Many of us will have heard GPs talking about their almost unmanageable workload. Even more of us will have noticed just how hard it can be to get a GP appointment when we need one. The importance of primary care should not be underestimated, it is primary care that keeps us from needing hospital admissions. It may also keep vulnerable patients safe and out of crisis. To start damaging primary care is very unwise as it may simply translate into patient harm, increased pressure on hospitals and increased costs for the state. So what is happening now with primary care?Image by Amanda Slater (view licence details)
We know that the part of the STP for the footprint 33 region that relates to primary and social care (place-based plans) has now been incorporated into the operating plans for the CCGs in East Sussex and West Sussex. As seems to be common in NHS policy the views of the people who should know best what needs to happen, the GPs themselves, do not seem to be taken into account.
General practice is facing increasing and unprecedented pressures. The gap between demand and capacity continues to grow. There are problems relating to inadequate resources, a workforce crisis and an unsustainable workload.
A BMA-Survey-of-GPs-in-England-Final-report revealed that only 1 in 10 of GPs would describe their workload as manageable and allows for safe and quality care. By contrast 57% of GPs would describe their workload as unmanageable and at times impacting quality and safe care. There were 27% of GPs surveyed who would describe their workload as unmanageable and significantly reducing the chance of delivering safe and quality care.
The percentage of NHS funding spent on general practice has fallen from 10.4% in 2005/6 to 7.4% in 2014/15. this leaves practices receiving on average only £141 per patient to deliver a year of general practice care. It would probably cost you more than that to get a year’s insurance for your pet hamster. There are fears that GP practices may soon be finding they have to pay increased rents for the buildings they occupy.
General practice does not have sufficient funds for workforce, premises and services to meet the demands of an ageing and growing population.
There are numerous circumstances where care that used to be secondary care has been moved back to general practice. The BMA has described this as being often inappropriate and underfunded.
The bureaucratic burden on practices and practitioners has also increased.
It is also clear from looking at the BMA website that GPs are looking to try and find solutions for the growing crisis affecting our surgeries. But with a funding deficit of at least £2.5bn already, clearly there is no simple solution possible. This will take a multi-faceted approach from a government who is committed to giving an adequate level of healthcare for every person in our society.
The cost of paying for locums is very much higher for a surgery than paying a salaried doctor. But 31% of practices are unable to fill a GP vacancy at all. Another 27% of practices are unable to fill GP vacancies within six months. When surveyed 76% of locums chose to be freelance as a means of controlling their workload.
It is not only the GPs who are calling for all EU nationals working in the NHS to be given a guarantee of their right to live and work in the UK.
Responses of GPs surveyed by the BMA showed significant differences across the regions indicating that there may be a real postcode lottery over the quality of care a person will receive from their GP. Their may also be a postcode lottery over the quality of life a GP can expect to have.
A society can’t really be efficient and prosperous when many in that society are sick and unable to access healthcare. This is one of the reasons behind the Beveridge Report that signaled the birth of the NHS back in 1948.
The public rejoiced in 1948 when they could finally go to a doctor and get medication to help with illnesses without worrying about cost. The only reason that prescription charges were brought in was because of the unexpectedly high demand from the UK population. Nobody will gain if we lose our NHS and our GP surgeries.
