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Pleas for GPs to step in as A&E and 111 struggle to cope with holiday demand

Exclusive GPs were asked to open on New Year’s Day to help clear the backlog of patients as hospitals fared badly under pressure in some parts of England during the Christmas and New Year period, Pulse has learned.

Essex local area team offered practices a one-off £80 per GP per hour payment to open on New Year’s Day as local A&Es declared a ‘black alert’.

It also said ambulances would not be dispatched unless the GP could name the consultant that had accepted the referral - a request that was later withdrawn.

It comes as reports from elsewhere in the country revealed that practices were being swamped with referrals from NHS 111, with one LMC leader claiming to have seen 90 patients in one day, while reports in the national media have suggested A&E waiting times in England have fallen to their worst level for a decade, while a number of hospitals have declared ‘major incidents’.

The meltdown comes after the Government tried to prevent chaos this winter by pumping an extra £700 million into services, although only 3.5% of this was earmarked for boosting GP access.

Despite the funding injection, many areas of England struggled to cope with the demand on NHS services.

The Essex area team approached GPs on New Year’s Eve with a message asking them to remain open over the following days.

The area teams said in a note that the plea came in response to ‘significant pressure’ on the whole health system in Essex and a ‘lack of beds to admit patients’.

The note said: ‘You will all be aware of the significant pressure on the whole Essex health system over the last few days with all local hospitals reporting high demand and lack of beds to admit patients

‘In order to minimise the impact on local hospitals, particularly A&E departments, the area team is also asking all local GP practices to consider providing additional cover during the New Year Period, particularly on New Year’s Day and the weekend of 3 and 4 January; this would be funded as an exceptional one off payment as we are asking practices to provide services outside core hours.’

According to Dr Andrew Bradshaw, deputy chief executive of Essex LMC, the pressures had affected all Essex hospitals at some point during the holiday period.

He said: ‘All hospitals in the county were on alert at some time during Christmas and New Year… This demonstrates the pressures there must have been on the system.’

The local area team was unable to provide details about the number of practices that took up the offer.

A spokesperson for NHS England in Essex said: ‘Due to significant pressure on the healthcare system across Essex, NHS England in Essex asked local GP practices to provide additional non-core hours cover over the New Year period.

‘A small number of practices took up the offer and provided additional non-core hours cover. We would like to take this opportunity thank those GP practices who provided additional cover over the New Year period.’

A separate letter to GPs from NHS England’s area team seen by Pulse declared a ‘black alert’ for A&E services, and pleaded for GPs not to refer patients to A&E if they could not be seen in the practice.

The note also informed GPs ambulances would not be dispatched to practices unless GPs could name the consultant that had accepted the referral - but it was understood this information was quickly rescinded.

Elsewhere, practices said they had been swamped by patients because the NHS 111 line was struggling to cope with demand, with patients being told there was a ‘technical fault’ with the helpline.

Dr Mark Sanford Wood, a GPC member and interim medical secretary at Devon LMC, said he had 90 patient contacts in just one day.

Dr Sanford Wood said: ‘I understand that NHS 111 suffered a system failure over the Christmas four-day break, although I do not have details. As a result Monday 29 December was a very heavy day in practices.

‘I was working that day and completed over 90 patient contacts including three visits. Colleagues report similar workloads, so the system was very close to collapse.’

On New Year’s Eve, South Western Ambulance Service NHS Trust, which covers Devon among a number of other areas, told patients via its website: ‘If when calling NHS 111 with an urgent medical problem, you receive a message saying there is a technical failure and get disconnected, please retry. There is no technical failure it is simply due to demand. Please be reassured that your call will be answered as soon as possible.’

Asked about the problem, a spokesperson for the ambulance service said they understood the NHS 111 problem had been national but was now thought to be resolved.

The meltdown comes after the Government tried to prevent chaos this winter via a £700 million injection of winter funding. But only £25 million of this was earmarked for boosting GP access.


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Readers' comments (40)

  • I want to help.

    I would like to go and help in A+E but I want proper compensation. £80 is nowhere near enough for overtime.

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  • "Essex local area team offered practices a one-off £80 per GP per hour payment to open "

    If that is totally correct reporting, then the Essex LAT has deeply insulted GPs and I earnestly hope no GP took it up. The fee for accountants and lawyers in normal daytime is approcahing £300/hr, goodness knows what they would demand to open on New Years Day.
    The big problem is that GPs do have a continual habit of accepting insultingly low fees from the NHS.

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  • Peter Swinyard

    £80 per hour is more like going rate for in hours general practice locum - but opening practices also involves paying staff overtime - even if they agree to work. Unrealistic rate and unrealistic demand. PPPPPP I think (poor prior planning produces p**s poor performance)

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  • .. and there lies much of the problem, a GP registrar wanting more than £166,000 per year (£80 x 40 x 52). What will you want when you are qualified? £266,000. Suggest you re-train to be a footballer.

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  • It wold be better if we could encourage GPs to take up GP posts rather than A&E posts !!

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  • Why the media publishes pressure on A/E only. What about pressure on GPs, OOH services. All services are stretched out, it is not A/E alone.

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  • Anonymous | Practice Manager | 06 January 2015 10:14am

    Are you really a PM? Because no PM is stupid enough to assume the rates you are talking about. Sessional GPs usually charge by the session and do not have sick, annual leave and do not always have work available.

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  • when we understand the problem we would be able to find a answer - previously many a&e depts. were staffed by IMGs who used to work in a&e before moving on to their chosen specialities but now because of changes in work rules, that's not possible. many eastern european drs would not prefer a&e because of the high pressure working environment and local drs would not prefer for various reasons. we all know it is the staffing crisis in a&e which has given rise to the current scenario. so looking at the above we can look into finding the solutions.

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  • £80 per hour on New Year's day ,,,,when Locum Services were offering GPs £100+ for that day in OOH Centres....c/mon be real...

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  • I am just feeling to bitterly laugh.
    The national culture and policy is to despise doctors and to raise complaints, accurately handled by "wise" managers; doctors are summarily tried and convicted by GMC and then suspended or expelled. What do you expect? How do you complain that you do not have doctors? Even gloomy days are on the horizon. There is no compensation that is worth spending one single day in your country.

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