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GPs buried under trusts' workload dump

Two-week wait for GP appointments to become the norm in many practices 'within a year'

Exclusive Four in ten GPs predict the average waiting time for appointments at their practice will exceed two weeks from next April, as they struggle to cope with unprecedented levels of workload.

The survey of nearly 500 GPs shows that they expect average waiting times for an appointment to increase from nine days in April 2014 to 13 days from April 2015.

Only a fifth of GPs said that the average wait for a non-urgent appointment at their surgery was more than two weeks currently. But this proportion doubled to 40% when they were asked for their prediction of waiting times in 12 months time.

GP leaders said that this is indicative of increasing workloads and reductions in resources, with GPs receiving a funding uplift way below inflation this year.

The results also showed that less than half of GPs - 43% - said that the average waiting time for a non-urgent appointment is currently less than a week.

However, only one-quarter of GPs said they would be able to offer less than one week average waiting times from April next year.

The results follow a Labour Party pledge earlier this month to consider a contractual change that GPs would see patients offered an appointment within 48 hours. 

It also chimes with analysis by the RCGP, which estimated that 34 million patients in England will fail to get an appointment with their GP in 2014, because of reductions in funding for general practice over the last decade.

GPC deputy chair Dr Richard Vautrey said: ‘These survey results demonstrate what all GPs know – GP workload is dramatically increasing but the resources to deliver a good service are decreasing.’

‘Instead of funding cuts we need real and long-term investment to take on more GPs and improve practice premises. That’s why we launched our “Your GP Cares” campaign, and we hope as GPs and patients join us we can make NHS England the Department of Health listen to our concerns and provide the investment we so urgently need.’

Essex LMCs chief executive Dr Brian Balmer said that GP shortages and surges in patient demand are the reasons behind the bleak predictions.

He said: ‘You will read in the news that some patients are waiting three weeks for an appointment, but it’s the same story as saying that the GP at that practice is working a 14-hour day.  It’s interesting because in the media when A&Es are full we hear that staff are working really hard, but when GPs surgeries cannot see patients quickly the perception is that GPs are not working hard enough.’

Survey results in full

How long is the average waiting time for a non-urgent appoint at your practice?

Less than a week: 43.7%

1-2 weeks: 37%

2-3 weeks: 14.9%

3-4 weeks: 3.8%

4-5 weeks: 0.2%

More than five weeks: 0.4%

 

How long do you predict the average waiting time for a non-urgent appointment will be in 12 months’ time?

Less than a week: 25.9%

1-2 weeks: 33%

2-3 weeks: 26.5%

3-4 weeks: 10.2%

4-5 weeks: 3.3%

More than weeks: 1.1%

 

About the survey: Pulse launched this survey of readers on 15 April 2014, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung HD TV as an incentive to complete the survey. As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. This question was answered by 460 GPs.

Readers' comments (25)

  • It's the demographic that's killing us . Demand fuelled by glory hunting politicians is making things worse . If the resources are cut from 11- to 8% of NHS budget then system failure is inevitable . More Gp's are required to maintain the level of access let alone increase it. Extra funding will suddenly be available when Branson swoops down to pick over the pieces. This is all part of the softening up process to privatisation.

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  • And perhaps input from Beardie might not be the disaster it's painted as.......

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  • 'input from beardie'
    If HMG through open the service to commercial rates with no subsidy then we all could compete.
    However just like the trains it'll get franchised to mates with massive public subsidy although it would then result in a fair, punctual, clean and reasonably priced service- just like the trains in this country!

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  • And, for the patient, who gets to decide what's urgent and what's not? A receptionist with no medical training?

    I never bother my GP EXCEPT when it's urgent, and I do not want to be told "Go to hospital" when I do so, yet that's increasingly the default response - infuriating when I know I could be treated perfectly well at home, rather than being stuck in an unhygienic bay picking up every wandering bacterium that comes my way and winding up very much sicker than when I went in.

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  • Air miles instead of a pension -I could really go for that .

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  • Ronald, I agree with you! The situation is dire and the service offered to patients is increasingly unacceptable.
    I am not quite sure what you do ( other HC professional) but wonder how you would cope if you had to provide unlimited access to you, within a week, on demand for £70 a year?

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  • I welcome that. At the moment i Waite 5 weeks!

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  • The system is collapsing in front of our eyes.

    We as a medical profession have a large degree of responsibility. You cannot have huge expansion in the number of doctors, without huge costs. and when those dr's are increasingly clock watchers and want to clock in and out this is destructive. this is now prevalent in and out of GP and hospital medicine.

    Yet the RCGP response is to have more dr's.

    Wrong , we need those who are trained at great expense to actually work full time or near full time. we need to promote continuity of care. those who are lucky to have full time GP's should look after them - they are increasingly rare.

    Those who moan at Partners fail to realize, once this groups disappear we will be left with fragmented services with private companies choosing to work in very selective ways

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  • Fund and we shall provide. If money follows workload then GPs should be able to cope with the added demand that is being imposed on them from work previously done in secondary care. I mean serious funding. Funding that could employ an extra salaried GP or a nurse practitioner. How much longer can the NHS as a whole go on. I have every sympathy for our emergency centre colleagues and I am sure they feel the same way about us. After all, we are all in this together.

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  • UK general practice is cheap - Get what you pay for in life

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  • not to worry you will be made (contractually) to provide appointments (routine) within 48 hrs and will need to see patients before they become ill !

    it's a question of how much more can vocationally -led NHS-pro partners take before waking up?

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  • Is it a stupid question to ask why 2 weeks is not acceptable for a non-urgent appointment? Surely the whole point is that these patients are seeing GPs for routine meds reviews etc and so another week or so is unlikely to make a big difference. If a patient comes to a GP "urgently" and requires a series of appointments, then I presume that is handled in a different way

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  • As

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  • I note the usual "impersonators" of healthcare! Aka journalists. On that note, Amanda Platell, the multimillionaire journalist who lives in a luxury MULTI-million pound Hampstead penthouse was ranting the other day in The Daily Mail about GPs being money focused. I had to laugh that this "monied celebrity" should be critising someone like me who lives in a £240,000 house and drives a vauxhall astra!!

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  • I'm afraid patients cannot pretend to have no blame in this. I am not talking about the individuals but patients as a group.

    Patients voted the current politicians in power win in turn decided to cut primary care funding & eating money on meaningless projects/managers. Patients attending for self limiting illness are ramping up the access demands. Patients wanting non essential treatments because 'it is important to me' is diverting resources from essential treatments.

    If they wish to believe all the problem in primary care is due to GPs being greedy, then they are welcome to that thought. But they'll have to accept what ever the change that's coming their way, and I very much doubt it would be a change for better service.....

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  • What are some GPs doing? I have a personal list of more than 2,000 patients and when I left work this evening I had only 4 patients booked in tomorrow morning with 13 unfilled routine appointments. Its just as quiet for the rest of the week! Mind you, no partners are on holiday this week.

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  • It is go to the doctor culture that is blocking appointments

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  • Dear anon 8.21
    Are the other partners so quiet? I would have been really concerned if no-one appeared to want to see me.
    Are you Dr "always available"?

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  • I ve just come home a practice business meeting !!!!! I'm not mourning as I like my job, full time partner , have a personalised lis of 1900t. My income ain't staying same for future and I ve just today given notice to reduce to 3/4 th due to pension changes. I feel like being attCked at both ends ... Income and pension changes

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  • As people get older and sicker - the multi morbidity silver tsunami - there will be more and more consultations on average. It has doubled from 3.5 to 7 in the last 15 years. Unless we change from average list size to appointments per 1000 patients, we will bear the brunt of it in increasing workloads and hours as time passes. This leads to depression, burnout and mistakes.
    We need to define safe working. This is crucial. If you look at Mid-Staffs where cuts in staff led to severe consequences for patients, the blame fell on those left behind.

    The moral of this story is this - in spite of working harder and harder to exhaustion - we will get the blame for poor care. It is happening already in every newspaper.
    We must define what is normal for all doctors if we are to survive at all. Otherwise, increasing and unsustainable workloads will drive doctors away. Patients will suffer.

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  • Barnet Healthwatch have published a report ( http://www.healthwatchbarnet.co.uk/about/docs/gp-appointment-system-report ) showing that patient satisfaction is more related to practice management, educating patients, managing patient expectations than resources per patient. They are producing a Communication Toolkit to help Practices audit and develop simple, coordinated communication plans.

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  • Took Early Retirement

    I wonder WHERE the doctor with lots of free apts works? I would be very surprised if it were an urban GMS practice, unless a University one.

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  • I believe that GPs are partially to be blamed for this crisis..
    ..so many patients are mismanaged being given unnecessary 'follow-up' appointments for reviews where god-knows-what happens. There is a way to managed patient demands, and it is to say I as a GP cannot change your lifestyle - that's your responsibility! Time and time again I have seen GPs over medicate and over medicalise patients (esp, the 'heartsink' ones). Quite frankly I think the number of patients on Z drugs and hypnotics is simply scandalous!

    Instead of wasting so much effort to negotiate a cushy contract back in 2004 GPs should have took a view that's in the wider public interest. GPs should have never accepted QOF, there should have been a lot more emphasise on tackling unnecessary demand and responsibilities such as sick lines etc. I hate having to waste time solving a myriad of social problems when I know that slot could have been better spent looking after an elderly patient with multiple co-morbiditites..I'm out of GP as soon as I can escape

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  • As a health care professional it would be totally unacceptable to expect clients to wait weeks for services, but my own experience is that I tend not to use my GP services if I can get treatment that I can buy over the counter, but most recently I needed my GP service, I was given an appointment for 4 weeks I attended the appointment was sent for an x-ray was told to wait two weeks before contacting my GP for a further appointment and was given an appointment for another 4 weeks 10 weeks in all no further on. With the acception for being told by the recptionist that she had looked at my file I did not need to see the doctor after a little persuasion by myself to the receptionist that actually it was my choice and i wish to see the doctors she proceeded to tell me that its a four week wait. who is the trained professional here.

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  • Sorry, am I missing something here? What is exactly so wrong about waiting 2 weeks for a non urgent consultation with your GP? Don't we wait 33 weeks for a 'routine' outpatient appointment in secondary care in Wales? I think I wait more than 2 weeks for an appointment with my dentist, bank manager, builder, electrician, hairdresser......and guess what? Things often get better of their own accord if you give them time!

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