients across England over this coming year,” the spokesperson said.

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