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Over one in five GP consultations caused or exacerbated by cost-of-living crisis

by Rachel Carter
3 February 2023

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Around 22% of GP consultations are currently mental or physical health problems caused or exacerbated by the cost-of-living crisis, a snapshot survey has found.

The survey of 1,000 GPs by Management in Practice’s sister title Pulse also revealed that 16% of partners are implementing initiatives in their practices to try and help patients, including providing warm spaces within the surgery.

GPs said that the impact of the cost-of-living crisis on mental health has been particularly noticeable due to strains on patients’ finances, while there has also been an impact on physical health due to patients having to eat cheaper and unhealthier food, with some having to reduce the use of heating.

A coroner’s hearing in Rochdale this week found that the death of Barbara Bolton, 87, was ‘particularly accelerated by hypothermia and there is a possibility of self-neglect due to the lack of heating’.

One respondent to Pulse’s survey said: ‘A lot of our patients live in fairly suboptimal housing; many have had mould or damp issues for a long time, and this crisis seems to be making things worse.

‘People mention that they are just not turning the heating on now because they are terrified of the bills they will get if they do. If we’re talking about someone who is immunosuppressed or has a respiratory condition, that’s really not going to help them at all.’

‘When money is tight you buy what’s cheap and that predominantly means carbs, so for a lot of our diabetic patients, type 2 particularly, their HbA1c levels are going up and up and up, which obviously is going to have an impact on their risks for things like heart attacks and strokes.’

Dr Clare Bannon, deputy chair of GPC England at the BMA, said: ‘Not being able to properly heat a home or buy enough food can have significant and detrimental impacts on people’s health. It’s also something most likely to impact the poorest in our communities, therefore widening health inequalities and putting more strain on the NHS as a result.’

Professor Kamila Hawthorne, chair of the RCGP, said GPs and their teams ‘are witnessing the impact of rising cost-of-living on our patients’ physical and mental health’.

‘Whether someone is concerned about their finances, are struggling to feed themselves and their family, or are living in a poorly heated home, these all have serious health implications and as these survey results show, are impacting on a significant number of patients. This can affect whole neighbourhoods, not just individual households,’ she said.

‘It’s vital that the Government ensures that patients, particularly our most vulnerable patients – the elderly, those with chronic illnesses, and those below the poverty line – whose health is most likely to be adversely affected, are protected against rising food prices and energy bills.’

Professor Hawthorne suggested ‘some sensible measures for consideration’ could include expanding free school meals, increased signposting to cheap but also healthy foods in supermarkets and ‘as a short-term measure’, creating ‘warm spaces’ for people during cold weather.

And she added: ‘GPs want to support their patients and do the very best for them, but we are currently facing intense workload and workforce pressures, with record numbers of patients currently needing our services.

‘The Government must act urgently to expand the GP workforce, by developing recruitment and retention strategies that go beyond the promised 6,000 GPs, and take measures to cut unnecessary bureaucracy, to ensure GP teams are equipped to deliver safe and timely care to the rising numbers of patients who need it.’

Dr John Hughes, chair of the GP Survival group, said: ‘These figures confirm what we have been hearing from members, that the cost of living crisis is increasing stress on both GPs and patients.

‘Practices are unable to mitigate the increased workload, as increased expenses   particularly energy costs, leave them less able to recruit or retain staff.

‘This is likely to further worsen the rates of burnout and GPs quitting the profession.’

GPs are finding themselves doing more signposting to other agencies and referring to foodbanks – and some have considered broadening their offer of support beyond the strictly medical. The survey found 17% of 469 GPs were implementing initiatives to help patients affected.

Examples given included actively contacting vulnerable patients to offer support, making more use of social prescribers, and working with other local agencies to provide a warm space and hot meal. GPs also commented that they were allowing patients to access their waiting rooms for longer to keep warm.

In September, the Project Surgery in Newham, London was repurposing its meeting room as a ‘safe space’ for local people to drop in get warm and have some soup over the winter months. GP partner Dr Farzana Hussain commented at the time that she wanted it to be a ‘non-judgemental, safe space’, adding that she was really scared one of her elderly patients would die of hypothermia: ‘That’s the heartbreaking thing because I think these things are preventable.’

Meanwhile, in Gloucestershire a ‘Warm Home Prescription scheme’ for struggling patients with cold-sensitive health conditions was launched in November 2022, allowing GPs and other healthcare professionals to prescribe a heating plan to support patients at risk, which includes paying their bills.

A version of this story was first published on our sister title Pulse.