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Nearly one in five patients attend A&E because they can’t see GP, claims Labour

Nearly one in five patients attend A&E because they can’t see GP, claims Labour

Labour has claimed that 18% of patients attending A&E did so because they were not able to get a GP appointment last year, amounting to 4.5 million attendances.

Leader of the party Sir Keir Starmer told The Guardian that this research showed the ‘collapse of general practice’, and said the NHS is ‘broken’.

Patients calling 999 waited for up to one and a half hour for their call to be answered, Labour also said.

The information obtained via FOI requests to NHS ambulance trusts, also showed that in December patients calling 111 waited up to three hours for calls to be answered.

Labour’s analysis revealed that last year one patient in the North West waited more than 40 hours to talk to a qualified clinician. 

Patients contacting the 111 service who needed a call back from a nurse in some instances waited more than a day to get a response, according to the FOI responses. 

Responding to the ambulance and 111 data, Dr Grant Ingrams, chair of the Leicestershire, Leicester and Rutland LMC, said figures like this are ‘an indication of a chronically underfunded service’.

He said: ‘You could say this about any part of the service – getting to see a consultant, getting to see a GP, a community nurse, a psychiatrist.

‘The waits across the whole of the NHS are indefensible. This is the sort of thing you’d expect to hear from a third-world country.’

Dr David Mummery, a GP in Kingston upon Thames, said ‘the demand is so huge’ and the ambulance service is ‘massively overrun and exhausted’.

From what he has heard from ambulance service colleagues, he noted that some patients’ ‘threshold’ for contacting emergency services like 999 has gone down, meaning they are making calls for things ‘that ambulances shouldn’t be called out for’.

The opposition party also cited NHS figures on ambulance waiting times which showed that in December patients with conditions like heart attacks and strokes waited on average 90 minutes for an ambulance to arrive. 

According to NHS ambulance performance targets, teams should respond to these types of conditions within 30 minutes, a standard which was recently lowered from 18 minutes for the year 2023/24.

In February, NHS England asked ambulance crews to review which emergency calls other than those classed as immediately life-threatening could be treated elsewhere, including GP surgeries. 

When asked about the impact of long ambulance and 999 call waiting times on GP practices, Dr Ingrams said it means ‘there’s a pressure for people not to call an ambulance when they should be’.

He said: ‘I’ve got patients who don’t like to phone them, who should be, because they know how busy the service is.’

Dr Ingrams also said sometimes ambulance crews will phone GP practices ‘to try and get us to take on the clinical risk of looking after the patient, rather than going to spend seven hours sitting outside an A&E department’.

Shadow health secretary Wes Streeting said: ‘After 13 years of Conservative mismanagement of the NHS, patients can no longer be sure their 999 call will be answered or that an ambulance will arrive when they need one. 

‘People are just praying they don’t fall ill or suffer an accident.

‘Labour will launch the biggest expansion of NHS staff training in history, paid for by abolishing non-doms, so that the NHS is there for us when we need it once again.’

Dr Sharon Raymond, a 111 GP in London and director of the Crisis Rescue Foundation, said the Labour Party’s figures, if correct, are ‘very troubling’, and agreed with the focus on training staff.

She highlighted the number of international medical graduates who ‘could be trained very quickly, bolstering the NHS workforce, including supporting paramedics’.

Dr Raymond added: ‘We need to be thinking about getting as many people appropriately trained up as we possibly can.

‘We’re seeing when there’s a pandemic, when the demand suddenly increases, it really stretches the NHS and we need to be really ready for those situations – and it is about having that extra person power.’

Over the weekend, the Labour Party pledged ‘thousands more GPs’ to ‘bring back the family doctor and guarantee face-to-face appointments to all who want them’. 

This was part of a promise to train 15,000 doctors a year, doubling the current figure, however GPs criticised the party’s focus on ‘soundbites’ rather than on meaningful policy.

Responding to the pledge for more GPs, chair of the RCGP Professor Kamila Hawthorne said: ‘It’s always encouraging to hear promises to grow the number of GPs in the UK – but we need to see comprehensive plans as to how this will be achieved.

‘Increasing medical school placements is a good and necessary start, but it will take a long time to see the impact of this on the front line, benefitting patients, and GPs and our teams are struggling now – we’ll also need to ensure a significant number of this expanded cohort of medical students choose general practice.’

The Labour Party sent FOI requests to NHS ambulance trusts asking for the longest wait for an answer to both 999 and 111 calls and the longest ambulance response time in each response category at the Trust in December 2022.

The responses revealed that the longest wait for 999 call handlers to pick up the phone was one hour and 37 minutes.

Labour’s separate research showing 18% of patients attended A&E because they could not get a GP appointment was based on polling of 1,500 adults which was carried out by Redfield and Wilton Strategies.



Please note, only GPs are permitted to add comments to articles

David Jarvis 19 April, 2023 12:00 pm

So one service is full to busting and that has an impact on another service. Sorry as an individual GP nothing I can do about my capacity apart from withdraw it completely because you lot moan about us all the time and blame us for not filling in for the inadequacy of a system over which we have zero control. Face bothered? Nope.

SUBHASH BHATT 19 April, 2023 12:54 pm

Give money to PCN to arrange out of hours service in place of 111. It will reduce a and e attendances.

Stephen Aras 19 April, 2023 1:06 pm

There are a number of factors, not all about money. We now have a culture that demands instant gratification and this of course has delayed ramifications. “Can’t see a GP” can likely be translated to “Can’t see a GP NOW” – Whatever the process we are now obliged to use – and we NEVER did the ‘8 O’Clock mad dash’ – It’s FAR better than the 3-4 week wait for an appointment. We triage online (eConsult) and those that need to be seen are usually seen within a day or two – But seldom NOW. A&E is ‘attractive’ because there is a belief that one will get seen ‘now'(ish) – The reality is of course that more urgent cases are triaged and seen earlier than non-urgent walk-ins but while I’m here I might as well wait. That there are GPs in many A&E departments somewhat defeats the argument of “which bit of your sniffle is an accident or emergency – Neither, well you’ve come to the wrong place – see your GP!” – Suitably funded of course. We get lots of A&E notes saying patients didn’t contact their GP and left before being seen. I wonder how much this skews the figures??

Fay Wilson 19 April, 2023 4:02 pm

If you count up the number that is tiny % of the total number of people who DO get to see their GP. If the resources currently going into NHS Trusts for this 18% of A&E patients were transferred into core GP funding, I bet GP practices would see more patients with it than Trusts do.

Sadly the LP is just using this to continue moaning about GPs without producing solutions. Can we tell the difference between one politician and another? Very disappointing.

Just My Opinion 19 April, 2023 4:35 pm

And the patients sent to GPs because the ambulance service is too busy?
Or the ones coming because the wait for an outpatient appointment is a year or more?
Or those directed by the pharmacist for paracetamol or canesten as they refuse to take any responsibility?
Lets highlight how GP is the dumping group for every other service who can not cope because they lack the capacity, the competence, or both.

Turn out The Lights 19 April, 2023 4:49 pm

Just more of the same red or blue.Not of them get it the service is broken,the good will is broken.They can clap their hands,they can stamp their feet like toddlers.To make the the system work the last 13+ years of austerity or pay restraint will not be reversed easily.It will cost the political establishment has lost the room workforce in the nhs are walking away.There are no solutions just inevitabilities.Red or Blue there are no changes to reverse the damage or get it working.The blame lies squarely with political system a. Busted flush of red and blue.

Faen Faen 19 April, 2023 10:58 pm

The Conservatives failed with a relatively modest target of 6,000 new GP’s. Labour are promising 2-3 times as many. More BS from the opposition. All to be employed on ‘murky’ contracts according to dimwit Streeting.

Fedup GP 20 April, 2023 7:45 am

To put it another way…1.4% of patients not seen in primary care results in an 18% increase in activity in A&E. Perhaps they are spending the money in the wrong place?

Anonymous 20 April, 2023 7:46 am

Agree with all of the above.

Amazon Prime society just cannot wait in line for their turn. Sadly, there is also quiet a lot of rich, entitled early retirees who have nothing to do but pester their clinicians about tests they have read about or borderline results with no symptoms.
All of the stuff ED would not even mention to them, but now they see on their apps.

Michael Green 20 April, 2023 8:40 am

The tsunami on the horizon is the 20 and 30 year olds who are now starting to have their own children.

Whereas a 25 year old’s notes might have in the past a few lines (vaccinations, one URTI, one AOM, one tonsillitis perhaps) now it is:

breastfeeding problem
CMPA / GORD (in reality regurgitation over feeding)
development concern
neurodiversity concern
tummy ache – bloods – paeds – constipation
letter to school about exams
request for dyslexia assessment
primary dysmenorrhoea
cannot tolerate x different COHC
premature ejaculation wants depoxetine
chronic penile pain (6 weeks, guilty itch, after holiday in Malaga)
early morning testosterone request
DocTap letter “needs specialist referral for hay fever”

Etc etc

I’m afraid £100 pa is not enough for the above.

Mark Howson 20 April, 2023 9:30 am

This is about 1% of GP consults. I have helped
Out in A&E recently and I find nearly al patients with problems that can be seen in GP were sent there by 111 advice.
The other two main driver to A&E is proximity of a patients home to A&E and/or having mental health problems.

Simon Gilbert 20 April, 2023 11:02 am

Nearly 1 in 2 patients attend a GP because: it’s a year before their dermatology follow up and the medication they were given doesn’t work and they want to know what to do; the mental health services feel this patient is best placed with weekly reviews with their GP for life; mental health gave zopiclone and benzos for a few months as ‘prn’ then discharged and advised patient to discuss with gp; hospital cancelled 2 appointments and the patient tried to rearrange more than once with a lot of notice so was discharged to GP; the hospital doctors want GP to arrange bloods then let them know the results but they have not given any way of contacting them; social services deflect all old people to ‘get a GP referral’; patient has just been discharged ‘to their home to die’ by hospital but it is a Friday afternoon and the ‘home’ is a new nursing home with a new GP; school is full of unopposed bullies and overcrowded lessons and child is refusing; neurosurgeons want GP to refer to pain clinic for a spinal injection then let them know how it goes so they can decide whether or not to do an operation; midwife told patient verbally ‘urine infection / low vitamin d / some kind of anaemia – see GP’; patient discharged after 6 weeks of hospital admission was on daily oramorph which was stopped as they were left the building and urgently needs a visit for severe pain; benefits agency/police/IAPT say patient mentioned self harm and you need to know; occupational therapy have assessed for wheelchair but form requires GP to complete etc etc

paul cundy 20 April, 2023 11:30 am

Dear All,
Should properly read “one in five patients CLAIM they attend because…..”. I’ve worked there, in OOH and as a GP. Patients lie. some may be genuine but most are not.
Paul C

Liam Topham 20 April, 2023 12:00 pm

Simon Gilbert, Michael Green – masterful posts! – add those two together and you have encapsulated modern general practice

Some" Bloke 20 April, 2023 12:55 pm

think we should all undertake regular audits (think modern term is QIA) to monitor activities listed in Just My Opinion and Simon Gilbert’s posts and put information out there- on our websites, FB pages etc. Public deserves to know why it takes a month to get a routine appt. Agree that it feels that nearly a third of my workload is due to issues highlighted above, third- dealing with lifestyle induced self inflicted illness, last half- dealing with complaints arising from all this mess

Rogue 1 21 April, 2023 11:08 am

Quite agree Paul famously said by Dr Gregory House ‘All patients lie’

Sam Macphie 21 April, 2023 5:29 pm

So many doctors are saying the NHS is broken, so why shouldn’t politicians agree with that? Also, comments about people waiting 2 weeks to discus, chat about normal results hardly seems the best use of anybody’s time and is 2 weeks or more of unnecessary wait and worry for them. The Tories themselves eg Braverperson have admitted having broken systems in other areas like immigration, so why not a ‘broken NHS’ too. Politicians are entitled to discuss and make comments (a bit like GPs).