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Found 385 results
  1. News Article
    The number of GPs in England has fallen every year since the government first pledged to increase the family doctor workforce by 5,000, a minister has admitted. There were 29,364 full-time-equivalent GPs in post in September 2015, when the then health secretary, Jeremy Hunt, first promised to increase the total by 5,000 by 2020. However, by September 2020 the number of family doctors had dropped to 27,939, a fall of 1,425, the health minister Maria Caulfield disclosed in a parliamentary answer. And it has fallen even further since then, to 27,920, she confirmed, citing NHS workforce data. In the 2019 general election campaign, Boris Johnson replaced Hunt’s pledge with a new commitment to increase the number of GPs in England by 6,000 by 2024. However, Sajid Javid, the health secretary, admitted last November that this pledge was unlikely to be met because so many family doctors were retiring early. Organisations representing GPs say their heavy workloads, rising expectations among patients, excess bureaucracy, a lack of other health professionals working alongside them in surgeries, and concern that overwork may lead to them making mistakes are prompting experienced family doctors to quit in order to improve their mental health and work-life balance. The British Medical Association (BMA) said the figures Caulfield cited showed that the lack of doctors in general practice was “going from bad to worse for both GPs and patients”, and it warned that patients were paying the price in the form of long waits for an appointment. “Despite repeated pledges from government to boost the workforce by thousands, it’s going completely the wrong way,” said Dr Kieran Sharrock, the deputy chair of the BMA’s GP committee. “As numbers fall, remaining GPs are forced to stretch themselves even more thinly, and this of course impacts access for patients and the safety of care provided.” Read full story Source: The Guardian, 11 April 2022
  2. News Article
    GP practices are set to face new targets for responding to patient complaints under standards being piloted by the health ombudsman. All ‘straightforward’ complaints should be dealt with within six months and 95% within three, while 80% of ‘complex’ complaints should be completed within six months and half within three, under the proposals. The new Parliamentary and Health Service Ombudsman (PHSO) complaint standards are currently being piloted in every sector of the NHS – including one GP practice – and were due to be implemented across the NHS this year. However, a PHSO spokesperson told Pulse that due to delays caused by the pandemic, the full rollout is now planned for the beginning of next year, with the ombudsman to implement the standards from April 2023. The proposed complaints standards said staff should ensure they ‘consistently meet expected timescales for acknowledging a complaint’ and ‘respond to complaints at the earliest opportunity’, providing ‘regular updates throughout’. They should also give ‘clear timeframes’ for how long investigating the complaint will take and ‘agree timescales with everyone involved’, including the complainant. An accompanying draft model complaint handling procedure said that complaints will be acknowledged within three working days either verbally or in writing. Read full story Source: Pulse, 24 March 2022
  3. News Article
    More than 80% of GPs believe that patients are being put at risk when they come into their surgery for an appointment, a new survey shows. A poll of 1,395 GPs found only 13% said their practice was safe for patients all the time. Meanwhile, 85% expressed concerns about patient safety, with 2% saying patients were “rarely” safe, 22% saying they were safe “some of the time” and 61% saying they were safe “most of the time”. Asked if they thought the risk to patient safety was increasing in their surgery, 70% said it was. Family doctors identified lack of time with patients, workforce shortages, relentless workloads and heavy administrative burdens as the main reasons people receiving care could be exposed to risk. The survey, which was self-selecting, also found that: 91% said more GPs would help improve the state of general practices. 84% have had anxiety, stress or depression over the past year linked to their job. 31% know a colleague who was physically abused by a patient in the last year. 24% know of a member of general practice staff who has taken their own life due to work pressures. Read full story Source: The Guardian, 21 March 2022
  4. News Article
    Just 1 in 10 patients preferred face-to-face GP appointments during the Covid pandemic, with most requesting telephone consultations instead, according to research carried out on behalf of NHS England. The Improvement Analytics Unit (IAU) – a partnership between NHS England and think-tank the Health Foundation – looked at data from 146 England GP practices using the askmyGP online consultation system between March 2019 and September 2021, examining over 7.5 million patient-initiated consultation requests. During the pandemic, GPs suffered a backlash from the media, Government and NHS England over accusations that general practice was closed and GPs were not seeing patients face-to-face. GP leaders suggested that NHS England needed to take the research into account and allow practices to decide their own way of working. The research found that: Before the pandemic, 30% of patients requests specified a face-to-face consultation, dropping to less than 4% at the beginning of the pandemic. But by the end of the study period in September 2021, only 10% of patients requests were for face-to-face GP appointments. Telephone consultations were the most popular option, making up over half (55%) of patient requests in 2020/21. However, less than 1% of patients preferred a video consultation, according to the data. IAU head at the Health Foundation Arne Wolters said: ‘Our analysis shows that patients often choose remote over face-to-face consultations and that GP practices can mitigate the risk of digital exclusion via a blended approach.’ He said that ‘traditional routes to accessing and delivering care’ had been ‘offered alongside an online option and, in planning care, practices were able to take account of factors such as patients’ age, frequency of use, clinical needs and preferences’, at the studied practices." And he added: ‘With patient demand at an all-time high due to the care backlog Read full story Source: Pulse, 18 March 2022
  5. News Article
    Two leading medical organisations have told the BBC that GPs are not getting the right support to treat eating disorders. The Royal College of General Practitioners (RCGP) and the British Medical Association (BMA) say doctors need more time with patients and more specialist units. Beat Eating Disorders asked nearly 1,700 people about their experience of trying to get a diagnosis from their GP. Over 92% asked thought their GP needed more training with eating disorders. Out of those questioned, 69% also said they felt their GP didn't know how to help them. The survey has been released to coincide with Eating Disorder Awareness Week. Jess Griffiths had an eating disorder between the ages of 11 and 21 and, now in full recovery, she works as a consultant to NHS England and with her local eating disorder service in Dorset. She tells the BBC that when she first went to her GP to try to get help, she wasn't entirely transparent about what she was struggling with. "I was presenting at a low weight and not having periods, so the GP put me on the pill, but I went there hoping he would ask me the questions [about a potential eating disorder]" she says. "But it's really hard for people with eating disorders to - in a really pressurised situation with a doctor - say how they really feel." Dr Richard Van Mellaerts is part of the BMA's GP committee and has told the BBC the results of the survey are "deeply saddening". "People with eating disorders should never feel that GPs are a barrier to accessing care, so it is vital that medical education and training supports doctors to identify eating disorders and support their treatment," he says. But he adds that there is "poor provision of specialist care", which has left GPs "frustrated up and down the country". Read full story Source: BBC News, 3 March 2022 Read hub blog from Dr Joanna Silver on the challenges the pandemic has brought to patients with eating disorders
  6. News Article
    Avoiding GP referrals by providing ‘advice and guidance’ will contribute significantly towards NHS performance on the government’s elective care targets, according to draft NHS plans seen by HSJ. Under the elective recovery plan, hospital specialists are being asked to offer more advice when GPs are deciding whether to refer a patient for an outpatient appointment, which would avoid some patients being added to waiting lists. This is aimed at reducing instances where GPs may want to be risk averse and refer a patient when they might be unsure whether a secondary referral is needed. New documents seen by HSJ, shared in draft by NHSE last week, reveal this avoided activity will be counted in assessing if the service or individual trusts have hit key government targets to increase activity. NHS England has agreed with government to carry out 10% more ‘clock-stop’ activity in 2022-23 than was taking place pre-covid, but this is “after accounting for the impact of an improved care offer through system transformation, and advice and guidance”. Read full story (paywalled) Source: HSJ, 28 February 2022
  7. News Article
    Face-to-face GP appointments have continued to fall, despite a rallying cry for doctors to restore normal services. The proportion of GP appointments held in person fell for the third month in a row to 60.3% in January, latest data show. Data published by NHS Digital on Thursday show about 25.6 million appointments were carried out in January. Of these, some 15.4 million were face-to-face. The last time it fell below this level was August 2021, when just 57.6% of appointments were face-to-face. Pre-pandemic, the proportion of GP appointments held in person was about 80%. Dr Nikki Kanani, NHS England’s medical director of primary care, told doctors last month to “restore routine service” following the successful rollout of the booster jab campaign. Writing to GPs, she said: “It is now important that all services across the NHS, including in primary care, are able to restore routine services where these were paused in line with the Prime Minister’s request to focus all available resource on the omicron national mission.” But patient groups say the “situation hasn’t improved” and patients are still struggling to see their doctor in person. Dennis Reed, from patient group Silver Voices, said the figures were “worrying” but not surprising. “I'm still getting complaints on a daily basis that people are struggling to see their GP,” he said. Read full story Source: The Telegraph, 24 February 2022
  8. News Article
    The Government has decided to cut the fee GPs are paid per Covid vaccination by a quarter, prompting BMA to issue a patient safety warning. NHS England has published the new enhanced service specification for Covid vaccines to be delivered between 1 September and 31 March next year, setting out that GPs will be paid £7.54 for each vaccine administered – down from £10.06 – and continue to be paid £10 for each housebound patient. The fee had already been reduced from £12.58 last year, when the BMA advised GPs to review whether they were still able to fulfil the ES commitments. The new specification said that practices with ‘sufficient workforce capacity so as not to impact the delivery of essential services and appropriately trained and experienced staff’ must indicate their willingness to participate in the programme before 5pm on 29 August. The Item of Service fee for flu remains £10.06 of each vaccine delivered, according to the new specification published last week. But the BMA said that that NHS England’s decision to reduce the Covid fee ‘undervalues general practice and threatens the safety of vulnerable patients’. Read the full article here: https://www.pulsetoday.co.uk/news/clinical-areas/respiratory/25-cut-to-covid-vaccine-ios-threat-to-patient-safety-bma-warns/
  9. News Article
    GP practices in England will be able to order a host of checks directly to help speed up the diagnosis of a range of heart and respiratory conditions. Traditionally GPs refer to specialists when conditions like heart failure and lung problems are suspected. But the ability to direct refer, which was rolled out for cancer last year, is now being extended. GPs welcomed the move, but questioned whether there was sufficient testing capacity to cope. Royal College of GPs chair Prof Kamila Hawthorne said: "Any initiative to accelerate the process by which patients can be diagnosed and begin to receive any necessary treatment should be seen as positive." She said GPs had "long been calling" for better access to diagnostic tests. But she added: "For this initiative to be successful, it is vital that diagnostic capacity - both in terms of testing and people to conduct and interpret tests - is sufficient." Read full story Source: BBC News, 3 August 2023
  10. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  11. News Article
    The Government has rejected several policy proposals to promote “continuity of care” in general practice which were put forward by Jeremy Hunt. The now chancellor championed significant policy changes to strengthen the link between patients and an individual, named GP, when he was Commons health and social care committee chair. However, the government’s response to the report rejects several of the key proposals. The committee under Jeremy Hunt said “NHS England should champion the personal list model” – under which each patient is linked to a particular GP – “rather than dismiss it as unachievable”. The Department of Health and Social Care response said: “The department does not accept this recommendation. We agree that continuity of care is important within general practice but do not agree that requiring a return to the personal list model is the correct approach. Government also rejected recommendations from Mr Hunt’s committee to introduce a new national measure to track continuity of care by practice; and to fund primary care networks to appoint a GP “continuity lead” for a session a week. Read full story (paywalled) Source: HSJ, 24 July 2023
  12. News Article
    GP trainers are more at risk of burnout than the average for all specialties, according to the GMC’s annual training survey results. The survey of over 70,000 doctors who are trainees or trainers found that 15% of GP trainers are at high risk of burnout, which is higher than the average of 12% and ranked second only to emergency medicine at 24%. The results also showed that 24% of GP trainers said that every working hour is tiring for them, compared to 11% of public health trainers. Last month, GP leaders raised concerns about how trainers and experienced GPs will handle the long-term workforce plan’s expansion of training places, especially given the existing pressures and lack of retention measures. Read full story Source: Pulse, 11 July 2023
  13. News Article
    GPs should offer all patients presenting with signs of colorectal cancer a faecal immunochemical test (FIT) to reduce the waiting times for a colonoscopy, the National Institute for Health and Care Excellence (NICE) has recommended in draft guidance. The current NICE recommendation is to offer FIT to people presenting to primary care with low risk symptoms suggestive of colorectal cancer, while people with high risk symptoms should be immediately referred to the suspected cancer pathway. However, patients often have lengthy waiting times for colonoscopy because of limited capacity. NICE estimates that the recommendation should lead to 50% fewer referrals for urgent colonoscopies being made by GPs each year. Read full story (paywalled) Source: BMJ, 5 July 2023
  14. News Article
    The Government is consulting on a draft code of practice which will ensure health and care staff, including GPs, receive training on learning disabilities and autism ‘appropriate to their role’. Since July last year, all CQC-registered health and social care providers including GP practices in England have been required to provide training for their staff in learning disability and autism, including how to interact with autistic people and people who have a learning disability. The legal requirement was introduced by the Health and Care Act 2022, but the Government has now launched a consultation on the Oliver McGowan Code of Practice, which outlines how providers can meet the new requirement. The BMA’s GP Committee last month said that the Act does not specify a training package or course for staff and that the CQC ‘cannot tell practices specifically how to meet their legal requirements in relation to training’. The Government’s draft code says that CQC-registered providers must ensure that all staff, regardless of role or level of seniority, have ‘the right attitude and skills to support people with a learning disability and autistic people’ and will need to demonstrate to the CQC how their training meets or exceeds the standards set out in the code. Read full story Source: Pulse, 29 June 2023
  15. News Article
    GP services "will collapse in Wales and the NHS will follow" soon after unless urgent support is provided, the British Medical Association (BMA) has warned. As patient levels rise, numbers of GP surgeries and doctors are falling amid inadequate resources and unsustainable workloads, BMA Cymru Wales has claimed. It has written to the Welsh government, urging more funding and staff help. The Welsh government said it was acting to cut pressure on GPs and increasing services by community pharmacists. Launching its Save Our Surgeries campaign, the BMA said the number of GP practices in Wales had decreased by 18% in the past decade from 470 to 386. Read full story Source: BBC News, 28 June 2023
  16. News Article
    The NHS is set to undergo the "largest expansion in training and workforce" in its history, Rishi Sunak has said. Speaking to the BBC, the prime minister said the plans would reduce "reliance on foreign-trained healthcare professionals". It comes at a time of record-high waiting lists in the NHS and junior doctors set to stage a five-day strike next month. The full plans are expected to be published next week. Pressed about the length of time it would take to see the results of the changes, Mr Sunak accepted it could take "five, ten, fifteen years for these things to come through", but that did not mean it was not the right thing to do. Read full story Source: BBC News, 25 June 2023
  17. News Article
    GPs have warned of a ‘tsunami of demand’ this winter as patient contacts surged 200% during the pandemic. One of the largest GP providers in the UK, Modality Partnership, told The Independent it received 4.8 million calls from patients in one year alone with around a quarter going unanswered every day. The provider, which covers 500,000 patients across the country, said its practices were now working above “safe levels” with 50 appointments a day per GP, far higher than the 35 advised by the British Medical Association. Speaking with The Independent, Vincent Sai, chief executive and partner at Modality said the new health secretary Therese Coffey must “not point fingers” and “not find a scapegoat” as “every part of the system is under pressure. Every player in the health system is under the cosh.” Dr Sai said: “We believe patient contacts have increased 200 per cent, over the last few years. The expectation is that GP practices have maybe four to five patient contacts per year, but if you just look at just the number of phone calls alone, it’s showing that it’s much more now. “So something is broken somewhere...there’s more work, there are fewer people. People say I can’t get access to my GP and the hypothesis is they’re just lazy and not working, but it’s not the case.” Read full story Source: The Independent, 7 September 2022
  18. 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)
  19. News Article
    A coroner has expressed concern at the difficulty of getting face-to-face appointments with GPs and other health professionals after a 17-year-old boy suffering from mental health problems was found dead. Sean Mark, who described himself as an “anxious paranoid mess”, was desperate for help but felt “palmed off” when he asked for assistance, an inquest heard. He was found dead in his bedroom four months after a phone consultation with a GP and before he had spoken to anyone in person about his concerns. The area coroner, Rosamund Rhodes-Kemp, recorded a verdict of death by misadventure, saying she could not be sure Sean had intended to kill himself. Dr Robin Harlow, clinical director of the Willow Group, where Sean Mark was a patient, said it had increased the number of face-to-face meetings. When told that Sean felt palmed off, he said: “I would want him to be seen face to face at the second time, if not the first time. We have seen a lot more face-to-face appointments since then.” Read full story Source: The Guardian (23 August 2022)
  20. 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)
  21. News Article
    GPs around England are to prescribe patients activities such as walking or cycling in a bid to ease the burden on the NHS by improving mental and physical health. The £12.7m trial, which was announced by the Department for Transport and will begin this year, is part of a wider movement of “social prescribing”, an approach already used in the NHS, in which patients are referred for non-medical activities. Minister for health, Maria Caulfield, said the UK is leading the way in embedding social prescribing in the NHS and communities across the country. “Getting active is hugely beneficial for both our mental and physical health, helping reduce stress and ward off other illness such as heart disease and obesity,” she said. Paul Farmer, chief executive of the mental health charity Mind, said he welcomed news of the extra investment, enabling the NHS to try new ways of supporting mental health, such as through social prescribing schemes. But, he added, prescribing exercise is not a miracle cure for treating mental health problems. “What we urgently need to see is proper investment into our country’s mental health services,” he said. “Only that will enable us to deliver support to the 1.6 million people currently sat on waiting lists, and the 8 million people who would benefit from mental health support right now but are deemed by the system not to be unwell enough to access it.” Read full story Source: The Guardian, 22 August 2022
  22. News Article
    Doctors and nurses often “weight-shame” people who are overweight or obese, leaving them feeling anxious, depressed and wrongly blaming themselves for their condition, research has found. Such behaviour, although usually the result of “unconscious weight bias”, leads to people not attending medical appointments, feeling humiliated and being more likely to put on weight. Dr Anastasia Kalea and colleagues at University College London analysed 25 previous studies about “weight stigma”, undertaken in different countries, involving 3,554 health professionals. They found “extensive evidence [of] strong weight bias” among a wide range of health staff, including doctors, nurses, dieticians, psychologists and even obesity specialists. Their analysis found that a number of health professionals “believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”, said Kalea, an associate professor in UCL’s division of medicine. She added: “Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and we know this acts as a barrier to the services and treatments that can help people manage weight. “An example is a GP that will unconsciously show that they do not believe that the patient complies with their eat less/exercise more regime they were asked to follow as they are not losing weight." “The result is that patients are not coming back or they delay their follow-up appointments, they avoid healthcare prevention services or cancel appointments due to concerns of being stigmatised due to their weight.” Read full story Source: The Guardian, 10 August 2022
  23. News Article
    The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show. NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020. Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital. Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments. Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.” She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.” Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.” Read full story (paywalled) Source: The Telegraph, 7 August 2022 You may also be interested in Patient Safety Learning's blog: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
  24. News Article
    A 27-year-old man died from complications linked to diabetes after GPs failed to properly investigate his rapidly deteriorating health. Lugano Mwakosya died on 3 October 2020 from diabetic ketoacidosis, a build-up of toxic acids in the blood arising from low insulin levels, two days before he could see a GP in person. His mother, Petronella Mwasandube, believes his death could have been avoided if doctors at Strensham Road Surgery, in Birmingham, had given “adequate consideration” to Lugano’s diabetic history and offered face-to-face appointments following phone consultations on 31 July and 16 and 30 September. An independent review commissioned by NHS England found two doctors who spoke to Lugano did not take into account his diabetes or “enquire in detail and substantiate the actual cause of the patient’s symptoms”. The review raised concern over the “quality and brevity” of the phone assessments and said the surgery should have offered Lugano an in-person appointment sooner. Read full story Source: The Independent, 7 August 2022
  25. News Article
    NHS England will ask GP practices to make ‘reasonable adjustments’ for patients with a learning disability or autism such as giving them ‘priority appointments’. They could also be asked to provide ‘easy-read appointment letters’ to the group, the Department of Health and Social Care (DHSC) said yesterday in a new strategy on strengthening support for autistic people and those with a learning disability. It said the measures aim to support Government plans to reduce reliance on mental health inpatient care, with a target to reduce the number of those with a learning disability or autism in specialist inpatient care by 50% by March 2024 compared with March 2015. The policy paper said: ‘We know that people experience challenges accessing reasonably adjusted support which may prevent them from having their needs met.’ It added: ‘To make it easier for people with a learning disability and autistic people to use health services, there is work underway in NHS England to make sure that staff in health settings know if they need to make reasonable adjustments for people." NHS England is also developing a ‘reasonable adjustments digital flag’ that will signal that a patient may need reasonable adjustments on their health record, it said. It plans to make this flag, which is currently being tested, available across all NHS services, it added. Read full story Source: Pulse 15 July 2022
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