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Over one third of GP practices forced to stop routine care in the past year

practices closed for routine care

Exclusive Over one third of GP practices have been forced to stop routine care in the past year, a major Pulse survey has revealed.

Of over 800 GPs surveyed, 35% said they have had to stop taking bookings for routine appointments at any point in the last 12 months.

The GPs, from across the UK, said this was due to unprecedented patient demand and staff shortages across general practice. Covid absences have also played a part.

It comes as March saw GPs in England deliver the highest number of patient consultations since records began, according to NHS Digital data unveiled last week (Thursday 28 April).

Lanarkshire local medical committee (LMC) medical director Dr Tyra Smyth told Pulse that the ‘distress and illness burden is currently higher than pre-pandemic’, driving ‘ever-increasing demand’.

But she added that GPs also need to ‘open conversation with the public’ about ‘which healthcare is clinically urgent’.

Kent LMC chairman and GP Dr Gaurav Gupta told Pulse: ‘It is not surprising that practices have at times been unable to provide the services they want to provide for their patients. 

‘GP numbers have been constantly falling and have decreased by thousands in the last few years. This is unsustainable and puts GPs and practice staff under enormous pressure and risk of burnout, as well as having a potential negative impact on patient care.’

He added: ‘We need the Government to deliver on its commitment of getting an additional 6,000 GPs in England by 2024 and reduce the unnecessary bureaucratic burden on practices.’

Midlothian GP Dr Amy Small told Pulse that ‘lots of staff sickness has had to force urgent-only contact on several occasions’ at her practice.

She said it has been a mixture of Covid and non-Covid related illness.

Norfolk & Waveney GP partner Dr Nick Morton said his practice has had to halt bookings for routine appointments.

He told Pulse: ‘We operate a safety valve system which is explained to patients so when we are overwhelmed, we stop pretending we have enough resources’.

He said: ‘Patients are directed to the walk-in centre, local pharmacies or if they perceive it to be an emergency, the A&E department, although the reception team have a list of presentations for which this does not apply which includes the vulnerable and end of life patients.’

He added that it is not used often but gives practice staff a ‘sense of being able to cope when deluged with demand’.

Northumberland LMC lead officer Dr Jane Lothian told Pulse ‘most practices’ have been ‘inundated’ with demand.

She said that practices have done their ‘utmost best to continue whatever they can, but there have been times when some of them have been under such pressure that they’ve had to stop some services’.

She added that ‘the pressures from Covid and Covid absences and everything has caused considerable difficulties’.

However she added that the Covid absence situation is ‘hopefully getting a lot better at the moment’.

Asked how we can ensure practices don’t have to stop routine care in future, Dr Lothian said: ‘It would be very nice if we got the same degree of investment as secondary care. That would considerably help. And a proper approach to workforce strategy in the health services.’

Other practices have been forced to switch of electronic access to patients, due to overwhelming demand.

A GP from Liverpool, who wished to remain anonymous, said his practice ‘initially switched off e-consultations at weekends, then overnight, and now when we reach a point where the workload and capacity would be unsafe due to massive demand’.

They said they still have to switch it off daily and will often do so in the morning.

In December, NHS England asked GP practices to ‘clinically prioritise’ Covid booster jabs over routine care, but asked them to restore routine services in January.

At the start of the year, Covid pressures forced GPs to provide ‘urgent-only’ services in two areas, while a BMA survey revealed that almost 70% of GPs have seen staff shortages affect patient care.

More recently, a number of GP practices had to shift to urgent-only care after staff Covid absences left them struggling to maintain regular services.

Survey question in full

Have you had to stop taking bookings for routine appointments at any point in the past 12 months?

Don’t know89
Total who answered this question: 824

The survey was open between 25 February and 3 March, with all UK GPs asked to respond to these particular questions. It featured a range of questions on various topics.

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David Church 3 May, 2022 8:33 am

I do not believe that two-thirds of GP practices remained fully open for all routine bookings for the whole of the last 12 months with no interruptions due to sickness absence, nor shortage of blood sample tubes – we had to stop routine phlebotomy because instructed so on account of lack of sample tubes, and most practices around have had short periods with only minmial cover while staff off sick with covid!

David Church 3 May, 2022 8:38 am

I know this is reporting results of a survey, but i think someone should have checked the accuracy of the responses supplied. I do not think the headline reasonably reflects the facts in terms of access to routine appointments in toto.
Perhaps too many practices had been unable to recommence routine work prior to the 12-month period?
Our local surgery has severe limitations to access for routine and urgent patient problems, and many routine appointment ‘types’ are still not available on a widespread basis – such as copd reviews.
I am sure the one-third result is way under-counted.