Life is becoming more hectic for GPs and many are opting out
Soaring patient demand combined with record numbers leaving the profession are threatening the future of local family doctors and sending shockwaves through the rest of the healthcare system.
Now the treasured service will undergo dramatic change as health chiefs launch a rescue plan to try to plug gaps before new doctors can be trained.
Under the new plans GPs will be surrounded with more support staff to diagnose and treat minor ailments while doctors concentrate on more complex, long-term cases.
Practice nurses, paramedics and physician assistants will tackle the minor ailments. Already pilot schemes are under way across the UK.
While GPs have to undergo 10 years of training, the support staff – who require less training – are being considered as an effective solution.
“There simply aren’t enough GPs and we are moving away from the traditional model to more of a triage system so people won’t simply be able to rock up and see their doctor,” said Dr Sarah Jarvis MBE, a GP for 27 years and clinical director at Patient, the independent health advisory service.
“There is a concern about losing that human touch between a GP and patient. We must be careful to ensure that personal contact is enshrined in any new way because the evidence is that people really value that long-term relationship with a doctor.”
The new plans must ensure that the quality of care for patients remains paramount, said Lucy Watson, chairwoman of the Patients Association.
The UK has the lowest number of doctors per head in Europe
She added: “It’s essential that patients are seen by the right professional at the right time. If a practice nurse, healthcare assistant or pharmacist is the right person to meet a patient’s needs, it’s entirely right that the patient’s care should be delivered by that professional.
“Introducing more flexibility to enable this might therefore often be beneficial – but doing it at a time of workforce and funding pressures clearly risks any such change being done to conserve resources first, and care for patients second. Any such changes must be made in full consultation with patients, and their impact monitored to ensure that they result in better care, rather than patients being shut out from accessing a GP when they need to.”
The Government has already pledged to have 6,000 new doctors in general practice by the end of 2024 and to pump £30million into training new support staff along with incentive schemes to retain staff and encourage others to return.
The Royal College of General Practitioners (RCGP), which represents many of the 61,500 registered family doctors, who carry out 370 million patient consultations a year, says the service is “under immense strain” with one in five GPs approaching retirement and a third considering leaving every month because of burnout.
The RCGP wants to see a greater role for practice nurses and healthcare assistants with high street pharmacists taking up some of the slack to counter the pressures.
‘In a triage system people won’t be able to rock up and see a doctor’
But doctors are worried that targets for recruiting GPs will not be met as trends show the number of GPs per head falling while the population grows and ages.
By 2025, 9.1 million Britons will be living with multiple serious conditions. GPs’ clinical workload has risen by 16 per cent in the past decade.
“GPs are being asked to deliver the impossible every day, seeing 35-plus patients, conducting phone appointments and chasing test results and referrals. They have no more to give and are taking early retirement because they have become demoralised,” said Michael Brooks, an A&E locum doctor at James Paget University Hospital, Great Yarmouth, and chief medical officer of PatientSource.
“I see the fallout where we are picking up more and more primary care problems. Patients frequently cite three-week waiting times for routine appointments and duty doctor appointments all booked within 10 minutes of a surgery phone line opening. This is not the fault of our GPs. It is a system of inertia, fragmentation and underfunding.”
He added that the primary care budget should be boosted from nine per cent of NHS spending to 16 percent and that health chiefs need to ensure technology integrates across the entire NHS.
Dr Michael Brooks, A&E doctor at James Paget University Hospital
The UK has the lowest number of doctors per head in Europe but health experts believe boosting GP numbers must be linked to greater use of technology and campaigns to influence public behaviour.
A pilot scheme by the Haxby Group, 11 GP surgeries serving 60,000 patients in York and Hull, has extended routine consultation times from 10 to 15 minutes by deploying nurse practitioners, physiotherapists, associate physicians and paramedics to treat patients. It has been welcomed by the public and has improved staff morale.
“We desperately need more GPs and changes in medical training will probably take a decade to have an impact so it is crucial to harness technology,” said Jonathan Patrick, CEO at Consultant Connect, which has saved the NHS £26million by providing doctors with rapid access to consultants across the NHS.
“Technology enables GPs to deal with patients more efficiently, but it also allows them to do more for their patients. Our app enables GPs to get immediate phone advice from hospital doctors which means that patients get treatment immediately and many patients will avoid waiting months for a hospital appointment.
“It also means the GP avoids all the admin that comes with referring patients to hospital.
“Given that the NHS itself estimates that as many as 20 percent of referrals are unnecessary, this is a huge opportunity to do something that is better for patient and NHS.”