Doctor and health watchdog warn over pressure for face-to-face appointments
- Credit: Sarah Lucy Brown
A Suffolk GP and health watchdog have hit out over a controversial government 'blueprint' for more face-to-face appointments.
The government has said the measures, including a £250million winter access fund from NHS England, will enable GP practices to "improve access to GP appointments".
But Saxmundham GP Dr John Havard said if all appointments were face to face it would lead to huge waiting lists, while Healthwatch Suffolk told of staff "burnout".
Dr Havard commented: "Be careful what you wish for. Just pause to think about it from the GP's perspective. GPs would love to see a list of patients face to face because it is so much easier for us.
"We have been forced since before Covid to see only those with a clinical need because there is so much demand and this is more difficult for us.
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"If everyone had an appointment with the GP then the wait would quickly climb to three months as we get 500 calls a day. Triage is sensible since without timed appointments I can quickly see a patient who needs to be seen by getting them to come directly rather than at the end of a booked surgery.
"Maybe the public need to ask themselves some direct questions. If the GP job is so cushy then why will no-one do it?
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"If GPs and their staff continue to receive the constant abuse and even more quit then where will that leave us?
"The Health Service has become much busier across the board, but in Ipswich Hospital we now have 28 orthopaedic surgeons where there used to be four, while over the same time period the number of GPs has fallen. Do we think that is right?
"About half of GP time is spent with patients while the rest is spent dealing with the work they generate. Our work carries on long after the last appointment.
"Chronic disease like diabetes, heart and kidney disease is managed in General Practice now, whereas it used to all be run by the hospital.
"Being a locum is easy because you just see patients and avoid all the other less enjoyable work. Beware of drawing GPs out of practice to the easy and quicker job of just seeing patients, leading to the final demise of GP Partnerships.
"Does that matter? When CCGs and other companies run failing practices (record number handed back their contracts last year), it cost up to three times as much and CQC standards fall – so be careful what you wish for.
"And this all started well before the Covid crisis and the intense workload vaccinating our patients showed the nation how effective GP partnerships can be."
Andy Yacoub, chief executive of Healthwatch Suffolk, also criticised the support package. He said: "£250m for the entirety of GP practices in England is a drop in the ocean, and as it seems to be a one-off payment, any potential change would simply not be sustainable.
“GP services have seen an almost doubling of patient contact over the past 18 months, all during a period when many have also provided vaccination services too.
"Staff are at an increasingly high risk of burnout, and some of these announcements will only add stress to an already pressured workforce."
"Practice teams throughout Suffolk are doing their best to make full use of the digital options available, to ease capacity and allow as many face-to-face appointments as possible.
"Sadly, when accessibility is an issue, a small minority of patients are verbally lashing out in frustration, which is having an additional detrimental effect on the wellbeing of staff.
“Despite the difficulties faced in primary care, patients are positive about many aspects of our health services, citing the convenience of accessing healthcare by digital means, while praising the supportive and compassionate care they have experienced.
Mr Yacoub added: “Of course, not everything necessarily runs smoothly. We are providing anonymised information shared with us by the public where problems are arising, such as when phone system issues leave members of the public upset, ongoing waiting times when a face-to-face booking is required, or when frontline staff and also, on occasion, clinicians have been 'rude' or 'dismissive' in their approach with patients.
"Such interactions, whilst inevitable to some extent, tend to ‘set the tone’ for people’s overall perception of services."
A spokesman for the Suffolk and North East Essex Integrated Care System said: “The Suffolk and North East Essex ICS welcomes the additional funding from NHS England to support the recruitment and retention of GPs.
“Already the system has a training hub which exists to support the primary care workforce and to help us retain and recruit GPs as well as other members of practice staff.
“As part of the role of the training hub, we will deliver five national recruitment and retention programmes which include schemes relating to GP fellowship and mentoring, which we are currently looking into to rolling out across our area.
“The system has also recruited a GP who is leading on this work. One of the first things he will do is to listen to the views of local GPs to determine the most effective ways of attracting new GPs to the area.”