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Showing results for tags 'GP practice'.
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News Article
Staff at UK GP surgeries facing abuse and ‘tsunami of demand’
Patient Safety Learning posted a news article in News
NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed. The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse. "Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue," says Jan Crowshaw, a GP manager It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism. Read full story Source: The Guardian, 28 May 2021 -
News Article
GPs told to resume booking face-to-face appointments following row over access
Patient Safety Learning posted a news article in News
NHS England has said GP practices must start opening their receptions and allow people to book initial face-to-face appointments — scrapping the controversial ‘total triage’ rule — for the first time since the early days of the coronavirus pandemic. Since last spring, NHSE guidance, supported by the profession, has said that face-to-face appointments must generally only take place after a phone, video or digital consultation. Many GP practice receptions have been closed to people wanting to make routine appointments. This rule was kept in place throughout last summer, despite covid circulation being low, and some health systems made the approach one of the pillars of planned post pandemic transformation. “Embedding total triage” was encouraged in 2021-22 operational rules for the NHS. The shift was seen by some as part of a move to a potentially more effective and efficient way of working. But there have been concerns about access and complaints in the media. Read full story (paywalled) Source: HSJ, 14 May 2021 -
News Article
GPs are at “breaking point” and in need of respite, leaders warn
Patient Safety Learning posted a news article in News
General practices are “reaching breaking point” because of the “intense” workload pressure facing doctors and staff, the country’s most senior GP leaders have warned. The warning came as new figures from NHS Digital showed that practices in England delivered almost five million more appointments in March 2021 than the month before and nearly three million more than in March 2019. Richard Vautrey, chair of the BMA General Practitioners Committee, said that the figures underlined the huge efforts practices were going to and the workload pressure on staff. He said, “GPs and their teams are consistently telling us they’re busier now than they have ever been, and this data—which does not include a large proportion of the vaccine programme undertaken by practices, nor a vast amount of other daily tasks—backs this up.” Last week the Ivy Grove Surgery in Derbyshire provided an example of the strain facing some practices in a 16 page open letter to its patients about the huge demand it was facing and the resulting risk of staff burnout. The surgery said it would be reducing its use of the video consultation tool eConsult, as it had seen a doubling of demand over recent months, with some patients submitting several requests a day. In a statement the practice told The BMJ, “We are aware of the stir our letter has caused but have also been overwhelmed by the kind feedback from our own patients, and the many encouraging messages of support we have received from GP surgeries all around the country. We therefore know that many of our GP colleagues are experiencing the same issues, but they may be fearful of articulating what is happening." “We feel that open and honest debate about demand and workload in general practice is vital. If this letter goes even a little way towards sparking some much needed discussion then it will have been a good thing.” Read full story Source: BMJ, 4 May 2021 -
News ArticlePatients are finding it increasingly hard to see their GPs, with warnings that pandemic restrictions have too often “closed the door” on NHS treatment, a report warns. The Patients’ Association survey comes as an investigation reveals that almost 100 GP surgeries closed down or merged with other practices last year. In total, almost 2.5 million patients were forced to switch to a new surgery because of 788 such closures since 2013, the freedom of information disclosures reveal . Rachel Power, chief executive of the Patients’ Association, said the findings from its survey were “worrying” and show “clear dissatisfaction” from the public. The report said: “It is increasingly clear that many patients have found that new methods for arranging appointments do not work for them, or simply that they do not understand how to go about it. GPs are the front door to the NHS, and patients are increasingly perceiving that that door is closed to them.” Roughly half of those who had telephone consultations said the experience was worse than a traditional appointment, with three times as many saying they were unhappy about their experience, compared with those offering praise. The report warns: “The data does not show a ringing endorsement of new or remote methods for accessing NHS care; indeed, in most cases patients rated these methods worse than traditional contact.” Read full story Source: The Telegraph, 30 April 2021
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Content ArticleGP practices are usually run separately from hospitals. In some places in England and Wales, the NHS organisations responsible for managing hospitals are now also running local GP practices. It is difficult in some areas for practices, which are small organisations, to recruit GPs and keep going. It is also desirable to coordinate GP services with hospital care. For these reasons, it may help if the organisations managing hospitals also run GP practices.
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News Article
CQC to expand inspection programme from April
Patient Safety Learning posted a news article in News
More Care Quality Commission (CQC) inspections will take place from next month as pressures from COVID-19 continue to ease. Board papers published ahead of a meeting on Wednesday have revealed the CQC will return to inspecting and rating NHS trusts and independent healthcare services which are rated “inadequate” or “requires improvement”, alongside those where new risks have come to light. From April, the CQC also plans to carry out well-led inspections of NHS and private mental healthcare providers, and programmes of focused inspections on the safety of maternity departments and providers’ infection prevention processes. Focused inspections into emergency departments, which the CQC began in February, will continue. Inspections into GP services rated “requires improvement” and “inadequate” will also resume in April, focusing on safety, effectiveness and leadership. Finally, the papers said the watchdog would prioritise inspections of “high-risk” independent healthcare services, such as ambulances, cosmetic surgery or where closed cultures may exist. Read full story (paywalled) Source: HSJ, 24 March 2021 -
Content ArticleThe Royal College of General Practitioners has updated its guidance on online consultations. The resource gives a useful set of questions to consider when using online consultations, such as which provider is used, the standard of patient care, and ensuring equitable access.
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Content ArticleWould you like to help our healthcare professionals understand how they can continue to use a new approach for prescribing safety in general practices? This research is looking at making prescribing safer in general practices in England and is jointly conducted by the Universities of Nottingham, Manchester, Edinburgh & Dundee. GP surgeries are working with pharmacists to use a computer programme to help find patients who may need their medicines reviewing. People from patient and public groups are invited to say what they think about continuing this service across the country in the longer term. If you choose to take part, this will involve being part of a group discussion on issues relating to continuing the service for medicines safety. You do not need to know about the service before taking part as this will be explained to you. If interested, please contact: azwa.shamsuddin@ed.ac.uk
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News ArticleGPs are being paid £1,000 to cancel second dose appointments for Covid jabs and given a script to follow to deal with angry patients amid growing chaos in the roll-out of the vaccine programme. Practices have been offered the payments to cover the workload of postponing hundreds of patients who were set to have their second dose and booking new ones in their place. NHS sources said the shift has contributed to delays in rolling out the programme. Some GPs have refused to postpone the appointments, with practice managers saying it was "too cruel" to dash the hopes of those who were booked for a second jab. In December, everyone given a first vaccine by Pfizer was told to come back for their second dose three weeks later. But the strategy was changed 10 days ago in a bid to get a first dose to more of the population more quickly. Patients are now being told they will have to wait 12 weeks for the second dose, with a reassurance from health officials that the longer gap could strengthen its effectiveness. By the time the plan was changed, around one million people had already been booked in for their second dose. GPs are now under orders to postpone such appointments and instead give the slots to those awaiting a first dose. Read full story Source: The Telegraph, 8 January 2021
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News ArticleAcutely ill patients requiring emergency care are being diverted to their GP via the new NHS 111 First call-before-you-walk A&E triage system, Pulse has learned. GPs have reported receiving inappropriate NHS 111 referrals including: an acutely dizzy elderly patient who was later confirmed to have had a posterior circulation stroke; a patient with acute coronary syndrome; and a patient with acute UTI symptoms. Meanwhile, GPs are also warning that patients are using the triage system as a way of ‘jumping the queue’ because the route is likely to get them an appointment quicker than calling their practice. From this month, patients in England are being asked to call 111 before attending A&Es – with 111 triaging them to the most appropriate service, including GP practices. Scottish patients are also being asked to phone ahead of attending A&E; while pilots are ongoing in Northern Ireland; and Wales is in the process of rolling out a ‘contact first’ model following summer pilots. The BMA has said the influx of inappropriate referrals by NHS 111 is likely being ‘compounded’ by the new 111 First system, which is ‘contributing to the immense pressures currently facing primary care’. GPs have raised concerns about several cases in which patients should not have been sent to them by 111 because they required more urgent care. One GP, who asked not to be named, told Pulse: "I had a patient with UTI symptoms – a temperature of 39°C, a heart rate of 140, nausea and abdomen/loin pain. They were told: speak to your GP." Read full story Source: Pulse, 21 December 2020
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News Article
GPs say rule change makes covid vaccine programme ‘unfeasibly challenging’
Patient Safety Learning posted a news article in News
Coronavirus vaccinations at GP practices will now take ‘twice as long’ after regulators announced new rules just days before the jabs are rolled out across primary care. The Medicines and Healthcare products Regulatory Agency announced patients would have to be observed for 15 minutes after they received the vaccine. This came after two people had severe allergic reactions to the Pfizer/BioNTech vaccine. Primary care directors told HSJ the change means they have had to overhaul plans in their primary care networks and, in some areas, the vaccine programme will be “unfeasibly challenging” to deliver. Sources told HSJ workforce plans are being overhauled, while vaccines risk being wasted because of the additional time constraints. There have been claims some practices may drop the vaccination programme altogether, as they lack capacity to carry out 15-minute observations for each patient. One primary care director, who spoke to HSJ anonymously, said: “For us, we now need additional space for an observation area. It also makes it more difficult to efficiently flow through the vaccines as the actual vaccination process might take a few minutes, but the through flow of patients will be limited by the 15-minute wait.” They added: “The vaccine now taking at least twice as long to do creates logistical problems. Not insurmountable but there nonetheless." Read full story (paywalled) Source: HSJ, 11 December 2020 -
News ArticleWearable devices will monitor the mood of all 70 staff at a large GP practice, in a trial aimed at improving employee health and wellbeing. Staff at Amicus Health, a GP practice in Devon, will be provided with a wearable device which allows the user to log how their day is going by pressing one of two buttons. The information gathered can be viewed by employers on a dashboard, identifying whether there are particular times in the day when moods drop. Users will also be able to see their data on a personal app, allowing them to track mood triggers and patterns. On the dashboard, employees’ data is divided into teams and is not anonymised, so employers can track the mood of individuals. Asked by HSJ whether this could deter some from using it, company co-founder Jonathan Elvidge said previous trials suggested it does not. He told HSJ that during trials on construction sites, employers found it easier to take action if they were able to identify workers who were regularly reporting that they were feeling low. He said employees preferred being identified as it gave them a voice and made it easier to express how they were feeling. The device — called a Moodbeam One — will be trialled on all 70 clinical and non-clinical staff members at the practice, including 25 GPs. It will largely be down to the practice to decide how the data is used, according to Mr Elvidge. Read full story (paywalled) Source: HSJ, 5 November 2020
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Content ArticleIn this short analysis from the Health Foundation, data from the GP patient survey, an annual independent survey run by Ipsos MORI on behalf of NHS England, was used to explore who gets good access to general practice, unpicking how patient satisfaction with the service they receive varies by deprivation, age and ethnicity. Note: The 2020 GP patient survey data were mostly collected before the COVID-19 pandemic, therefore this analysis doesn’t reflect patient experiences or service changes during the pandemic.
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Content ArticleThis NHS Resolution video looks at three diseases where GPs often miss the diagnostic signs resulting in late referrals: cauda equina, colorectal cancer and subarachnoid haemorrhage. Clinical symptoms to be aware of in these diseases are highlighted.
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Content ArticleWith the emergency response to the COVID-19 pandemic disrupting many patients’ access to GP services, the Patients Association investigated what patients felt about their GP’s premises, and whether they would be confident to return to them.
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Content ArticleIn this study, Avery et al. estimated the incidence of avoidable significant harm in primary care in England, and describe and classify the associated patient safety incidents and generate suggestions to mitigate risks of ameliorable factors contributing to the incidents. The study found there is likely to be a substantial burden of avoidable significant harm attributable to primary care in England with diagnostic error accounting for most harms. Based on the contributory factors we found, improvements could be made through more effective implementation of existing information technology, enhanced team coordination and communication, and greater personal and informational continuity of care.
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News Article
Covid-19: GPs need extra support to withstand second wave, BMA warns
Patient Safety Learning posted a news article in News
General practices will struggle to cope with a second wave of COVID-19 unless urgent measures are put in place to support them, the BMA has warned. It said that practices in England were reporting that they did not have the capacity to carry out all of the work required of them while managing ongoing patient care, dealing with the backlog of care put on hold during the first wave of the pandemic, and reconfiguring services. Richard Vautrey, chair of the BMA’s General Practitioners Committee England, said, “GPs, like all doctors, are extremely concerned that without decisive action now services will be overwhelmed if we see another spike in the coming weeks and months.” In the report, the committee called for a package of measures to support the GP workforce, including making occupational health services available to all staff to ensure that they are properly risk assessed and to provide free supplies of personal protective equipment. It also called for the suspension of routine inspections by the Care Quality Commission and of the Quality and Outcomes Framework, as part of efforts to reduce bureaucracy. NHS England’s covid support fund for practices should be rolled over until March 2021 and expanded to ensure that all additional costs such as additional telephony and cleaning are included, it added. Vautrey said, “The measures we’ve outlined are aimed at supporting practices and their staff to deliver high quality care while managing the increased pressures of doing so during a pandemic, and it is vital that the government and NHS England listen and implement these urgently, to ensure that primary care can continue to operate safely through what looks to be an incredibly difficult winter.” Read full story Source: BMJ, 1 October 2020 -
Content ArticleThis NHS Resolution video outlines the key components of good medical record keeping and highlights common mistakes to avoid.
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News ArticleGP practices are being told they must make sure patients can be seen face to face when they need such appointments. NHS England is writing to all practices to make sure they are communicating the fact doctors can be seen in person if necessary, as well as virtually. It's estimated half of the 102 million appointments from March to July were by video or phone call, NHS Digital said. However, the Royal College of GPs said any implication GPs had not been doing their job properly was "an insult". NHS England said research suggested nearly two thirds of the public were happy to have a phone or video call with their doctor - but that, ahead of winter, they wanted to make sure people knew they could see their GP if needed. Nikki Kanani, medical director of primary care for NHS England, said GPs had adapted quickly in recent months to offer remote consultations and "safe face-to-face care when needed". Prof Martin Marshall, chair of the Royal College of GPs, said general practice was "open and has been throughout the pandemic", with a predominantly remote service to help stop the spread of coronavirus. He said: "The college does not want to see general practice become a totally, or even mostly, remote service post-pandemic. However, we are still in the middle of a pandemic. We need to consider infection control and limit footfall in GP surgeries - all in line with NHS England's current guidance." He said most patients had understood the changes and that clinical commissioning groups had been asked to work with GP practices where face-to-face appointments were not possible - for example, if all GPs were at a high risk from coronavirus. "Any implication that they have not been doing their job properly is an insult to GPs and their teams who have worked throughout the pandemic, continued delivering the vast majority of patient care in the NHS and face an incredibly difficult winter ahead," he said. Read full story Source: BBC News, 14 September 2020 Research from the college indicated that routine GP appointments were back to near-normal levels for this time of year, after decreasing at the height of the pandemic. "Each and every day last week an estimated third of a million appointments were delivered face to face by general practices across the country," added Prof Marshall.
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News Article
GPs asked to keep doors open after ‘significant incidents’ warning
Patient Safety Learning posted a news article in News
New guidance requires GPs to offer at least some face-to-face appointments, amid reports that some had completely eliminated them, sparking ‘significant incidents’. NHS England’s instructions for the third phase of the NHS response to COVID-19 were issued on Friday, including the call that “all GP practices must offer face to face appointments at their surgeries” along with remote triage and remote consultations. Most appointments in primary care have been carried out remotely since the NHS instituted new operating procedures in response to covid, with practices offering a mix of remote consultations over the telephone or video, with a diminished number face-to-face. However, there have been reports of some GP practices not offering any face-to-face appointments at all, and continuing this approach following the peak of cases in the spring. A letter to GPs last month told them they must offer appointments in person “where clinically appropriate”, now reiterated in the phase three guidance. The letter added: “It should be clear to patients that all practice premises are open to provide care, with adjustments to the mode of delivery. No practice should be communicating to patients that their premises are closed.” Read full story Source: HSJ, 4 August 2020 -
News Article
All GP consultations should be remote by default, says Matt Hancock
Clive Flashman posted a news article in News
All GP appointments should be done remotely by default unless a patient needs to be seen in person, Matt Hancock has said, prompting doctors to warn of the risk of abandoning face-to-face consultations. In a speech setting out lessons for the NHS and care sector from the coronavirus pandemic, the health secretary claimed that while some errors were made, “so many things went right” in the response to Covid-19, and new ways of working should continue. He said it was patronising to claim that older patients were not able to handle technology. The plan for web-based GP appointments is set to become formal policy, and follows guidance already sent to GPs on having more online consultations. But the Royal College of GPs (RCGP) hit back, saying it would oppose a predominantly online system on the grounds that both doctors and patients benefited from proper contact. Read full article here -
News Article
A third of GP practices may take year or longer to return to pre-Covid capacity
Patient Safety Learning posted a news article in News
A third of GPs believe it will take up to a year or longer for their practice to return to pre-Covid levels of capacity, even with ‘no future spikes’ of the virus. The data comes from the BMA’s latest COVID-19 tracker survey, which polled almost 2,000 GPs in England and Wales. GPs have previously warned that they are battling a backlog of referrals and patients who have been ‘overlooked’ during the coronavirus crisis. Around 26% of the 1,770 GP respondents said consultations would take between three and 12 months to return to normal when asked how quickly their practice will ‘return to full pre-Covid levels of capacity... assuming there are no future Covid spikes’. And a further 7% of GPs believed it could take ‘longer’ than a year or that consultations would ‘never’ return to pre-Covid levels. Read full story Source: Pulse, 23 July 2020 -
News Article
All patients' Covid test results to become visible to GPs
Patient Safety Learning posted a news article in News
GP systems will now be updated in 'near-real time' to reveal the result of Covid-19 tests taken by all of their patients. GPs will not need to act on the information, which will be visible on systems whether the patient tested positive or negative. This will apply to all patients where it has been possible to identify the patient's NHS number, NHS Digital said. EMIS Health chief medical officer Shaun O’Hanlon said: "Technology has played a pivotal role in the response to COVID-19 across the board and keeping the medical record up to date with COVID-19 test results means everyone who can share that record has a full picture of the patient’s health, including the patient themselves via Patient Access." "This will not only help day to day patient care, and it will also help on a wider population health level, as data-led insight relies on full and complete medical records as analysts continue to research COVID-19 and its short- and long-term impact on the nation." Read full story Source: Pulse, 20 July 2020 -
News ArticleA GP practice serving one of Greater Manchester’s most deprived communities has been banned from operating for four months after regulators uncovered a catalogue of basic failures - including failing to follow up on a child reporting breathing difficulties for three days. Jarvis Medical Practice in Glodwick has had its registration with the Care Quality Commission (CQC) suspended after ‘serious concerns’ passed to the body led to a snap inspection last month. Inspectors found the practice, based at Glodwick Primary Care Centre, was failing 20 separate standards, many of them relating to patient safety. It noted ‘poor quality’ and conflicting records that were sometimes impossible to properly understand and urgent home visits delayed or not carried out at all. In one case a patient with a lump apparently received no physical examination and was not referred for tests or scans ‘due to Covid-19’. Inspectors also found examples of patients with breathing difficulties, including a child, who were not dealt with for days after they got in touch. In one case no further contact was made for 11 working days, with no explanation provided in the patient's notes. The practice, which serves more than 5,000 patients in the Oldham neighbourhood of Glodwick, has now been suspended by the CQC until October 11. Read full story Source: Manchester Evening News, 17 July 2020
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News ArticleA GP surgery that had been told it required improvement has been shut down after an inspection found patients could be at "risk of harm". Hampshire's Brockhurst Medical Centre had already been due to close on 31 December. However, the Care Quality Commission (CQC) suspended its registration with "immediate effect" following an unannounced inspection on Monday. Patients are expected to be transferred to other practices on Saturday. In September, a CQC assessment of the practice, on Brockhurst Road in Gosport, rated it overall as "requires improvement". The issues highlighted in the report included that the practice "did not have systems for the appropriate and safe use of medicines" and "there was a risk that some patients were not receiving the care and treatment they needed". Following Monday's inspection, Garry Higgins, of the CQC, said it had taken "urgent action" to suspend the registration of the GP surgery. "We took the action because we believe if we didn't people using the service may be exposed to the risk of harm," he added. Read full story Source: BBC News, 5 December 2020
