A GP was forced to field 84 patient appointments in one day last year as the 2013/14 GP contract imposition created an untenable workload.
The Holbrooks Health Team in Coventry submitted a workload report to the local area team of NHS England which showed that one GP undertook 84 appointments on 1 August 2013, and revealed that a GP had seen more than 60 patients in a day on 34 different occasions over the two-year period covered bu the report.
The practice blamed the imposed changes to QOF for a rapid deterioration in the availability of appointments and concluded that it may have to drop chunks of QOF work related to long-term conditions such as diabetes because it was loss-making – threatening instead to refer all to hospital as outpatients.
Dr Ken Holton, one of the GPs at the practice, said: ‘This was an internal analysis performed by the practice concerned because appointment availability declined from very easy to terrible – despite the introduction of telephone appointments, which made it worse – just in the space of a few months, associated with the QOF changes to shorter intervals and higher targets.’
In concluding the report, the practice said: ‘The diabetes element in QOF already costs more to perform than it produces in revenue. The proposed “bundling” of indicators renders the disease unsuitable for delivery in primary care and all patients with diabetes should be referred to hospital for treatment with immediate effect.’
However the practice has opted against taking up the recommendations in full after discussions with its patient group.
Dr Holton said: ‘The recommendations were those proposed by the doctors for discussion with the patient group representatives and the NHS England Area Team. That meeting was in March, since then a new appointment regime has been drawn up and may be implemented in the next couple of weeks.’
‘The diabetes workload was given a thumbs down by the patient group who said they didn’t want to go to the hospital all the time. We have slightly increased our referral rate however.’
It comes as an RCGP poll showed many GPs are now working 11 hour days with 60 patient appointments in one day.