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Found 385 results
  1. 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
  2. News Article
    The NHS must be more welcoming to patients who often feel they should not bother doctors, the new patient safety commissioner for England has urged. Dr Henrietta Hughes, who takes up the role this week, said it was vital that patients had time to ask questions, despite pressures on the health service. Clinicians and managers need to put themselves in the shoes of their patients, she said, highlighting “highly inappropriate” interactions between doctors and patients that showed “a total lack of care and respect”. Hughes said it was not a surprise that all the groups affected in the Cumberlege report were women. “That’s something which is a societal problem, and it’s really important that the voices of all patients, including those of women, are listened to and taken really seriously,” she said. “Because otherwise untold harm happens and it can not only extend to the individual patient themselves, but to their families, to their children, to their livelihoods. This role is a real opportunity for championing patients’ voices, and also making sure those who are in charge who are able to make the changes, listen and respond appropriately." Read full story (paywalled) Source: The Times, 14 July 2022
  3. News Article
    Patients are being put at risk because GPs wrongly assume they will actively seek their test results, a study says. Researchers from the University of Bristol said the mismatched expectations could harm patients, with delayed diagnosis a likely result. The study found: “Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety.” Dr Jessica Watson, a GP and doctoral research fellow at the Centre for Academic Primary Care at the university, who led the study, said: “GPs have a medico-legal and ethical responsibility to ensure they have clear, robust systems for communicating test results.” Watson added: “Relying on patients to get in contact and making assumptions about their knowledge of how to do so were particular risks highlighted.” Read full story (paywalled) Source: The Times, 12 July 2022
  4. News Article
    The shortage of GPs in England is set to become worse, with more than one in four posts predicted to be vacant within a decade, an analysis suggests. The Health Foundation study said the current 4,200 shortfall could rise to more than 10,000 by 2030-31. The think tank believes the government will struggle to increase the number of GPs, while demand will continue to rise - creating a bigger shortfall. The government has promised to recruit 6,000 extra GPs by 2024, but ministers have admitted they are struggling to achieve that. The analysis said the numbers entering the profession are on the rise, but this will be offset by GPs retiring or moving towards part-time working, according to current trends. The worst-case scenarios suggested more than half of GP posts could even be vacant. Anita Charlesworth, director of research at the Health Foundation, said: "It's sobering that over the next decade things are set to get worse, not better." "It's critical that government takes action to protect general practice and avoid it getting locked in a vicious cycle of rising workload driving staff to leave, in turn creating more pressure on remaining staff and fuelling even more departures." Prof Martin Marshall, chairman of the Royal College of GPs, said the predictions were "bleak" and the worst-case scenario would be a "disaster". "Our members have told us they lack the time to deliver the care that they want to deliver for patients - and that patients need," he said. Read full story Source: BBC News, 30 June 2022
  5. News Article
    When you think of cancer, a glamorous mum in her mid-30s is not the first image that springs to mind. But You, Me and the Big C podcaster Dame Deborah James was just 35 when she found out she had bowel cancer. Blood and stool tests had come back normal and her GP had laughed "not once, but three times over the course of six months" at the idea she could possibly have a tumour in her bowels. The diagnosis came only when she paid to have her colon examined privately. Her experience has raised questions about how good we are at spotting and treating cancer in the under-40s. Simply - are we failing young people with cancer? Overall, around 4.3% of cancers diagnosed in the UK are in the under-40s, while those over 75 make up more than a third of all cancer cases, which poses a challenge for us and the doctors who treat us. When we are young, we're less likely to attribute any ill health to cancer. Changes to our bowel movements could just be stress, blood in the toilet after we poo could be inflammatory bowel disease or haemorrhoids. Because, for most people, cancer is something that happens to our parents or grandparents. Your doctor should be alert to major warning signs of cancer, but there is a medical saying: "When you hear hooves, think horses, not zebras". It's a call to look for the most common or likely explanation, and the younger you are, the less likely cancer is to be behind your symptoms. This helps channel the health service's limited resources to those most likely to need them. But that means some younger people aren't being seen quickly enough, although the problem can affect older people too. Bowel Cancer UK's Never Too Young report in 2020 found that four in 10 people surveyed had to visit their GP three or more times before being referred for further tests to see if they had cancer. "I don't think GPs are a problem," says Genevieve Edwards, chief executive of Bowel Cancer UK. "It [bowel cancer] is rare in younger people... It will usually be something else." The question is - what if you are the zebra, that relatively rare case who does have cancer at a young age?" Read full story Source: BBC News, 14 May 2022
  6. News Article
    Rapidly falling continuity of care levels pose an “existential threat” to patient safety, Britain’s top family doctor will warn today as research reveals only half of Britons regularly see the same GP. Prof Martin Marshall, chair of the Royal College of GPs (RCGP), will say trusted relationships between family doctors and patients are the most “powerful intervention” for delivering effective, high-quality care as they boost patient satisfaction and health outcomes, and reduce use of hospital services. But in a keynote speech to the college’s annual conference, Marshall will warn that continuity of care is becoming almost impossible to deliver on the NHS amid soaring demand and shrinking numbers of GPs, in what he will describe as the “most worrying crisis in decades”. There are mounting concerns over the ability of the NHS to tackle record waiting lists, with 6.5m patients awaiting care in England alone. Earlier this month Sajid Javid, the health secretary, admitted the current model of GP care “is not working” but insisted there would be no more money for the health service. At the RCGP conference in London, Marshall will tell delegates that because of rising workloads and fewer staff, GPs no longer have the time to properly assess patients, with 65% warning safety is being compromised due to appointments being too short, according to a recent survey commissioned by the college. Only 39% of respondents said they were able to deliver the continuity of care their patients need – down from 60% two years ago. Read full story Source: The Guardian, 29 June 2022
  7. News Article
    The cost of living crisis is adding to pressures on GPs, the British Medical Association (BMA) in Northern Ireland has warned. The BMA said that is because the number of people asking for prescriptions for medicines that can be bought over the counter is increasing. That includes medicines like painkillers and allergy medication, Dr Alan Stout of the BMA said. Prescriptions are free for everyone in Northern Ireland. The rise in prescription request increases "the cost to the health service as a whole and the pressure on GPs", Dr Stout told Ulster's Good Morning Ulster programme. "We have talked before about the difficulties people have accessing GPs and this is just more demand and difficulties," he said. Dr Stout added: "I absolutely don't hold that against anyone, it is not our position as GPs to deny people medication or deny people prescriptions if they need this medication." Read full story Source: BBC News, 23 June 2022
  8. 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
  9. News Article
    Pharmacists and some other healthcare professionals, rather than just GPs, will soon be able to sign people off sick from work, under new rules. The law change will take effect in July and apply across England, Wales and Scotland. The aim is to free up family doctors' time. People off work for more than seven consecutive days because of illness may need to show a note from a healthcare professional to their employer. When the new legislation is passed, nurses, occupational therapists, pharmacists (working in hospitals and GP practices) and physiotherapists will be able to provide the notes, in addition to GPs. Health and Social Care Secretary Sajid Javid said: "I know how important it is for people to be able to see their GP speedily and in the way they want. "That's why we are slashing bureaucracy to reduce GPs workloads, so they can focus on seeing patients and giving people the care they urgently need. Read full story Source: BBC News, 9 June 2022
  10. 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
  11. News Article
    Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice. Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021. The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022. It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”. On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.” Read full story Source: The Independent, 4 March 2023
  12. News Article
    Pharmacies do not have the capacity to absorb pressure from GPs unless it comes with additional funding, pharmacy leaders have warned. A new NHS England ad campaign, announced earlier this week, aims to redirect patients from GP practices to local pharmacies for minor conditions such as coughs, aches, cystitis and colds. But community pharmacy negotiating body PSNC has spoken out against the campaign calling it ‘deeply concerning’, ‘irresponsible, ‘extremely unhelpful’ and ‘irritating’. Malcom Harrison, chief executive of the Company Chemists’ Association (CCA) said: ‘Community pharmacies are often the best place for patient to go for help with minor health concerns. ‘However the current situation that many pharmacies find themselves, with a 30% cut in real term funding, the NHS recruiting their pharmacists and technicians to work in general practice and with the continuing increase in the number of medicines prescribed, will mean that there is now a very real risk that when patients visit a pharmacy, they will be faced by exhausted teams and longer than expected waiting times. ‘The NHS policy of moving asking patients to visit their local pharmacy does not address the problem of delays to access in primary care, it simply moves it from one pressurized location to another. The NHS must address the chronic underfunding of primary care, and of pharmacy in particular, if patients are to be able to access the care they need and should rightly expect.’ Read full story Source: Pulse, 28 February 2023
  13. News Article
    A new report has condemned ‘serious issues’ with NHS referral processes, amid findings that one in five patient referrals made by GPs went into a ‘black hole’. Healthwatch England said that 21% of people they spoke to with a GP referral to another NHS service were rejected, not followed up on or sent back to general practice. The watchdog said that more support should be given to help GP and hospital teams to reduce the numbers of people returning to general practice due to ‘communication failures’ following a referral. According to the findings, the failures were due to GP teams not sending referrals, referrals going missing between services, or being either booked or rejected by hospitals without any communication. Louise Ansari, Healthwatch England’s national director, said that thousands of people told the watchdog that the process is ‘far from straightforward.’ She said: "Falling into this “referrals black hole” is not just frustrating for patients but ultimately means people end up going back to their GP or visiting crowded A&E departments to get the help they need. "This adds more burden to already stretched services, making things even harder for the doctors and nurses trying to provide care." Read full story Source: Pulse, 20 February 2023
  14. News Article
    GPs are attempting to deal with up to 3,000 patients each, amid worsening staff shortages, according to new analysis commissioned by the Liberal Democrats. 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. The figures, which track the number of “full-time equivalent” fully qualified GPs, show the number has fallen from 29,320 in 2016 to 27,372 last year. The trend follows a rise in part-time work, with the average GP now working a three-day week. On average, there are now 2,273 patients per fully qualified doctor, up from 1,981 in 2016, the research commissioned by the Liberal Democrats shows. While the total number of GPs fell by almost 2,000, the number of registered patients grew from 58 million to 62.2 million, according to the House of Commons Library. Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said the research “shows yet again how GPs and our teams are working above and beyond to deliver care to an ever-growing patient population, with falling numbers of fully qualified, full-time equivalent GPs.” Read full story (paywalled) Source: The Telegraph, 14 February 2023
  15. News Article
    GPs have raised concern about a new colorectal cancer pathway aimed at reducing referrals into one of England’s largest acute hospital trusts. The pathway was implemented in December 2022 to tackle long waiting lists at United Lincolnshire Hospitals Trust (ULHT) by reducing the number of referrals from primary care. But the Lincolnshire LMC and Primary Care Network Association both raised concerns about the pathway and its impact on general practice in a letter to their ICB earlier this month. Read full story Source: Pulse, 13 February
  16. News Article
    Charging for GP appointments will worsen patient safety and drive more people to A&E, the head of a national safety watchdog has warned. Dr Rosie Benneyworth, the chief investigator for the Healthcare Safety Investigation Branch (HSIB), was responding to a suggestion by former health secretary Sajid Javid who said the present model of the NHS was “unsustainable”. He said “extending the contributory principle” should be part of radical reforms to tackle growing waiting times. But Dr Benneyworth said it would only drive more people to seek help from already overstretched services. She said: “I don’t want to be drawn into the politics around this but I believe in free at the point of delivery NHS and my concern would be [if] we charge people that people would not come forward early for their care and that would leave people needing more urgent and emergency care, because of delayed presentations.” Dr Benneyworth said there needed to be a bigger focus on patient safety in services outside of A&E, such as NHS 111 and out-of-hours services. Read full story Source: The Independent, 26 January 2023
  17. News Article
    Two-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
  18. News Article
    A law student who died after four remote GP consultations might have lived had he been given a face-to-face appointment, a coroner ruled. David Nash, 26, died in November 2020 from a bone infection behind his ear that caused an abscess on the brain. Over a 19-day period leading up to his death, he had four phone consultations with his GP. The coroner, Abigail Combes, said the failure to see him meant he underwent surgery ten hours later than it could have been. Andrew and Anne Nash fought for more than two years to find out whether their son would have lived if he had been seen in person by clinical staff at Burley Park Medical Centre in Leeds. Yesterday they said they were “both saddened and vindicated by the findings that the simple and obvious, necessary step of seeing him in person would have saved his life” and wanted to make sure “others don’t die as David did”. Read full story (paywalled) Source: The Times, 21 January 2023
  19. News Article
    "I got my cervical screening letter in November and I've been putting it off because I don't want to do it - I don't think any girl really wants it done to them." Elena Coley Perez is 26 and due to have her first cervical screening - or smear test - that examines the opening to your womb from your vagina. NHS records show 4.6 million women - or 30% of those who are eligible - have never been screened for cervical cancer or are not up to date with their tests. Women are sometimes too embarrassed to come forward or put it off because they are anxious, surveys have found. Struggling to book their tests due to GP backlogs will not help the situation, say charities. Elena has told the BBC she was already worried about having a smear test, and the difficulty she experienced in booking one put her off even more. "I got another letter in December so I went to book online because with my local GP you have to go through this long-winded form," she said. "I typed in cervical screening and nothing was coming up, so I ended up waiting 35 minutes on the phone to be told they had no appointments for the rest of the year and to phone back in the new year." Elena then tried again in January and was told there was no availability. "At this point I was like, 'what's the point?' - you're trying to do something that can hopefully prevent you from getting cancer and you get to the doctor's surgery and you just get a 'no' - it's really off-putting," she says. Read full story Source: BBC News, 25 January 2023 Further resources on the hub: For patients: Having a smear test. What is it about? (Jo's Cervical Cancer Trust) Cervical cancer symptoms (Jo's Cervical Cancer Trust) For staff: RCN guidance: Human papillomavirus (HPV), cervical screening and cervical cancer
  20. News Article
    Two in five GPs are facing verbal abuse every single day, a new poll suggests. Some 74% of family doctors have claimed they or their staff have experienced verbal abuse on a weekly basis, including almost 40% who say it occurs daily, according to the survey conducted by GP publication Pulse. And 45% said practice staff experience physical abuse every year, according to the poll of 1000 GPs. As well as facing abuse in GP surgeries, a third reported practice staff have faced abuse on social media on a weekly basis. The Royal College of GPs described the survey findings as deeply disturbing. One GP told the journal: "Last week a patient, without any mitigating circumstances, was desperately abusive to one of my receptionists bemoaning the fact it wasn’t the US where she could buy a gun and 'sort us all out'. "Primary care seems to be bearing the brunt and blamed by all and sundry for the current issues and the public are picking up on this." Read full story Source: Medscape, 19 January 2023
  21. News Article
    GPs whose patients want to stop taking antidepressants should reduce the dose of their medication in stages to lower the risk and severity of withdrawal symptoms, the medicines watchdog has said. About one in six (16%) adult Britons experience moderate to severe depression, according to the Office for National Statistics. In England alone, 21.4m antidepressant drugs were prescribed between July and September 2022, according to the NHS Business Services Authority. A new draft quality standard for the care of adults with depression from the National Institute for Health and Care Excellence (NICE) – the first update in 11 years – includes specific guidance to help adults come off antidepressant medication permanently. NICE’s independent advisory committee, which includes experts in treating adults with depression, recommends the staged withdrawal of antidepressants in patients who want to stop taking the drugs. A staggered reduction of medicine, known as tapering, helps to reduce withdrawal effects and long-term dependence on the medication, according to Nice. The committee said primary care and mental health professionals should follow the NICE guideline recommendations on stopping antidepressant medication, including agreeing with their patient whether it is right for them to stop taking the medication and, if so, the speed and duration of withdrawal from it. Read full story Source: The Guardian, 17 January 2023
  22. News Article
    Medicine shortages are an “increasing problem” for Australia and antibiotics are among the commonly prescribed drugs currently in short supply, the peak body for general practitioners says. The drugs regulator, the Therapeutic Goods Administration (TGA), said the three most commonly prescribed antibiotics – amoxicillin, cefalexin and metronidazole – are scarce. They are used to treat a range of bacterial infections, including pneumonia and other chest infections, skin infections and urinary tract infections. To see patients through the shortage, the TGA has authorised pharmacists to provide alternative antibiotics without approval from the prescribing doctor. “Importantly, many of these medicines have alternatives available,” the TGA said. “Your pharmacist may be able to give you a different brand, or your doctor can prescribe a different strength or medicine with similar spectrum of activity.” A TGA spokesperson said “most of the antibiotic shortages are caused by manufacturing issues or an unexpected increase in demand”. Dr Nicole Higgins, the president of the Royal Australian College of General Practitioners, said the shortage of certain medicines was “becoming an increasing problem in Australia”. Read full story Source: The Guardian, 12 December 2022
  23. News Article
    The government should ‘relieve’ GP practices of being the sole controller for their patients’ data, a senior NHS England director has said. Tim Ferris, NHSE director of transformation, said it was a “challenge” that GP practices acted as the sole controllers of their patients’ data. Dr Ferris, whose background is as a primary care doctor in the US, was giving evidence to a Lords committee on integration of primary and community care today. He was asked whether it was time to revisit legislation on the control of GP patient data. He said: “Thirty years ago when the law was created, it made more sense. But I think it might no longer be fit for purpose… The idea that if I were a GP in this country, if I had legal liability for the exchange of data, I would be worried about that.” Dr Ferris agreed there would be merit to the committee recommending the government “relieve” GPs of the sole responsibility for data protection, and their data controller status. Read full story (paywalled) Source: HSJ, 20 June 2023
  24. News Article
    The current GP funding model ‘does not sit comfortably’ with NHS England’s plans for primary and community care integration, according to a senior NHS England director. In a Lords Committee hearing today, NHS England’s national director of primary and community care services Dr Amanda Doyle said a ‘rethink’ was required with regards to the primary care estate, with Integrated Care Boards (ICBs) tasked to draw up local plans. Asked whether the GP partnership model was compatible with integration, Dr Doyle told the committee that this was ‘one of the challenges’ they are facing. She said: "One of the challenges that the current predominant ownership model in general practice gives us is that both investment and revenue flows support that model [of] an individual, practice-sized building. "And lots of the things we want to do as we move forward into co-located primary care services and scaled-up primary care delivery drive the need for bigger premises with a wider range of capacity, and those two models don’t sit comfortably together." Read full story Source: Pulse, 19 June 2023
  25. News Article
    Two-thirds of GP practices from a sample of 100 in London declined to register a patient without an address, contrary to national rules which are meant to ensure homeless and excluded people can get healthcare, HSJ has found. NHS England guidance states anyone can register with a GP without proof of address, and that people without a permanent address “can still register using a temporary address or the address of the GP surgery”. Practices normally need to record an address, but the exception rule is meant to ensure people who are homeless, or living in unstable or short-term accommodation, are still able to access primary care or referrals for secondary services. Despite this, when HSJ called 100 randomly selected practices in London (about 9 per cent of the total), 64 refused to register the caller. Read full story (paywalled) Source: HSJ, 19 June 2023
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