Overworked Suffolk GPs are struggling to deliver a caring service due to workloads considered “unsafe and unreasonable” in other developed nations, a report has found.
A report on the provision of GP services in Suffolk, due before Suffolk County Council’s Health Scrutiny Committee on Wednesday, looked at the current issues affecting capacity and demand.
It found that Suffolk GPs were dealing with up to twice the amount of patients of counterparts in other countries.
The report said that dealing with 40 to 50 patients per day resulted in GPs spending less time with each patient and deriving less job satisfaction
– Credit: PA
The report followed an August briefing with Ipswich and East Suffolk Clinical Commissioning Group (CCG) to agree key areas of investigation for a formal review.
The briefing highlighted that a growing population of people were living longer, with more complex health issues, while fewer newly qualified doctors were entering the profession to replace retiring GPs.
Issues were said to have been further compounded by the impact of Covid-19 and the backlog of elective care in acute hospitals, leaving patients to manage health problems alone for longer.
The resulting report, by the CCG’s deputy chief operating officer, David Brown, found multiple pressures on GPs, including a lack of control over workload.
It also found that, until recently, there had been no attempt by national systems to quantify or remedy the effects of changes on primary care, including increased demand as a result of successful campaigns around mental health awareness and cancer symptoms.
While about 25 patient interactions was considered a safe and reasonable daily workload for primary care systems in countries like Australia, New Zealand and the Netherlands, it was common for Suffolk GPs to be expected to consult 40 to 50 patients in various formats, while also handling 20 to 30 blood test results, letters from a multitude of sources, prescriptions, home visits and the supervision of junior staff.
“It is self-evident that dealing with 40 to 50 patients per day results in less time to spend with each patient,” said the report.
“This, in turn, means it is very difficult to provide a high quality, caring service.
“The result is not only a poorer service, but one in which practitioners derive less job satisfaction.”
The report called the recruitment and retention of new GPs a “significant challenge”, with adverts for some vacancies lapsing without a single applicant.
Among a wide ranging list of potential solutions, the report suggested making Suffolk a ‘GP friendly’ county by recognising that alternative routes exist for the majority of requests for information and help.
It highlighted the need to reframe the discussion around prioritising needs, to be explicit about demand management, waiting times and expectations, and to narrow the scope of general practice where possible.
Dr John Havard, of Saxmundham Health, has worked in the NHS for 35 years
– Credit: Sarah Lucy Brown
Dr John Havard, partner at the 9,000-patient Saxmundham Health practice, said: “While it’s useful to compare to other countries, you only need to make a comparison to ourselves, over time, to see that we used to provide that ‘traditional’ service everyone knows and likes.
“I used to get out of bed at 3am to see patients, but that was at a time when the day work was much lighter.
“I’d start at 9am and be able to come home for lunch. Now GPs are working 8am-8pm.
“We receive probably 500 calls a day. Where we used to have one lady dealing with calls and a waiting room, we now have a call centre of four.”
Dr Havard said that, following Covid-19, patients wanted and expected a return to normal service.
“Our experience is that demand is going through the roof,” he said.
“Everyone wants more, now.
“Telephone triage causes a lot of controversy, but it’s so important in deciding who needs to come to the surgery and who doesn’t. We have to do that now because the numbers are so massive.
“Demand is out of control – but it’s important not to blame patients, because what else can they do?”
The government has previously said it was investing £270m to expand GP capacity following the Covid-19 pandemic and had committed £1.5bn for general practice until 2023/24.
In its mandate to Health Education England for April 2021 to March 2022, the Department of Health and Social Care instructed the workforce body to progress its contribution towards the government’s commitments on primary care by increasing the number of GP training places from 3,500 to 4,000 a year.
Last month, the Prime Minister Boris Johnson unveiled a new UK-wide 1.25% health and social care levy, which he said would be “fundamental to putting the NHS back on its feet” and enable “radical innovation” in the health service.
This weekend, according to The Sunday Times, plans were being considered by Health Secretary Sajid Javid for more prescriptions to be provided for routine illnesses through pharmacies and hospitals to allow doctors more time to see patients in person.
Mr Javid last month vowed that the Government would “do a lot more” to ensure GPs see more patients face-to-face, following complaints from the public.
