A GP speaks from the very, very sharp end with shocking information

A Devon GP shared this on the Save our Hospitals website:

“I put this post on my constituency [Labour] womens FB group.

I am an NHS GP- ex partner at ELM surgery- went off with burnout 2014- locuming since 2015 including at 2 practices that have handed back their contracts one has closed and the other in merging with Mount Gould.

I went to an important meeting last night- Arranged by GPs worried about the situation in Primary care in Plymouth and looking for a way forward.

About 30-40 GPs turned up (not bad for a short notice meeting on a Friday night which started when most of us would normally be at work!) We also had some patients representing their practices’ Patient participation groups and someone from Health Education England (responsible for workforce planning in the future/training GPs etc). Luke Pollard- Labour MP was the only MP to turn up. I know it was short notice (I think the venue was only confirmed on 2/1/18) but even so you would have thought may be the potential collapse of Primary Care in your constituency may be quite important to any MP?

It was a great opportunity for us to share issues and think about what could solve them and this is the summary:

Firstly – our wonderful NHS is one of the more cost-effective, safe and efficient health systems in the World and GPs are very cheap and cost effective within that.

Primary Care throughout the UK is being overstretched because of major cuts to services that support particularly our most vulnerable patients- cuts to: Mental Health Teams for adults and children, MIND and other charities, Drug and Alcohol services, Probation, Health visiting, School nurses, District nurses (40% vacancy rates in Plymouth), Social Care and unfair benefit cuts and sanctions etcetc.

Plymouth has a population with higher levels of deprivation than the UK average. These cuts are therefore more severely affecting our Primary care services (but there are similar problems in many similar areas).

Secondly: The NHS and Social Care have been severely underfunded for the past 7 years and now this has reached a tipping point.

GPs are working longer hours, seeing more patients and trying to continue to provide excellent, cost-effective care but are becoming burnt out and demoralised and therefore are retiring early, leaving permanent positions or leaving the UK or medicine.

It is also harder to recruit practice nurses as there is a massive shortage of nurses nationally. As practices are becoming more short staffed the remaining clinicians become even more pressurised and eventually become ill or leave or hand back their contracts.

Now 12-13% of Plymouth patients are from “failed practices”. We have a shortfall of between 26 (LMC figures) and 35 (Healthwatch figures) Full time equivalent GPs in Plymouth. Caretaker organisations – which look after these patient populations until new providers are found- are paid much more per patient than GPs are- I have heard unsubstantiated quotes of £300 per annum compared with GPs £115 per annum if we tick all the Government’s boxes and claim everything we can.

This works sort of as an insurance system where those that need little care sort of subsidise us for the patients that need a lot of care. Yet there is no money or help from NHS England forthcoming to go to practices before they fold. Also neighbouring practices are being put under extreme pressure because NHS England is not allowing any planning for the new patients. Adjoining practices must just keep their lists open without any inkling of how many patients could ultimately join their list. (my friend’s practice may have to take between 0 and 1800 patients within the next 3 months as an adjacent practices closes- when a similar thing happened in 2006 they were allowed to have a planned list of patients and recruit staff to serve those extra patients, WELL in advance)

We are also not allowed to move notes direct to the adjoining practice and Capita is taking 6 months to move notes between practices (much less when NHS run) and the GP2GP computer transfer is only working for 1 in 3 patients. Most patients who move before their practice closes are the ones that require the most care and are the most complex. The other patients, who maybe only see a GP every few years do not move until they need care again therefore effectively financially disadvantaging the new practice too.”