New GP contract ‘will see more GPs quit and patients wait longer for care’

I think the shortage of medical staff is worldwide Zoejory because Australia, New Zealand, Canada, and other first world countries are all short of the professionals they need.

It appears that a shortage of medical staff is happening all over Europe. My cousin in Alaska also cites the same problem. She's having massive problems getting appointments for her and children. Anecdotal of course but after a swift google I found this.

Apparently Europe is a million short

"The challenges across the Members States are similar: in the sense that it is not possible for health systems to deliver high quality care to all Europeans without a health workforce in sufficient numbers, with the right skills and in the right places.

There is an estimated shortage of nearly 1 million health workers in Europe. There is also a ‘brain drain‘ of doctors and nurses who move to countries with better working conditions and pay, leaving other countries with shortages.

Equally worrying is the skills mismatch among health professionals, which wastes human capital, strains public resources and undermines the cost-effective delivery of healthcare.

We also need to ensure that technological changes in healthcare are adjusted to the needs of the health workforce as well as of the patient, that the workforce can adapt to new situations and that the changes do indeed improve care delivery.

There is no one-size-fits-all solution - each Member State must develop its own reforms according to the needs of its health system."

health.ec.europa.eu/other-pages/basic-page/health-eu-newsletter-250-focus_en

Deedaa

So it looks as if it will mean less people being told "Sorry try again tomorrow" but others left holding on even longer while decisions are made about where they should go. I'm not sure how helpful this will be. For me the big problem is shortage of GPs leading to no continuity of care. Over the last few months I've had one GP worrying about whether I might develop diabetes, another worrying about my kidneys and another wondering if heart failure might be the problem. none of them seem to speak to each other and I never hear from them about the results of tests they order. If I ask about results myself I'm told that the doctor says they were normally. Naturally I've never met these GPs in person.

I don't think it will work like that at all. If it's anything like my GP practice, it's almost impossible to get a "first contact". The surgery shuts down the online triage system when they can't cope with any more requests and the receptionists won't speak to anybody, unless it's an emergency or for a child.

What is being envisaged is a 111-type system with a form to fill in. The algorithm will direct people to a pharmacy, nurse, GP, A&E or recommend home treatment. The "first contact" will be with a computer.

I agree with you Deedaa. One of my biggest issues is the lack of continuity of care.

PS. You can insist on a print-out of your test results. I was doing that for years before I got online access to them. It's quite shocking how many times the results have come back with a "discuss with GP" message, but I've not been contacted.

Luckygirl3

growstuff

As somebody with at high risk for a stroke or heart attack, I'd love to know what the government intends. I can't get an appointment for my routine annual check up for love nor money. I'm quite savvy about looking after my own health, but I'd love to know how GPs are going to reach those who aren't that aware, when getting a GP appointment is like breaking into Fort Knox. The real issue - which is a shortage of doctors - isn't being addressed, but probably been made worse.

At least the words annual health check are known to your GP practice Nothing like that here.....

Where's "here"? Diabetic check ups are part of a GP's contract with the NHS.

growstuff

As somebody with at high risk for a stroke or heart attack, I'd love to know what the government intends. I can't get an appointment for my routine annual check up for love nor money. I'm quite savvy about looking after my own health, but I'd love to know how GPs are going to reach those who aren't that aware, when getting a GP appointment is like breaking into Fort Knox. The real issue - which is a shortage of doctors - isn't being addressed, but probably been made worse.

At least the words annual health check are known to your GP practice Nothing like that here.....

Do you have the NHS App Deeda? I can enquire about test results via the app and my GP will ring me back with results.

So it looks as if it will mean less people being told "Sorry try again tomorrow" but others left holding on even longer while decisions are made about where they should go. I'm not sure how helpful this will be. For me the big problem is shortage of GPs leading to no continuity of care. Over the last few months I've had one GP worrying about whether I might develop diabetes, another worrying about my kidneys and another wondering if heart failure might be the problem. none of them seem to speak to each other and I never hear from them about the results of tests they order. If I ask about results myself I'm told that the doctor says they were normally. Naturally I've never met these GPs in person.

growstuff

So does the surgery have an arrangement with other surgeries? I don't understand how that would work.

It was a walk-in centre elsewhere in the suburbs of the city. I don't know how they arrange it. It's miles away from them. And a really different social demographic too so I can't imagine the posh people who use that GP being happy sent there.

Thank you GagaJo for bringing this to the attention of Gransnetters. It is very worrying, but the situation regarding GPs has been worrying for some time. Things are certainly not going to get better. We have insufficient GPs.

So does the surgery have an arrangement with other surgeries? I don't understand how that would work.

growstuff

I assume your surgery is part of some chain. To be honest, that wouldn't bother me too much. It's the norm now that there aren't any appointments, so being offered one elsewhere would be great and take some pressure of those who do need one locally.

I'm more bothered by the shortage of doctors and the outsourcing at every opportunity.

No, it's just one. It has two sites but one overall head of the practise.

From my long experience of working with GPs and their practices and managing a few of them I am confident that their professional bodies will get a good deal out of the government even if their working arrangements have to change.

I assume your surgery is part of some chain. To be honest, that wouldn't bother me too much. It's the norm now that there aren't any appointments, so being offered one elsewhere would be great and take some pressure of those who do need one locally.

I'm more bothered by the shortage of doctors and the outsourcing at every opportunity.

What this means at my surgery is that if they don't have appointments at our local surgery, they book appointments elsewhere. Great if you can drive to the other side of the city (the walk-in centre), but what about the elderly, people without cars (public transport not available between the 2 areas)?

As somebody with at high risk for a stroke or heart attack, I'd love to know what the government intends. I can't get an appointment for my routine annual check up for love nor money. I'm quite savvy about looking after my own health, but I'd love to know how GPs are going to reach those who aren't that aware, when getting a GP appointment is like breaking into Fort Knox. The real issue - which is a shortage of doctors - isn't being addressed, but probably been made worse.

An update to the contract to ‘make clear that patients should be offered an assessment of need, or signposted to an appropriate service, at first contact with the practice

I'm trying to get my head round the implications of this in practice.

"First contact" will, in most cases, be the triage service. In my practice, this is about to be outsourced to a private provider. The idea is that patients can't request an appointment with a doctor. They write what's wrong with them and the triage service directs them to a pharmacist, practice nurse, physio or doctor or whatever.

It should (in theory) mean that doctors only see patients who can benefit from medical treatment which only a doctor can provide. However, it destroys any doctor/patient relationship. People are going to need to "tick the right boxes" on the triage form, so that vague symptoms are taken seriously.

It's been known for ages that the government wants to move to more remote consulting. If you're in Durham, you could very well end up with an e-consult with a practitioner in Cornwall. It's going to be a bit like 111. I don't think GPs want to be part of a glorified call centre. The days of the "family doctor" are over.

I think that basically GP practises are being expected to provide a lot more (list below) with no extra funding.

* An update to the contract to ‘make clear that patients should be offered an assessment of need, or signposted to an appropriate service, at first contact with the practice’

* The majority of the IIF – worth £246m – will be entirely focused on improving patient experience of contacting their practice and providing appointments within two weeks;

* Changes to the childhood immunisations payment system, with lowered thresholds for the QOF targets;

* The number of indicators in the IIF to be reduced from 36 to five (worth £59m), focusing on flu vaccinations, learning disability health checks, early cancer diagnosis as well as the two-week access indicator;

* Changes to the additional roles reimbursement scheme, including adding advanced clinical practitioner nurses to the reimbursable roles, increasing the cap on advanced practitioners to three per PCN and removing the caps on mental health practitioners.

GP teams will also step-up preventive action against heart attacks and strokes over the next year, with health professionals encouraged to prescribe statins alongside other preventative measures such as exercise to a much wider number of patients with heart disease, arterial disease and those who suffered a stroke or who have high levels of cholesterol.

Acting GPC chair Dr Kieran Sharrock said: ‘This hasn’t been properly considered, ramping up GP workload, and without the support needed, will lead to more GPs leaving the profession.

According to Dr Sharrock, the GPC had hoped to collaborate on contract negotiations, but has been repeatedly disappointed with the lack of support for struggling practices.

Dr Sharrock said the recent meeting with the health secretary was merely a ‘tick-box exercise’.

Local TV showed a 'day in the life' of an experienced Dorset GP. She had 20x15min appointments (inc 2 no-shows when she got on with admin including writing to a hospital consultant) 9am-2pm? She was then the afternoon 'GP on-call' (phone & online consultations and emergencies). Then admin. She left work at 7.45pm.
(I hope I've got that all correct.)

Wow!

A new general practice contract will lead to more GPs leaving the profession and more patients waiting longer for care, the acting chairman of the General Practitioners Committee (GPC) England has said.

Remember this is a statement issued by a body in a direct pay and conditions conflict with the government. It will be part of the PR operation around all such deals, by both sides.

I am neither for or against. Just standing back and watching the games people play.

What is it that GPs are objecting to in the new contract; do you know, GagaJo?

The article isn't very informative.