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NHSE primary care lead acknowledges 'huge' increase to GP workload

NHS England's medical director for primary care has acknowledged GPs who say they are suddenly seeing an influx of workload, while Covid-19 cases are still rife.

Tagging Dr Nikki Kanani in the post, Leicestershire GP and LMC member Dr Grant Ingrams tweeted on Wednesday that his practice had experienced the 'highest workload all year' in the last two days, including a 'huge transfer of work from hospitals' coming amidst 'still increasing Covid cases'.

GPs commenting on the post suggested the rise was linked to people venturing out more since the easing of the lockdown in England, as well as a backlog of routine work that has been building up since March.

Responding to the post, Dr Kanani said this 'seems to be the case almost uniformly now', adding that NHS England is 'considering this' as it reviews what work to 'phase back in' and 'what to hold back'.

Tweeting in response to Dr Ingrams, Watford-based GP Dr Simon Hodes said he has seen an influx of work including patients with long-term health conditions requiring review as well as experiencing a 'major issue' with 'rejected or delayed' outpatient appointments. In addition, he said GPs were 'getting dental enquiries'.

'Would normally not treat these - but at present we are being more flexible,' he added.

At the end of last month, GPs were advised to resume the delivery of ‘routine and preventative work’ including screening.

But over the past couple of weeks Dr Kanani has advised that GPs should base their resumption of routine services on capacity and clinical need, and only resume work where it was safe to do so.

And Dr Ingrams told Pulse: 'Every day has been 10 hours without break so far [this week].'

The news that workload is now rising comes as the number of GP appointments in England declined by more than six million in April 2020 compared with the same point in 2019, representing a 27% drop, according to the latest NHS Digital data.

Nearly two thirds of consultations (63%) took place on the same day they were booked during April and nearly half (48%) were via telephone.

In his tweet, Dr Hodes said: 'Telehealth is convenient but can take longer and [increases] clinical risk.'

Readers' comments (41)

  • Maybe the Editor could link this to the anonymous locum who thinks workload is dropping, and that excessive paperwork 'doesn't count'...

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  • This goes to prove NHS work never goes away.Locking patients down just delayed its presentation for a few weeks. Now it is flooding back on top of usual work and is inundating us.

    We too have had an extremely busy week and not helped by all face to face appointments taking 50% longer due to Covid precautions.

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  • Could NHS England's medical director for primary care draw up a plan to rationalise primary care I.e. dumb all the useless, wasteful and demoralising stuff (not hard to figure which stuff)?

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  • This is the same across the country, as a locum, I have been lucky enough to be kept on somewhere I am working. Workload did reduce for a few weeks but this week, in particular, there has been quite a significant increase in workload. The main difficulties are navigating what hospital is accepting in referral and what not as different hospitals and different individual departments are all doing their own thing, some are bouncing them back, some are assessing patients over the phone where possible, I had an email to say one department is saying we are NOT referring enough!!! It takes significantly longer to see face to face patients with the cleaning the room afterward, etc. A local oncologist is saying cancer diagnosis is down quite a bit compared with the same time last year and the surgeons arent doing cancer surgery for the same reason we are not sending them in to get it diagnosed. What likely to happen is when things restart there will be an impact in already in delay diagnosis and further delay in future diagnosis and treatment because if there is a surge they cant deal with all the backlog in one go. May be those empty Nightingale hospitals across the country can be put into good use.

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  • Acknowledgement is a start. Now to do something about it. I'd suggest anything NHSE are currently thinking about doing could be delayed (indefinitely would be fine). As for dental enquiries, I don't see how anyone can be "flexible"; I'm still not a dentist. I haven't started having a go at treating peoples' pets because access to vets is limited (please don't get any ideas RCGP/NHSE)

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  • Maybe now would be a good time to increase primary care funding? Perhaps this would increase GP/nurse/receptionist recruitment and retention? Wild idea, I know. Dave Cameron will be spinning in his grave.

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  • There was a quiet time. This though was not an easy time as there were many tricky telelphone consultations and lots of anxiety about the pandemic. Staff abscence was also a challenge.

    We are now entering the next phase. Patients are becoming more demanding. The genuinely sick are coming out of the woodwork. Staff abscence may become a massive problem.

    Thankfully there is help at hand. I can't wait for my friendly call from the CQC.

    Oh dear--I feel 14 days isolation may be required!

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  • The whinging about excessive work load is not too uncommon amongst us GP’s.
    Questions :
    1. How does your own practice compare with the survey of the PULSE indicating the average National waiting time to access GP appointment is 2 weeks.

    2. In spite of this horrendous waiting time, pre pandemic, the average appointments per GP per session is 15, which is max 150 a week compared to German GP’s seeing on average 250 patients a week. How many patients do you see per week. How many sessions a week you actually do?

    British GP’s with partners earning in excess of £100,000 and inviting doctors to join them at £10,000 a session ( see today’s PULSE ads) are one of the highest paid professionals in the UK and the world.

    And whereas the hospital doctors were daily exposed to the virus, we the GP’s were conducting 99% of consultations by phone.

    Come on my fellow GP’s stop this complaining and be grateful for the wonderful
    9-6, week ends & night’s free lifestyle that the British taxpayers continue to provide us.

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  • Philosopher 1 needs to check his figures. I very much doubt each GP in Germany is seeing 250 patients per week as that would equate to 16.6 sessions a week of 15 patients a session. The German doctor would be working 8 days a week ......

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  • Philosopher 1, Could I respectfully suggest you have absolutely no clue about what the workload for GP partners is. It certainly isn't 15 patients twice a day, 9-6 with evenings and weekends off. That is realistic for a locum and some salaried GPs (note "GPs" doesn't need an apostrophe), but they aren't earning over £100,000 a year. The 30 patients a day is only the start, there's the extra patient contacts, the admin, the running of the practice, keeping up with the demands of CQC/CCG/NHSE etc etc. Do you have a source for German GPs seeing 250 patients a week?

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