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Found 133 results
  1. News Article
    Nearly 1.5 million patients have lost their GP in the last eight years after the closure of almost 500 practices, research has suggested. Issues around recruitment were a factor in the closure of about two-fifths of the surgeries, while workloads and inadequate premises were also cited as triggers. The investigation, by Pulse magazine, revealed for the first time the number of premises that have closed for good since 2013. Previously, research has identified the number of practices where GP partners have returned their contracts, or certain branches have closed or merged with others. Prof Martin Marshall, the chairman of the Royal College of GPs, said: “The impact of a practice closing on its patients and neighbouring practices can be considerable. As such, a decision to close a practice will be one of the most difficult a GP partner can make. When the reason for closing a practice is workload pressures, and not being able to fill vacancies, then this needs to be addressed as a matter of urgency.” Read full story (paywalled) Source: The Telegraph (29 August 2022)
  2. News Article
    An LMC has created template letters to help practices reject secondary care workload dumping, including rejected referrals and requests to complete work on behalf of hospital trusts. Cambridge LMC said it developed the tools amid a growing ‘tsunami’ of secondary care workload transfer into general practices. One template letter tackles the rejection of a referral ‘on the basis that a proforma was not enclosed or completed in full’. It points out that the GMC requires GPs to refer when they ‘believe it is necessary to do so’ and that their ‘contractual obligations make no mention of a requirement to complete a proforma’. Cambridgeshire LMC chief executive Dr Katie Bramall-Stainer told Pulse that ‘we need the temperature to rise on the understanding around pressures across general practice’. Read full story For more information on the issues raised, read a blog by Patient Safety Learning about the patient safety risks of rejected outpatient referrals. Source: Pulse (19 August 2022)
  3. News Article
    Patients are increasingly avoiding seeing their GP because they find it too difficult to book an appointment, the latest data show. Results from the 2022 GP Patient Survey also show that satisfaction with family doctors in England has dwindled since the previous year. The findings come as the Government and the NHS struggle to retain GPs and boost recruitment to meet rising patient demand and an ageing population. The survey found that overall satisfaction ratings have declined over the past 2 years, although most patients who responded to a questionnaire reported a good overall experience with their GP practice, had confidence and trust in the healthcare professional who saw them, and considered they received good care and treatment. The results also revealed an increase in the barriers patients faced in getting an appointment in the first place, with 55.4% who needed one in the last 12 months saying they had avoided making one – an increase of 13.1% since the last survey. The most common reason given was that they found it too difficult, cited by 26.5% of respondents, and a huge increase on last year's figure of 11.1%. Commenting on the results, Beccy Baird, senior fellow at The King's Fund said: "For many of us, general practice is the front door to the NHS – these results show that patients are finding that door increasingly hard to push open. "GPs are working harder than ever before, yet these findings show a dramatic fall in patients' experience of getting an appointment." She said recruitment of GPs, nurses, and other professionals to meet rising levels of need was proving tough "because in many cases those staff simply don’t exist". Read full story Source: Medscape, 14 July 2022
  4. News Article
    Polling by the Royal College of General Practice (RCGP) as part of a campaign to make NHS GP services sustainable for the future found that 42% of 1,262 GPs and trainees who took part said they were likely to quit the profession in the next five years. A workforce exodus on this scale would strip the health service of nearly 19,000 of the roughly 45,000 headcount GPs and GP trainees currently working in general practice. RCGP chair Professor Martin Marshall warned that general practice was a profession in crisis - with the intensity and complexity of GP workload rising as the workforce continued to shrink. He warned that 'alarming' findings from the RCGP poll must serve as a stark warning to politicians and NHS leaders over the urgent need for solutions to begin to tackle the crisis facing general practice. Four in five respondents told the RCGP they expect working in general practice to get worse over the next few years - while only 6% expected things to improve. Nearly two in five respondents said GP practice premises are not fit for purpose, and one in three said IT for booking systems is not good enough. Professor Marshall said: 'What our members are telling us about working on the frontline of general practice is alarming. General practice is significantly understaffed, underfunded, and overworked and this is impacting on the care and services we’re able to deliver to patients. Read full story Source: GP, 22 June 2022
  5. News Article
    A GP surgery that provides treatment to about 5,600 patients has been placed in special measures by a regulator. London Street Surgery, in Reading, Berkshire, was found to have "significant backlogs of test results and care-related tasks". The Care Quality Commission (CQC) found there was "poor identification of risks to patients" during an inspection in April. The surgery has been approached for comment. The regulator rated the surgery's safety and leadership as inadequate, and said it had insufficient processes to ensure services' safety and effectiveness. Repeat prescriptions and medicines were "not managed safely", which could have posed risks to patients, and there were "risks associated" with the storage of blank prescriptions, it found. Staff training was "not monitored appropriately" and inspectors found patients with learning disabilities were not provided with health checks to make sure their wellbeing was properly monitored. Read full story Source: BBC News, 7 June 2022
  6. News Article
    GPs are facing “insurmountable pressures”, experts have said as they warned that the NHS “will not survive” without general practice. A new report into GP pressures suggests one in four staff fear their practice is in danger of closing because of unmanageable workloads and rising demand. The document, from the Royal College of GPs (RCGP), says general practice is “in crisis”, and makes a series of calls to help ease pressures and stop the growing number of GPs from quitting. The report says GPs are bracing for “winter-style pressures” well into spring and summer. “The workload pressures in general practice over this winter have been immense, and high levels of patient demand are set to continue for some time,” the report authors wrote. “General practice is in crisis. We cannot rely on short-term emergency funding pots over winter to try and paper over the cracks." Read full story Source: The Independent, 10 March 2023
  7. News Article
    GPs are attempting to deal with up to 3,000 patients each, amid worsening staff shortages, according to new analysis. The research shows that the number of patients per GP has risen sharply, as rising numbers of doctors reduce their hours, or opt for early retirement. Daisy Cooper, spokeswoman for Liberal Democrat Health and Social Care, said: “This ever-worsening GP shortage is having a terrible human cost, as people face delayed or missed diagnoses and A&Es fill up with desperate patients looking for treatment." Read full story (paywalled) Source: Telegraph, 14 February
  8. News Article
    A GP surgery accidentally told patients they had aggressive lung cancer instead of wishing them a merry Christmas. Askern Medical Practice sent the text message to people registered with the surgery in Doncaster on 23 December. Sarah Hargreaves, who was waiting for medical test results, said she "broke down" when she received the text, only to be later told it was sent in error. The first text told recipients they had "aggressive lung cancer with metastases", a type of secondary malignant growth. It directed patients to fill out a DS1500 form, which allows people with terminal diseases to claim certain benefits. However, about an hour later people received a second text telling them it was an error and it was meant to wish them a merry Christmas instead. Read full story Source: BBC News, 29 December 2022
  9. News Article
    Most GP practices in England are still using ‘archaic’ Lloyd George paper records despite a commitment to digitise them, HSJ has found. NHS England’s 2019 GP contract included a commitment to do away with the so-called “Lloyd George envelopes” – named after the early 20th century prime minister who introduced a pre-NHS health insurance scheme – and digitise them by 2022-23. The NHS stopped issuing new envelopes for first-time registrations in January 2021. But Freedom of Information requests submitted by HSJ have revealed that the famous brown paper records, some of them many decades old, are still widely used in England. Where they are still used, staff typically use electronic records for new information, but have to find and consult the paper records occasionally, when they need older information. This is less efficient than if the records had been digitised, and storing the paper records takes up several rooms in many practices. Read full story (paywalled) Source: HSJ, 5 June 2023
  10. News Article
    Northern Ireland GPs are being hit with bills of thousands of pounds as they are sued by patients coming to harm on hospital waiting lists. Family doctors are being taken to court by their patients as a result of spiralling hospital waiting lists — even though GPs are not responsible for the crisis. It comes as official figures show 14% of the population — around one in seven — had been waiting longer than a year for an outpatient or inpatient appointment at the end of March. The growing risk to patient safety, as the health service struggles to cope with demand, and the potential for primary care doctors to be held accountable have been blamed as reasons for the rising number of GPs who are handing back their contracts. Sixteen GP surgeries in Northern Ireland have handed back contracts in recent months, bringing the key NHS service closer to collapse. Read full story Source: Belfast Telegraph, 30 May 2023
  11. News Article
    Only 10-15% of GP practices are using all three of the ‘modern’ patient access tools — including overhauling their approach to triage — which are at the centre of NHS England’s primary care recovery plan, its GP lead has told HSJ. Amanda Doyle, national director for primary care and community services, told HSJ this was its current estimate of the share of practices which already have in place all three of: digital phone systems; online messaging; and modern triage, response and care navigation. These are cornerstones of the primary care recovery plan,published by the government and NHS England this month, which says they are prerequisites for offering “modern general practice access”. Read full story (paywalled) Source: HSJ, 23 May 2023
  12. News Article
    ICBs should ensure there are ‘formal escalation routes’ in place for GPs after 25 daily clinical contacts, the BMA has said in new guidance. From next week (15 May), GP practices are contractually required to offer an ‘appropriate response’ to patients the first time they get in contact, by offering them an appointment or redirection, rather than asking them to call back at a different time. While GP leaders warned this would lead to increased pressure on NHS 111 and A&E, NHS England attempted to clarify in this week’s recovery plan that GPs should only redirect patients in ‘exceptional circumstances’. It also said practices should inform their ICB on each such occasion. However, conflicting BMA guidance has now been published, warning that practices attempting to adhere to the new requirement ‘may do so at the expense of clinician wellbeing and patient safety’. It reiterates the GP Committee for England’s safe working guidance recommending that clinicians have no more than 25 clinical contacts per day because anything beyond this "can lead to decision fatigue, clinical errors and patient harm, and clinician burn out". Read full story Source: Pulse, 11 May 2023
  13. News Article
    It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023
  14. Content Article
    A patient participation group (PPG) is a group of people who are patients of a GP surgery and want to help it work as well as it can for patients, doctors and staff. The NHS requires every practice to have a PPG. In this blog, Alan Bellinger reflects on what he has learned during his time as chair of his GP surgery's PPG, highlighting three key lessons: Be collaborative not combative If patients don’t engage with the PPG it’s your fault for not being engaging Never lose sight of the value-add you create for the practice
  15. Content Article
    This study in the journal Health and Social Care Delivery Research aimed to assess the scale, scope and impact of changing the type and number of different healthcare practitioners in general practice in England. The authors undertook an analysis of employment trends, looked at motivations behind employment decisions, examined staff and patient experiences, and assessed how skill mix changes are associated with outcome measures and costs. They found that: employing clinicians who are not GPs did not reduce GPs’ workload or improve their job satisfaction. patients appreciated the longer appointments they had with other clinicians. patients wanted better information about what other practitioners can do, and how to use new booking systems.
  16. News Article
    Thousands of doctors are being prevented from working in overstretched GP surgeries across the UK because of unnecessary “red tape”, leaving NHS patients experiencing “unprecedented” waits for care, the head of the doctors’ regulator in the UK has said. Charlie Massey, the chief executive of the General Medical Council, said barriers that stopped medics from being deployed to meet areas of high demand, such as in primary care, must be removed urgently if the NHS workforce crisis was to be resolved and access to care improved. “Red tape is stopping the UK from making the most of many of its skilled and experienced doctors,” he said. “Without action, patients will suffer.” The regulator will on Tuesday call for a relaxation of rules so the fastest-growing part of the medical workforce – skilled doctors in non-training roles – can undertake a wider range of work beyond hospitals, such as in GP surgeries. “There are no easy answers to the challenges facing the NHS. There is no army of new doctors coming over the horizon, so part of the solution must be to make sure that we have more doctors in the places that patients need them,” Massey said. “The government should make a start immediately by changing the performers list criteria so more doctors are allowed to work alongside GPs. That needs to be done urgently. “But beyond technical changes there is also a need for fresh thinking in the way our health services are structured and in how teams of health professionals work together. We can’t keep doing things the same way they have always been done, or nothing will change." Read full story Source: BBC News, 18 October 2022
  17. News Article
    Five million people were unable to book a GP appointment in October, analysis of NHS data suggests. The Labour party, which studied figures from the GP Patient Survey, warned the struggle to see a doctor will mean many patients will not have serious medical conditions diagnosed until it is “too late”. According to the survey, some 13.8% of patients, or around one in seven, did not get an appointment the last time they tried to book one. With almost 32 million GP appointments reported in England in October, the party said it means that more than 5 million people could have been unable to book a GP appointment when they tried to make one that month. October saw GP surgeries carry out the highest number of appointments since records began in 2017, despite a depleted work force. Labour’s shadow health secretary Wes Streeting told Labour List: “Patients are finding it impossible to get a GP appointment when they need one. I’m really worried that among those millions of patients unable to get an appointment, there could be serious conditions going undiagnosed until it’s too late". Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, said in a statement: “GPs and their teams are working flat out to deliver the care and services our patients need. GPs want our patients to receive timely and appropriate care, and we share their frustrations when this isn’t happening. But difficulties accessing our services isn’t the fault of GP teams, it’s a consequence of an under-resourced, underfunded, and understaffed service working under unsustainable pressures.” Read full story Source: The Independent, 6 December 2022
  18. News Article
    Plans have been drawn up to avoid the NHS being overwhelmed this winter by encouraging patients to “behave in ways they’ve not experienced before” and cut down on in-person GP visits, the Guardian can reveal. An advertising campaign devised by M&C Saatchi, awarded a contract by NHS England worth up to £28.6m, suggested ways people could be encouraged to settle for a virtual appointment or visit a pharmacist instead. To help reduce the mounting pressures facing medics, documents show the agency also advised patients should be told that seeking help via alternative routes instead of rushing to A&E would help the NHS “work better for everyone”. The three-year contract is for the ad campaign “Help Us Help You”, which seeks to change people’s behaviour when accessing healthcare to reduce pressures on the NHS and maintain capacity. Wes Streeting, Labour’s shadow health secretary, said patients were already cutting back on in-person GP appointments – “not because they don’t need them but they’re finding it impossible to get one”. He told the Guardian: “Among those millions of patients who can’t get an appointment when they need it, there will be problems which go undiagnosed until it’s too late". Read full story Source: The Guardian, 30 November 2022
  19. News Article
    GPs are struggling to cope with as many as 90 appointments and consultations a day – more than three times a recommended safety limit. General practices in England are carrying out more appointments than before the pandemic but face severe workforce shortages. More than 1.45 million patients waited at least 28 days to see a GP in September, according to the most recent NHS figures. GPs who spoke to the Observer last week say that almost every day they breach the BM) guideline of “not more than 25 contacts per day” to deliver safe care. One doctor said he had more than 90 consultations on one day. A conference of local medical committee representatives in England this week will highlight the growing pressures faced in general practice. Surgeries are being urged to impose stricter caps on the number of patient appointments for each GP. One of the proposed motions submitted to the conference by Kensington and Chelsea local medical committee says “focusing on patient safety” is more appropriate than meeting high patient demand. It says the NHS should focus on “safe capacity”. Such a move would mean longer waits for GP appointments, but doctors say it would help safeguard patient care and the welfare of staff in general practice. Read full story Source: The Guardian, 20 November 2022
  20. News Article
    GP surgeries across Scotland are at risk of collapsing because of staff shortages and increased demand, a senior doctor has warned. Dr Andrew Buist, chairman of the British Medical Association's (BMA) Scottish GP committee, told the BBC many practices were at "tipping point". More than a third of surveyed surgeries reported at least one GP vacancy – up from just over a quarter last year. About half of the GP surgeries in Scotland took part in the BMA survey. It showed 81% of practices said demand was exceeding capacity - with 42% saying demand substantially exceeded capacity. Dr Buist told BBC Scotland: "I worry that we're reaching a tipping point for some practices. "They lose one or maybe two doctors out of three, and the remaining doctors cannot continue so they return the contract and the practice may cease to exist. "That is a real concern in some parts of Scotland that that is happening and it's going to happen increasingly as the situation develops over this winter." Read full story Source: BBC News, 15 November 2022
  21. News Article
    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
  22. News Article
    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
  23. News Article
    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
  24. News Article
    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
  25. News Article
    A 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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