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The waiting game

NHS admits GPs 'consistently exceeded capacity' last winter despite extra funds

The NHS has admitted in a new report that GP services ‘consistently exceeded the planned capacity’ last winter despite extra Government funding to provide more appointments.

NHS Improvement’s review of winter 2017/18 revealed that GPs and nurses provided over 345,000 more appointments than were commissioned by CCGs, in what was the worst flu outbreak since 2010/11.

This comes after Pulse revealed in January that GPs were forced to cancel their leave and work overtime to deal with the influx of patients hit by flu, despite an extra £20m in Government funding to support general practice.

But the BMA argues that 'winter pressures' are now year-long, and these short-term fixes do not support GPs trying to meet growing and unprecedented demands.

In the report NHS Improvement found that nearly 1.3m additional GP and nurse appointments were provided over the winter, while only 950,000 were commissioned.

On top of this, GPs also provided 2,000 more home visits and 50,800 more out-of-hours contacts than were commissioned.

When comparing the last winter period with 2016/17, the NHS review of winter 2017/18 found:

  • There were 400,000 more calls to NHS 111;
  • An additional 290,000 people attended A&E departments;
  • An extra 100,000 people were admitted to hospital as an emergency.

The report said: ‘Over the Christmas and new year bank holiday we asked local commissioners to ensure sufficient access to GP appointments to match assessed demand on each day, commissioning additional capacity where necessary. In aggregate additional GP activity provided over this period consistently exceeded planned capacity.’

The report also said that the situation was worsened by the late arrival of the £20m Government funding to support access to more GP appointments.

It said: ‘This [funding] was welcome, but it was only announced in November and therefore the full potential impact was harder to achieve in time for January and February.'

BMA GP Committee chair Dr Richard Vautrey said: 'This report confirms what GPs experienced first-hand this winter, as they endeavoured to continue to provide high-quality care to their patients despite unprecedented demand on services...

'While more money for extra appointments was welcome last year, this took too long to reach the front line. The Government must invest in supporting practices to cope with the increased workload winter brings and provide resources earlier so they can meet the surge in demand.'

He continued: 'It is no longer realistic to expect GPs to continue to deliver beyond what is pragmatically possible. The BMA has been clear that so-called "winter pressures" in the NHS are now year-long pressures, and this is no more evident than in general practice.'

At the beginning of this year, flu cases suddenly spiked with consultations for flu-symptoms increasing by 78% in just one week.

Researchers later reported that GPs were dealing with an average of 89 extra appointments a week during the busiest period over the winter.

Readers' comments (13)

  • National Hopeless Service

    oooh...... that means they will back date some extra pay..........

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  • So glad I left the practice in early 2017 because often the partners pick up the extra work and extra costs so a double hit

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  • CCG's commision a set number of appointments? News to me. GMS is the John Wayne contract I thought....A Gps gotta do what a GPs gotta all you can eat fixed price buffet of healthcare.

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  • Primary care offers circa 10 million appointments a week - this report is just about winter pressures or out of hours?

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  • if we take 350,000 appts at £35 per appt = £12.25 million, plus home visits at £100 per visit = 2000 x 100 = £200,000 plus ooh visits at £50 per appt at £2.7 million = £15.15 million unpaid to GP practices and OOH providers. ie a massive freebie to this country. why not just pay GPs directly now before winter starts from a GP fund of £40 million so they can get systems in place to cope with the demand when it comes. or is this just too simple an idea? ps bypass CCGs -pay direct to GP practice.

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  • This broken system is very difficult to fix. People are leaving in droves.

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  • All the extra money could have commissioned 50% more appointments if it wasn't earmarked for late night and weekend vanity project non urgent appointments.
    I have staff who would happily do an extra session in between school hours but quite rightly decline this work at the margins for late night clinics.

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  • And they thanked us all for our continued hard work by giving us a 2% 'pay rise'. We have to paid per appointment it's the only way

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  • I thought GP capacity was considered infinite! Think of the poor souls in secondary care with impending winter misery, send all the sick to GPs. We can see everyone immediately and 20 patients at once online.

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  • It is our own fault. Our Independent! Contract has no limits. How can we complain about workloads which have no upper limit definitions? If we defined safe working,then we can complain about excessive workloads and winter pressures. What is winter pressure, when we have no definition of what normal should be? The Contract is outdated and needs rewritten. Otherwise GPs will continue to leave. As I have pointed out before, in NI our profit has fallen from £ 80 to £60 with an increase in consultation rate from 2.7 to 6.6 per patient year. If you can get out please do. These figures tell you why.

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