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Trust declares black alert and directs patients to local GPs

A hospital trust has directed patients to local GPs following the issue of a black alert on the hospital, which GPs warn will increase pressure on general practice.

The Royal Bolton Hospital has declared a black alert following a particularly busy day yesterday (9 December) and has urged patients not to come to hospital if they have had sickness, diarrhoea or flu-like symptoms.

GP leaders have said they already experienced a ‘much busier’ day in general practice and questioned the trust’s advice for patients to seek GP extended hours appointments.

Bolton NHS Foundation Trust directed patients to GP extended hours, pharmacies and NHS 111 and added to only visit A&E if necessary.

Dr Sharif Uddin, Bolton LMC chair and GP partner at Halliwell Surgery, said he had already seen patients yesterday presenting at his practice with flu-like symptoms.

He added he expects GPs in the area to be ‘absolutely’ inundated with on-the-day requests, following the black alert.

He said: ‘I was on duty yesterday at my practice and as it happened there was an LMC meeting last night and all the GPs on the table mentioned that yesterday seemed to be a much busier day than usual.

‘A lot of young people, adults, elderly, complaining over flu-like illness, so we’ve already seen an increase in demand yesterday and that has continued into today, at my practice certainly.’

Dr Uddin also said he was surprised the trust has directed patients to extended hours as the service, which is run across three hubs, offers pre-bookable appointments.

He said: 'I’m surprised that the hospital has said to try and get access to the extended hours service because it tends to be pre-booked appointments for people that can attend evenings and weekends.

'There are certainly some on-the-day appointments released by the extended primary care service.

'However, practices can only book into that after 3:30 in the afternoon. So if you’ve got the practice inundated all morning for emergency appointments, it's hard to book a patient in a 3:30 if you don’t know what the availability is.'

He added that GPs were informed of the black alert at a Bolton LMC meeting last night (9 December) by a trust representative.

Rae Wheatcroft, deputy chief operating officer at Bolton foundation trust said the Royal Bolton Hospital was particularly busy on 9 December but the situation has 'eased' now.

She said: ‘The situation has eased although we are still busy with high attendances at A&E.

‘There are a lot of winter bugs around at the moment, and we ask people not to come to the hospital if they have had sickness, diarrhoea or flu-like symptoms within the past 48 hours.

‘In Bolton, GPs offer extended hours appointments, your local pharmacy can offer advice and you can contact NHS 111. Please choose well and only visit A&E if necessary.’

In Cambridgeshire, an LMC recently issued a 'black alert' for general practice, saying financial resource cuts has put 'unprecedented' pressure on GPs.

Readers' comments (18)

  • I understand the GP but these patients should not be going to A&E. By all means ring 111 but the majority should be advised self care with the vulnerable being directed to Primary Care.

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  • ...but at the same time make sure don't prescribe any antibiotics and don't miss any early cases of sepsis or we will be down on you like a ton of bricks.

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  • Well GP is on black alert 6.

    And that's when 5 is the maximum.

    Therefore patients shouldn't bother going calling the GP and should go straight to hospital.

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  • David Banner

    A long long time ago GPs provided drop in surgeries with no appointments.
    Then HMG decided to dump more and more tasks upon us, forcing GPs to introduce appointment systems across the board to manage the deluge of patients, the majority of whom were well, not ill.
    So what about the acutely unwell?
    Well, they started rocking up at A&E.
    No worries, NHS111, extended hours, walk in centres.....these will mop them up.
    And yet the hordes are still invading A&E.
    Transforming GPs from care givers for the ill to administrators for the well was a catastrophic error which continues to reverberate throughout a broken NHS.

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  • Double black alert level a billion at my practice.
    All patients diverted to hospital!

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  • I divert patient to A/E because I have hours of work to do chasing up or responding to work dumped on me from hospitals.
    There are no peaks of demand in GP - we are always at capacity.

    If GPs are full and direct to A/E, but A/E are full, who gets sued/struck off/imprisoned when things go wrong?

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  • Why so busy? Terrorism? Fire? Ebola?
    Or just predictable winter levels of business in a stretched hospital?
    GPs going the extra extra mile (first extra is a normal day) for a broken NHS model of providing healthcare is not worth the individual GPs’ loss of life expectancy.

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  • Vinci Ho

    Ok , I take the point that we should help our colleagues in A/E as they are in our same boat of under-resourcing and suffering . Indeed , these patients( with flu symptoms particularly),perhaps , should not turn up in A/E . Nevertheless, the argument lies where the current system has no guarantee of a safety net for these patients . Logically, they all need to be assessed appropriately medically somewhere , someway and somehow . Fine , one may refer to innovation to use other non-face to face (nFTF) means , still there are many serious enough needing FTF.
    General practice, currently with a backpack called extended hours( PCN with a even bigger backpack of extended access , 7 day a week , in 2021) , is running with some serious levels of ‘alert’ every bloody day . The scheme of extended hours and hence , extended access , originates from the controversial ideology of allowing working patients to book GP appointments outside their working hours , remember that ?
    Furthermore, we are all fed up with the argument of the seven day GP opening protagonists(and the last prime minister) that we, GP, are responsible for the chaos in A/E all the time because we are open only five days a week .
    The more we use these additional GP appointments (serving a completely different purpose) , the more we play into the hands of this argument that we should be the ‘guilty party’ for what is happening in A/E right now . Politicians will now simply say GPs/PCNs is the ‘solution’ getting away with murder without properly addressing the core problems of this crisis .

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  • So people needing their boiler checked will have to go to the back of the queue - disgraceful!

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  • GPs should have always been allowed to make certain that those that are acutely unwell with appropriate primary care problems can be seen on the same day.
    Chronic disease management is not a same day issue . This is the area that should have been concentrated on by other health care professionals and not the other way round .

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