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GPs refute briefing claims that they are 'referring large numbers to A&E'

More than 450 GPs and primary care staff have signed an open letter after an emergency medicine professor suggested in last night's Government briefing that practices have 'referred large numbers of patients to the emergency department'. 

Named as 'Suzanne from Chesterfield', Professor Suzanne Mason, professor of emergency medicine at the University of Sheffield, made the comments in the live televised briefing with the Prime Minister, chief medical officer and chief scientific officer - the final of the daily updates. 

During the questions from members of the public, Professor Mason asked: ‘When will primary care and dental practices be encouraged to work normally again now that the threat level is at three? We are seeing large numbers of patients referred to the emergency department because their GP or dentist are refusing face to face consultations. How soon will they be getting back to normal?’

Professor Chris Whitty, the chief medical officer, replied: ‘GPs have of course been working throughout this and done an absolutely fantastic job if I may say so to my colleagues.

‘Inevitably, to reduce the risk of transmission – to reduce the risk that people come into contact in waiting rooms and indeed between clinical staff and patients – they have changed the way they’ve worked and many of those changes are actually things that make sense for the longer term, even if it wasn’t for coronavirus.’

The GPs' open letter - which at time of publication has been signed by 452 primary care staff - reads: ‘During the Prime Minister’s daily coronavirus briefing on 23 June, [Professor Suzanne Mason] stated that “large numbers of patients” were being referred to the emergency department in which she works because their GP or dentist had refused to see them face-to-face.

‘As general practitioners, we wish to reassure the public that NHS GP surgeries are open and available to patients who need us, and have been throughout the pandemic. In order to safeguard the public from unnecessary risk, GPs have shifted to online and telephone consulting where safe and appropriate.

‘We hope that Suzanne’s comments do not deter patients from approaching their GP if needed, and respectfully invite Suzanne to spend a day with a local GP so she can see first-hand how hard NHS GPs are working during this pandemic.’

The letter's author, Dr Heather Ryan, a GP in Warwickshire, explained: ‘I found Suzanne's comments very frustrating, as it feeds the public perception that general practice has been closed during the pandemic. In fact, GP surgeries have been open throughout. What has changed is the way in which GPs are working - to minimise the risk of coronavirus transmission, GPs have moved to other forms of consulting, such as telephone and video calls.

‘I started the open letter because I wanted to reassure the public that general practice is still very much open for business.  I don’t feel it’s helpful that a consultant colleague talked about general practice in this way on national television.'

One of the signatories, London GP Dr Thomas Round, added: ‘The comments show a total lack of understanding of primary care and the massive changes we have made almost overnight in the face of a pandemic. We have on the whole moved to a full triage system of digital/phone access to keep patients and staff safe.’

The sentiment also won the support of NHS England’s medical director of primary care, Dr Nikki Kanani, while a Facebook post from ‘Dr Rant’ has warranted almost 3,000 likes today on the topic.

Pulse has contacted Professor Mason, who declined to comment. 

Readers' comments (28)

  • Vinci Ho

    It is bound to generate many contentious issues : we , GP, are subjected to both clinical(at work ) and non clinical (outside work) exposures . Once being traced , you are to isolate for 2 weeks if PPE was not worn .
    Perhaps , it is a logical argument to test frontline medical professionals twice a week ?
    Otherwise , this matter of ‘recovery’ is questionable where the workforce is to be challenged constantly by at least , the Trace part of the equation. Undoubtedly , the scheme needs to be implemented more consistently among those tested positive .
    After 4th of July , the risk is more about infection among relatively younger population as the vulnerable ones are still in shielding until august . The R rate could go up rapidly but the death rate might remain low . This is the phenomenon seen in Beijing , California right now .

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  • (Apologies - there was previously a comment on here that wasn't meant for this story)

  • Clearly its a variable experience accessing GP surgeries during the total triage system mostly now in place.
    Anecdotally, I am aware of comments from many local patients who cannot get through on the phone after long periods trying.
    Obviously, this will need to get sorted as the backlog for "routine" medical care build up.
    Not quite world class is it.
    Austerity hurts.

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  • My understanding was that A+E attendance across the country had been at record low levels during the pandemic?

    Not sure what her point is but well answered by Chris whitty as always.

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  • BOTTOM LINE IS----PATIENTS DO NOT LIKE THE WAY GPs ARE HANDLING THEIR PROBLEMS----VIRUS OR NO VIRUS

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  • Vinci Ho

    Ok , let’s revisit this statement from our professorial colleague :
    :
    ‘When will primary care and dental practices be encouraged to work normally again now that the threat level is at three? We are seeing large numbers of patients referred to the emergency department because their GP or dentist are refusing face to face consultations. How soon will they be getting back to normal?’
    What are the logical pitfalls of this statement?
    (1)I presume that this is the majority of what she said during the daily updates as I did not watch the programme on television. The first part of the question is a fair one . In fact , we would like to ask the same question of when will hospital be encouraged to work normally again now that the threat is at three ?
    (2) The principles of a proper debate include making subjective comment based on objective evidence . ‘Large numbers of patients referred to emergency department....’ needs an objective number or percentage, to the least , to support this subjective comment. So is for the rest of the sentence ,’ because their GP or dentist are refusing face to face consultations’ . Furthermore, non-face-to-face consultations are the mainstay for our hospital colleagues up to this point unless I have missed some major changes . I would apologise if I am wrong , Professor .
    (3) ‘How soon will they be getting back to normal ?’ is ,in fact , a melancholic question : what is ‘normal’ now ? The biggest question is how soon will WE be getting back to normal in face of the enemy from nature . I share your frustration and anguish , Professor . Please look after yourself and be safe .

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  • We did consultations equivalent to 7% of our list last week.
    And we haven’t really got up to speed on chronic disease management.
    Highest quintile for deprivation (ie most deprived) though so commissioners don’t give a ...

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  • As we all know GPs are easy canon fodder as always.The real question is when will the hospital services be getting back to normal?

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  • The real question is when will A+E operate TOTAL TRIAGE and re-direct inappropriate attenders to the correct pathway be it pharmacy, WIC, mental health services, social worker etc without letting them through their doors? The fact that A+E gets a handsome tariff for seeing them, rather than rejecting them says it all.

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  • Thank you Jaimie and Ellie for bringing this to everyone’s attention here on Pulse. Please can everyone consider signing the open letter (which seems calm , measured and non -inflammatory ) and spreading the word. Frankly I find it sickening that one of our medical colleagues should use this high profile event to persue her GP bashing agenda when we have been working our socks off since day 1 . Yes we have reduced F2F but we are still willingly seeing and visiting patients when clinically indicated. The admin and organisational challenges have increased significantly and , again , GPs have risen to the challenge. Come on colleagues !! Let’s not accept GP bashing and lets try to educate this ‘professor’ about how GP practices work..... I also agree with comments elsewhere that we must thank all our staff - Nurses , PAs , managers and admin teams , IT support and pharmacists as its not just about GPs....thank you

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  • But don’t forget that The Hospital is the centre of the universe and all other services/providers orbit it like specs of dust. The Hospital is all important.
    Anecdotal reports of GPs sending patients to A&E in higher numbers than The Hospital deems appropriate?
    They must be stopped!
    The Prime Minister must be informed!

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  • Totally agree with Phil. It was a very loaded question and it implies that GPs and dentists have been wilfully refusing to see patients when that is not true. It’s really sad to see a fellow medical colleague behaving like this. I can’t stand the whole hospital vs primary care attitude; it’s nothing but destructive and serves no purpose. We should all be supporting and working with each other to deliver care as safely as possible.

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  • I think it should also be pointed out that since so many hospital appointments and all routine surgery have (understandably) been delayed or cancelled and (certainly in my area) GP access to X-rays/scans etc are severely restricted it seems inevitable that more patients will end up being admitted as emergencies.

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  • Not to worry Professor. Not only has your hospital trust had all its debts written off - after being supported for years by the locality CCG - meaning you will have abundant new toys and staff very soon, you will be picking up the increased demand/ waiting list initiatives from autumn. £2000 per day incentives to "meet demand" will help you get better from your sadness and disappointment..

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  • National Hopeless Service

    Its a complex beast. I did a gastro referral a few days ago, cant do FCP at present, for someone who probably has colitis. Advised the patient there will be extended wait so she took it upon herself to go to A&E. The whole of the NHS isnt quite open.

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  • WHAT EXACTLY IS A PROFESSOR OF EMERGENCY MEDICINE?-----NEVER HAD ONE IN MY DAY

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  • doctordog.

    We all know patients who have come to serious harm or died because of the triage and admitting procedures of local A+E departments.
    Is her statement just a diversionary tactic?

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  • You got one lonely GP caring for 2500 complex people. And he refers some in. So he might not DIE alone. Big deal NHS. You are becoming a scandalous employer.

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  • We should recall that A&E didn’t stop offering core services and move to video consultations and phone calls.
    If patients turned up we saw them.
    For most patients a phone call or a video consult is a poor second best to a face to face encounter.

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  • Professor Mason looking for a senior NHSE role and a dong
    Newsflash- Professor Suzanne being mobbed by NHSE to work for them
    2 years later: Professor Suzanne is on the Honors list
    While in the real world- GPs slogging their backsides off with even further reduced numbers.

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  • Hospital colleagues act as if they are a separate 'tribe' from primary care and a lot of the time they are oblivious of the prescribing restrictions we are under, expecting us to prescribe unlicensed meds or meds not on formulary.
    There needs to be some kind of 'coordinator' so that secondary care doctors have a better understanding of what goes on in Primary care.
    The final year students i teach from Birmingham University have a greater understanding once they leave the post.

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  • Dear All,
    Will she comply with her professional responsibilities as set out in Good Medical Practice, and apologise?
    Regards
    Paul C

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  • @ Paul Cundy - no, she won't do that. What Prof Suz will do is continue "researching" clinical areas she knows next to nothing about and are literally none of her business. Like a plumber who wants to review the international wiring regulations, the production of gypsum plaster and how to care for your lawn mower : Research interests _
    "Current studies include CLAHRC 2: avoiding admissions and attendance in patients with long term conditions"

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  • General practice seems to have unilaterally decided that it can work remotely from here on in with no patient consultation ( excuse the pun)
    Fine but are you then happy for your job to be outsourced to a call centre of cheaper doctors abroad ?
    Careful what you wish for

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  • when we are all gone they will soon realise how much we actually do but by then it will be too late. when you kick the guarding dog enough times don't be surpised when one day they are no longer there to protect your door.

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  • Yossarian | GP Partner/Principal26 Jun 2020 12:22pm

    General practice seems to have unilaterally decided that it can work remotely from here on in with no patient consultation ( excuse the pun)
    Fine but are you then happy for your job to be outsourced to a call centre of cheaper doctors abroad ?
    Careful what you wish for

    Don't think so mate. We are seeing more F2F now gradually. Eventually this will surely increase further. But whatever doesn't require a physical exam can be dealt with by phone usually.

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  • I for one will not be paying much attention to the ill informed “Suzanne from Chesterfield”. Imagine my surprise to learn on social media that Suzanne regards the Prime Minister as a “hero” and has described criticism against him as “vitriol”. How could such a champion of the Prime Minister be so lucky to be randomly selected to pose an independent question/statement to the Prime Minster on a Downing Street coronavirus briefing? I wonder?

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  • @Conor O Loughlin
    Good spot.
    What type of screwed up world would you have to inhabit to regard the current PM as a 'hero'?
    She is obviously one of his cronies as you suggest. Any suggestion of 'randomness' in her selection is entirely debatable.
    Bevan had it right. Vermin.

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  • GPs have been seeing patients F2F throughout -yes smaller numbers, post triage with and without adquuate PPE. At least 12 have died so far. Let's not forget this.

    My current bugbear is Hospitals doing telephone consultations (only) no triage, and asking GPs and staff to don PPE to do their blood tests, ECGs for their patients.

    The half-empty A&E depts during covid were not having to manage continuity of care for any patient, unlike us, nor manage teams and premises.

    I feel we have been having to manage hospital workload completely for 3 months plus -not the other way round.

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