We do understand that our patients are concerned with the current wait times for routine appointments at our Practice. We would like to share a little more about the current climate in Primary care, to give greater awareness to the access challenges we, like all other GP Practices in the UK, are facing.
The demand on Primary Care services has increased significantly both in terms of the numbers of consultations and the length of the consultations taking place. Along with the increased demand to see GP’s, the complexity of patients’ problems has also increased, which in turn has seen the average attendance to the Practice more than double versus previous years. Various NHS studies show that people aged 50 or over are now presenting with two or more long term conditions which require a complex management from the whole clinical team but largely managed by the GP. This in turn requires more medicine management which can rarely be managed during a typical 10-minute consultation.
With rising demand and clinical complexity, the number of UK GPs continues to fall, a trend that, unless adequately addressed by the UK Government, appears likely to continue. Reduced funding and the pressure within the system also makes the GP career less attractive to newly qualified doctors, making recruitment particularly challenging for General Practice. With all the increased pressure on the role, long term sickness amongst existing GPs is a continual concern and those wishing to remain in the service are rightly looking to better manage their own work life balance. This results in the need to recruit more GPs to join the team to enable the Practice management to fulfil the GP sessions required to meet the local demand.
There is also disparity in the perception of what a GP does in a working day which can result in unfair criticism of the profession. A GP in our Practice will see more than 30 patients a day. They also deal with phone calls and complex home visits. On a very busy day, the duty doctor can have contact (by phone or face to face) with between 80 and 100 patients. GPs also each receive between 50 and 100 tasks and test results each day which they must deal with.
GPs are expected to undertake regular training and must keep their detailed training portfolio up to date. GPs also have to attend meetings and be involved in local decision-making or fulfil other roles such as safeguarding lead or mentors to student GP’s. There is huge pressure to move more services out of hospitals into the community but instead of funding being increased to help GPs deal with this additional work, it is being cut.
In addition, in an average month, more than 100 hours of GP surgery time are wasted because patients book appointments for which they fail to turn up. If all our patients had a responsible attitude and cancelled any appointment that they no longer needed or could not attend, the wait for a routine appointment would be shorter.
To give you an idea of the scale of the problem we can report the following figures for June 2023
Total missed GP appointments = 247
Total Did Not Attend (DNA) All appointment – mixed types- for June = 734
As GP appointments are a particular concern, we have broken down the missed GP appointment numbers below
Total GP Appointments wasted by failure to attend = 247 appointments
– GP Appointments = 150 appointments (26 hours) – this is F2F or telephone appts the patient has booked themselves
– GP Appointment = 26 appointments (4 hours) – this is appointments that were requested by GP or IAC for a review or F2F appointment
– GP Locum = 40 appointments (7 hours)
– GP Registrars = 31 appointments (9 hours)
Where we have mobile phone numbers registered on patient records, we send SMS reminders about the appointments booked. We also regularly communicate our 24-hour cancellation line and currently rely on patients being responsible and cancelling the appointment if they no longer require it. In other Practices, where there is more than one surgery in the location, the GP Practice will have a policy to delist patients who fail to attend their GP appointments on three or more occasions. As the sole GP Practice in Melton Mowbray, we are unable to put this policy in place as we are aware patients don’t currently have the option to register elsewhere locally. We are however looking into how we can be more proactive in managing appointment attendance. Unfortunately, this will mean additional work and cost to the Practice, which we can ill afford, to maintain this increased communication.
We would like to thank the vast majority of our patients who use our services sensibly and considerately and urge them to continue to seek help or advice when needed. Please be assured that, although you may sometimes have to wait for a routine appointment, we will always have arrangements in place to deal with truly urgent medical cases on-the-day. However, these arrangements will only work if they are not abused by the very small minority of patients who insist on immediate access for minor or self-limiting illness.
We remain committed to our recruitment and retention strategy and have had some success this year with recruiting three new GPs to our team, Dr Waddingham, Dr Finn and Dr Saxena. Given the challenges faced with recruitment in this sector, we were delighted to be able to offer these GP’s positions at our Practice.
We also continue to recruit locum GPs to cover sessions and would like to apologise to patients who may not have had the consistency we would like to provide with their family GP.
We would appreciate your continued understanding and support.