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GP workload a threat to standards of care, poll shows

1 October 2014

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Almost two thirds (65%) of respondents to a Royal College of General Practitioners (RCGP) poll worry that GP workloads, with some GPs seeing 40-60 patients a day, are a threat to the standard of care GPs can provide to their patients.

The survey, conducted by ComRes, also found that only 23% think that  there  are  enough  GPs  to  deal  with  Britain’s changing and growing population, with more people living longer but with multiple and complex conditions.

The RCGP estimates that England needs 40,100 full-time equivalent GPs in order to meet increasing patient demand, but there are currently only 32,075.
Faced with ballooning workloads and longer hours in surgery, growing numbers of qualified GPs are choosing to emigrate, retire early or change medical specialty.
So desperate has the workforce situation become that the RCGP estimates that:
– More than 1,000 GPs will be leaving the profession on an annual basis by 2022.
– Around 22% of GPs in London could step back from front line patient care within the next five years (with 41% of London GPs being over 50).
– The number of unfilled GP posts has nearly quadrupled in the last three years  (2.1% in 2010 to 7.9%  in 2013).

The results of the poll coincide with predictions from the RCGP which show that there will be 60 million occasions in 2014 when patients will not be able to get an appointment with their GP or practice nurse within the same week.

The predictions are based on the RCGP’s latest analysis of the GP Patient Survey, published in July, in which patients were asked whether they were able to get an appointment to see or speak to someone in general practice.

The RCGP says that the number of patients failing to see a GP at all will continue to increase – due to the ongoing cuts in funding for general practice, allied to rapidly growing demand.

More than 90% of patient contacts within the NHS are managed within general practice – yet funding has fallen to an all-time low of only 8.39% of the overall budget in 2012/13.

In 2005/06, 10.95% of the NHS budget in England was spent on general practice. However, by 2011/12, just 8.5% of the NHS budget in England was spent on general practice – with a cumulative loss of £9.1bn since 2004/05 in real terms.

Despite this, general practice has increased efficiency to such an extent that an estimated 40m additional patients per year are being treated by family doctors and practice nurses than was the case even five years ago, and the average number of consultations carried out by each GP in England per year has increased from 9,264 in 2008 to 10,714.

In response to the growing crisis in general practice, the College and the National Association for Patient Participation (NAPP) have launched the campaign Put patients first: Back general practice, in a bid to increase the share of the NHS budget for general practice to 11% by 2017.

This week, RCGP Chair Dr Maureen Baker and Patricia Wilkie, Honorary President and Chair of NAPP,  presented petitions with almost 300,000 signatures from patients, GPs and their practice colleagues to Downing Street and the first ministers of Scotland Wales and Northern Ireland to support the call.

In its new manifesto launched ahead of the political party conferences, the RCGP calls for a ‘new deal’ for general practice.

The manifesto makes ten demands of the three main political parties including:
– A commitment to train 8000 extra GPs across England.
– A promise to maintain and preserve ‘free at the point of need’ healthcare.
– A pledge to incentivise trainee GPs and provide financial bonuses to those prepared to work  in under-doctored or deprived areas.    

It was estimated in March that applications to undertake GP training had dropped by 15%, with only 40% of medical graduates choosing to enter general practice training – as opposed to training for other specialties – despite a national target to ensure that by 50% of medical graduates go into general practice.

Dr Maureen Baker, Chair of  the RCGP said: “Every patient should be able to get an appointment with their GP or practice nurse when they want and need one, and GPs are working harder than ever to try and meet the demand.

“But these devastating statistics show that waiting times are now a national disgrace and that the situation is set to get even worse over the year ahead.

“Even more worrying is that we have no way of finding out how many patients decide not to seek treatment because they cannot get an appointment, which means we might be missing opportunities of detecting illnesses at an early stage or preventing them happening in the first place.”