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Half of GPs say patients came to harm from cancelled operations last winter

Exclusive GPs have revealed the extent to which patients were put at risk of harm, including death, as a result of hospitals struggling to deal with winter pressures last year.

More than half of GPs (52%) responding to a recent Pulse survey said hospital delays to operations last year due to winter pressures had led to avoidable emergency admissions among their patients.

The same percentage said their patients developed complications of their original illness during the 2017/18 winter, as a result of postponed operations.

Last year NHS England told hospital trusts just before Christmas to defer all non urgent in-patient elective care ‘until mid-January’.

The postponement of non-urgent operations and appointments was later extended to the end of January, with Pulse revealing at the end of February that a number of hospitals had still not fully resumed all procedures.

Pulse’s survey of 750 GPs, carried out in November, also revealed 46% of GPs saw their patients’ treatment escalated last winter due to pressures in the acute sector.

In addition 43 of the 750 respondents – almost 6% – said the pressures led to the avoidable death of a patient (see chart).

One GP taking part in the survey recalled ‘a memorable case – a middle-aged man with young child, agonising renal stones, lithotripsy cancelled, delayed, leading to GP visit to beg me to contact hospital.’

Another respondent said: ‘A patient with a delayed total knee replacement had a fall that was mobility related. They had a neck of femur fracture, were still waiting for TKR. They were also waiting for a lap chole and had several A&E attendances.’

Dr Michelle Drage, chief executive of Londonwide LMCs said: ‘We are concerned that once again winter will see the NHS attempting to compensate for a lack of capacity in hospitals by pushing activity into general practice, which is symptomatic of investment failing to keep up with demand across the whole health and social care system.

‘Caring for people in general practice when they should be getting hospital treatment only compounds the problem, taking up GP and practice nurse time which would be spent keeping people healthy in the community and out of secondary care. It also places even greater pressure on practices struggling with workforce shortages, increased demand and winter pressures.’

She added: ‘The usual seasonal gifts of cash to trusts are no substitute for sustained investment in general practice, community services and hospitals, which is required to create a system which properly supports its workers and patients.’

Professor Helen Stokes-Lampard, chair of the RCGP, said: ‘It is important for politicians and policymakers to remember that GPs, and not just hospitals, are also operating under enormous strain on the frontline of patient care, and our profession – and our patients – are now facing the adverse impacts of these pressures on a daily basis.

‘Our workload has increased by at least 16% over the last seven years, but investment in our service has not risen at the same pace. We will always do our absolute best for our patients, but demand is rising at the same time as we have a severe shortage of GPs and there is a limit beyond which we can no longer guarantee safe care.’

An NHS spokesperson said: ‘The actual number of cancelled planned admissions was just 3% in January this year, despite significant pressure across the health service. The NHS already has extensive plans in place for this year, including increased access to clinical advice through NHS 111 as well as evening and weekend GP appointments.’