Winter demand leaves GPs in midst of 'national crisis'

Soaring patient demand and a lack of GPs are leaving doctors unable to cope with winter pressure in what amounts to a national NHS crisis.

NHS planning for winter has focused on providing resources for hospitals and emergency departments, which have seen record demand and admissions in recent weeks.

However, GPs also face huge demand, and doctors’ groups including the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) say that not enough resources have been dedicated to primary care.

Estimates suggest there are thousands of unfilled vacancies for GPs, and the most recent figures compiled by NHS Digital show 600 left the service in the six months to September last year.

A survey by GP’s magazine Pulse has found that doctors are seeing an average of 41.5 patients a day, above the 25 recommended as safe by European GPs.

Sky News visited a practice in Folkestone facing acute pressure because of the GP shortage.

Guildhall Street Surgery was originally designed for 850 patients but now has a list of 9,000, more than a thousand of whom were passed to them in November when another practice in the town closed.

It has just two full-time GPs and two part-time doctors, both of whom are close to retirement, and patients face a four week wait for routine appointments.

The phone rings constantly from 8.30am to 6.30pm and it can take 40 minutes to get through, and all emergency appointments are taken in the first 15 minutes every day.

And the premises are in desperate need of repair. After lead was stolen from the roof before Christmas the roof leaked and flooded the waiting room, and bids for a new purpose-built surgery have been rejected by the local clinical commissioning group (CCG).

The practice has been trying to recruit two new doctors for more than two years but has had only one credible applicant, and the partners believe the limitations of the premises, and the huge demand, are a factor.

Practice manager Tina Byrne said she believes the difficulty of accessing primary care is adding to the pressure on hospitals. Earlier this month every hospital in Kent with an A&E department bar one declared a ‘Black Alert’, meaning they were unable to guarantee life-saving emergency care.

"We are absolutely in a crisis," she said.

"With the volume of patients we have coming through the door the 10 minute appointment slots that we allocate are not enough.

"They have complex problems like mental health issues, and it has a knock-on effect. If we can’t see them here they end up in A&E, so this crisis, we are at the forefront of it, it starts here. If we can’t see those patients here they end up in hospital."

Professor Helen Stokes-Lampard, Chair of the RCGPs, said: "We understand our patients are frustrated at how long it takes to secure an appointment with their GP – and we share their frustration. The long and short of it is that we simply don’t have enough GPs across the country.

"Our workload has increased 16% over the last seven years, yet the share of the NHS budget general practice receives is lower than it was a decade ago."

Dr Krishna Kasaraneni, BMA GP England executive team lead on workforce issues, said: "The situation in Folkestone is sadly illustrative of a wider crisis facing the GP workforce across the country.

"Too few graduates are choosing general practice, while experienced doctors are choosing early retirement as they struggle to contend with unmanageable workloads, staff shortages and dwindling budgets."

The Department of Health says it will recruit 5,000 new doctors by 2020 and is fast-tracking around 2,000 from overseas to try to hit the target. It is also offering £20,000 "golden hellos" to GPs willing to work in areas that face recruitment challenges, including coastal towns and rural areas.