British Medical Association survey of more than 2,800 GPs also found 68% regard their workload as unmanageable as ‘pointless paperwork’ takes toll

This article is more than 4 years old

This article is more than 4 years old

Family doctors have warned that the service patients get from their local GP surgery is getting worse because they cannot cope with “an avalanche of workload”.

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In a new survey of 2,837 GPs, 55% said the quality of the service they provide has deteriorated in the last year. It shows that too many patients are no longer getting the appointments, treatment and range of services they need.

The survey, which covered 35% of all England’s 7,962 GP practices, also found that 68% of family doctors regard their workload as unmanageable some or all of the time.

“These figures clearly show that general practice is in a state of emergency, with the majority of GP practices across England registering a deterioration in the quality of care being delivered to patients,” said Dr Beth McCarron, a member of the GP executive team at the British Medical Association (BMA), which undertook the research.

“Behind these figures is the real impact on a GP service that is being starved of resources and staff. I share the frustration of patients who can’t get the appointments, treatment and services they deserve.”

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She identified the growing number of frail and older people who often have several things wrong with them as a key driver of pressure on GPs.

“But the problem we face is that an overworked, overstretched GP workforce is being buried under an avalanche of workload, including pointless paperwork generated by a box ticking culture and the sheer number of older patients coming through the surgery door who need intensive, specialised care,” said McCarron.

“This is having a direct impact on the services that patients are seeing at their local GP practice and it cannot go on.”

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The findings come weeks before the health secretary, Jeremy Hunt, plans to unveil an emergency package of measures to relieve the growing strain on family doctors. He is keen to tackle what GPs say are the rising and unsustainable pressures on them, which are also caused in particular by hospitals giving them ever more responsibility for the medical management of patients who have been treated and then discharged back home.

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Two-thirds of GPs in the south of England said service had deteriorated in the last year – the highest proportion of any part of the country. The east Midlands had the lowest proportion, at 51.3%.

The West Midlands had the highest proportion of GPs – three in four (74.7%) – who said they could not keep up with their workload. Among those, it was “unmanageable a lot of the time” (58.7%) or “unmanageable all of the time” (16%).

Another 30% said it was “generally manageable, but too heavy at times” and only 2% said it was “low” or “generally manageable”.

The Department of Health sought to play down the findings and stressed that they were not representative of GPs as a whole because they were based on the views of only one in three of them.

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“General practice is at the heart of the improvement we want to see in the NHS,” said Alastair Burt, the health minister. “We recognise absolutely that it is under pressure, which is why we are delivering record investment, with funding for the sector increasing by about 5% every year for the rest of the parliament, as we commit to 5,000 more doctors in general practice [in England by 2020].

“The health secretary will shortly announce further support for GPs, which should assist in meeting the pressures doctors are reporting.”

Local medical committees, which represent GPs across the UK, held an emergency meeting last weekend to demand urgent action to reduce the burdens under which they find themselves.

Dr Chaand Nagpaul, the chair of the BMA’s GPs committee, told delegates that the government’s drive to introduce a fully fledged seven-day NHS could potentially undermine patient safety by deflecting family doctors from seeing patients during normal weekday hours.

The BMA’s survey also found that 92% of GPs had seen demand for appointments grow over the last year.

More and more surgeries are closing because GPs feel they can no longer cope with their increasing workload.

Last week the Queens Road medical centre in Leicester announced that it would close on 1 April. Dr Jonathan Lenten, who helps run it, said: “We have been a family practice in Leicester city since the 1920s and have been privileged to provide caring and personal medical services to generations of patients.

“Unfortunately, in the current healthcare environment, small practices are becoming unviable, as the workload has reached an unsustainable level and access to funding is becoming more and more difficult for practices which are set up like ours in the traditional way.”

NHS Leicester city clinical commissioning group, the local GP-led NHS organisation that funds care in the area, has advised patients affected by the closure to register with one of 23 other surgeries which are within one and a half miles of the Queens Road practice.

Meanwhile, leaked figures appear to show that the number of young doctors applying to become trainee GPs has fallen to a record low. Data obtained by Pulse, a website for GPs, cast fresh doubt on the government’s pledge to increase the GP workforce in England by 5,000 by 2020.

Health minister Alistair Burt said: “The health secretary [Jeremy Hunt] will shortly announce further support for GPs, which should assist in meeting the pressures doctors are reporting.”