Seven-day NHS plan puts weekday surgeries at risk, warns top GP

Britain’s top GP has said surgeries will have to stop seeing patients during the week unless ministers abandon their drive to guarantee access to family doctors at weekends.

Dr Helen Stokes-Lampard condemned the policy, a key Conservative pledge, as unrealistic and said it was ignoring the lack of demand among patients to see GPs at weekends and a serious shortage of family doctors.

The government has promised to ensure that people in every part of England will be able to see a GP from 8am to 8pm every day of the week by 2020 as a key element of its push to create a “truly seven-day NHS” by the end of the current parliament.

“It’s unrealistic in the current climate. We haven’t got the people, we haven’t got the resources. If you give people access on a Sunday afternoon they’re not going to have access on a Tuesday morning. They can’t have it all”, the chair of the Royal College of GPs said in an interview.

Calling for surgeries weekend opening to be restricted to Saturday mornings, Stokes-Lampard said: “We should be responding to what is needed in an area, and balance that realistically by what can be provided safely. Because quite frankly if you open on a Sunday afternoon but you’re closed on a Tuesday morning, who’s going to benefit?.

There is so little demand from patients to see a GP on Sundays that plans to compel at least one surgery in each area to open on that day by 2020 should be dropped, she said. Nor do many people want to attend a surgery on a Saturday afternoon, she added.

David Cameron pledged access to GPs from 8am to 8pm seven days a week at the Conservative party conference in 2014, and established a £50m “challenge fund” to deliver it. Some surgeries that have begun opening at weekends, however, have scrapped their experiment because of the small numbers of patients seeking appointments on Saturdays and Sundays.

The chair of the Royal College of GPs, Dr Helen Stokes-Lampard. Photograph: Andy Hall for the Observer

A relentless rise in the need for care is prompting more GPs to retire early or move abroad, leaving the profession facing a growing workforce crisis and patients facing long waits for appointments, Stokes-Lampard said. As a result “we’re layered too thin at the moment, we’re spread too thin. We can’t sustain a good five-day service at the moment, a seven-day service is unrealistic. If we can’t provide eight to six Monday to Friday because we’re stretched to breaking point, we’re certainly not going to be able to provide seven days a week.”

She said general practice was “closer to the edge than it has ever been in living memory”, and cast serious doubt on ministers being able to fulfil another key NHS pledge – to increase the number of GPs in England by 5,000 by 2020 compared with 2015. It will be very hard to deliver that number without many GPs coming from overseas or former doctors being persuaded back into work, she said.

The Liberal Democrat MP Norman Lamb, who was a coalition health minister until May 2015, denounced the pledge of access to GPs all day and every day as a “superficially attractive gimmick”.

“This target is driven by seductive headlines, not sound policy. It will distort priorities and resources away from action which could make a real difference to people’s lives, such as ensuring that people have both their physical and mental health needs effectively met in primary care,” he said.

“No one believes that there will be sufficient resources to deliver this plan. The risk is that it will leave dangerous gaps in provision during the week.

“Pursuing superficially attractive gimmicks like this amounts to a smokescreen for the dire threat the NHS and care system now faces as it is starved of the resources it needs to provide effective, prompt and safe care.”

The shadow health secretary, Jonathan Ashworth, said: “These serious doubts about a flagship government pledge will raise widespread concerns. It’s yet another warning about the scale of the underfunding and understaffing now impacting our NHS.

“In her six months as prime minister Theresa May has shown no regard for the state of the NHS, so it’s no surprise it now looks like her own manifesto commitments will be broken.

“But in 2017 the government simply must not carry on ignoring the warnings. Instead they need to come forward with a genuine plan to give the NHS and social care the resources they need to deliver the very best care every patient deserves.”

The Department of Health insisted the government would achieve its ambition of seven-day opening, and that the policy was popular. “This is a common sense reform with wide public support, and one we will deliver”, a spokeswoman said.

“People don’t just get ill Monday to Friday, nine to five, and 18 million patients now have weekend and extended access to a GP, which has already shown evidence of relieving pressure on other parts of the NHS.

“To deliver our pledge, we are putting an extra £2.4bn into GP services, which will help expand the workforce.”

Seven-day NHS plan puts weekday surgeries at risk, warns top GP

GP companies are imploding as surgeries "at threat of closure"

He will tell 500 delegates: “We’re forced into supplying conveyor belt care at breakneck pace.

“Ministers disregard this workforce crisis at their peril which seriously dangers leaving individuals bereft of a GP service in some locations.

“I urge politicians to open their eyes and wake up to the reality that general practice is not just in crisis, it’s imploding.”

One practice in Cumbria is facing closure meaning patients would have to cross a lake to reach the nearest GP.

Other folks in inner city places are also below strain and neighbouring practices are too total to get on far more individuals, the BMA stated.

It has emerged that GP practices are underneath this kind of stress they are getting rid of patients from their lists by shrinking their boundaries.

Medical doctors are also struggling ‘burnout’ with older GPs retiring early or turning out to be locums even though youthful medical doctors are shunning general practice to function in hospitals as an alternative, Dr Nagpaul said.

Maureen Baker, chairman of the Royal School of GPs said: “What we are seeing now is a sad consequence of the desperate shortage of GPs in numerous parts of the nation, and many practices are obtaining it tough to locate replacements for people doctors that have retired.

“This is leaving basic practice teetering on the brink of collapse and obtaining a extreme affect on the care we can supply for individuals.

“Family physicians are heaving beneath the strain of increasing patient demand, due to a expanding and ageing population, and plummeting investment.”

GP companies are imploding as surgeries "at threat of closure"

GPs" surgeries "at danger of closure"

He will inform 500 delegates: “We’re forced into offering conveyor belt care at breakneck velocity.

“Ministers ignore this workforce crisis at their peril which critically hazards leaving patients bereft of a GP services in some locations.

“I urge politicians to open their eyes and wake up to the truth that standard practice is not just in crisis, it is imploding.”

A single practice in Cumbria is dealing with closure meaning patients would have to cross a lake to reach the nearest GP.

Other folks in inner city areas are also under stress and neighbouring practices are as well complete to get on much more sufferers, the BMA mentioned.

It has emerged that GP practices are underneath this kind of stress they are removing individuals from their lists by shrinking their boundaries.

Medical professionals are also suffering ‘burnout’ with older GPs retiring early or turning into locums even though younger physicians are shunning common practice to operate in hospitals as an alternative, Dr Nagpaul said.

Maureen Baker, chairman of the Royal School of GPs explained: “What we are seeing now is a unhappy consequence of the desperate shortage of GPs in several elements of the nation, and several practices are finding it difficult to find replacements for individuals physicians that have retired.

“This is leaving general practice teetering on the brink of collapse and obtaining a extreme influence on the care we can offer for individuals.

“Family doctors are heaving under the strain of growing patient demand, due to a expanding and ageing population, and plummeting investment.”

GPs" surgeries "at danger of closure"

Medical professionals surgeries striking off thousands of patients due to lack of GPs

The very same surgical procedure, Watton Health care Practice, has also deregistered a wheelchair-bound 52-yr outdated former soldier who has lost both legs due to significant diabetes.

Dave Pendry must now full a 14-mile round journey to see his new GP in the village of East Harling.

It has also left mom-of-eleven Kirsty Hutchinson dealing with a 16-mile journey every time one of her children is unwell or requirements an injection soon after telling her she can longer use their providers.

In yet another example, a practice deregistered a nursing property of 59 residents, several of whom endure from Alzheimer’s.

But senior medical doctors mentioned these have been not isolated occasions and warned other practices had been forced to strike off up to a hundred individuals at a time as they referred to as for more funding for GPs.

The lack of GPs has been worsened as a lot of loved ones doctors pick to retire early whilst younger medics often select hospital-based mostly operate.

But there are fears that vulnerable patients are getting eliminated from surgical treatment lists due to the fact they consider up the most time and demand a lot more care.

Earl Howe, the overall health minister, has referred to as for NHS England to ‘urgently’ investigate the choice to strike off Ms Dove.

Dr Sukdev Singh, executive companion of the Bellevue Health care Centre in Edgbaston, Birmingham which chose to deregister the nursing residence, denied claims the surgical treatment had targeted the home since residents needed so many visits.

He mentioned Bellevue had been forced to get rid of 75 patients who dwell the furthest away following a medical professional retired.

“It’s a national difficulty,” he said.

“We are struggling to recruit doctors and we do not have the needed funding.”

Referring to the situation of Mrs Dove, Mr Howe mentioned: “We have asked NHS England to urgently look into the situation reported in the Mail.

“We anticipate practices to perform with their individuals and NHS England to make sure that residents get the superb care they require from local GPs, particularly these above 75 or with prolonged-phrase conditions.”

Cancer specialist Dr Clive Peedell, co-leader of National Well being Action Celebration, mentioned: “I’ve surely heard that up and down the country sufferers are getting eliminated from practice lists because they can not deal with the workload.

“The pressures are enormous at the second. There are genuine staffing problems and we are really concerned about the lack of funding.”

Medical professionals surgeries striking off thousands of patients due to lack of GPs

GP surgeries are not match for goal: BMA

The problem will be raised at the BMA conference in Harrogate following week and a summit will be held with ministers on July 10.

The conference will also hear warnings that programs to open GP surgeries from 8am to 8pm seven days a week are “unaffordable and inappropriate in the context of financial austerity”.

The BMA has stated that basic practice is in crisis with reduced funding forcing some practices to close and health-related college students refusing to train as family members physicians. It has also warned that increasing workloads are pushing doctors into early retirement.

1000′s of GPs are even now practising in Victorian terraced houses, which are not match for 21st century medication, Dr Chaand Nagpaul, chairman of the BMA’s GP committee said. He added: “The government is in denial. The rhetoric of moving hospital companies into the neighborhood hasn’t a hope with out the premises in the local community to house them.”

He added: “GP premises are fossilised … They are woefully inadequate and there has been no national investment.”

The preliminary results of a survey of GPs discovered:

 - Three in 5 practices say their medical professionals have to share consulting rooms, and of these, half say this restricts treatment method.

– More than two thirds feel their premises limit the GP companies and local community providers they can provide.

– A lot more than half of respondents have not witnessed significant refurbishment to their premises since 2004.

The CQC began inspecting GPs for the first time last 12 months and identified the buildings to be a major problem. One practice was not permitted to register with the CQC to legally treat patients right up until it offered doors to its consultation rooms. Another had to use a Portacabin for further space.

A Department of Health spokesman said NHS England was prioritising applications for funding at the moment.

She stated: “GPs agreed to be at the heart of our radical ideas for a lot more personalised community care.

“This was in return for cutting their targets by much more than a third to free of charge up more time with individuals.

“GP premises must be match to help provide a single seamless support for the elderly and most vulnerable.”

GP surgeries are not match for goal: BMA

Doctors" surgeries to offer out-of-hrs appointments and Skype checkups

The scheme will give funding for more personalised care for 800,000 elderly and vulnerable individuals. Photograph: Alamy

1 in ten surgeries are to offer sufferers the selection of seeing a GP at evenings and weekends, reserving appointments on the web, getting electronic prescriptions and having checkups more than Skype, David Cameron will say on Monday.

The prime minister unveiled the £50m scheme in October amid fears that also many men and women are turning up to A&ampE when they can not get appointments with their GP, placing too much strain on emergency departments.

Medical professionals have been invited to apply for funding, and demand for the money indicates seven million patients at far more than 1,a hundred practices – rather than the 500,000 sufferers envisaged – will benefit from the trials from up coming month.

Nonetheless, Labour raised concerns that the vast majority of folks nevertheless have unacceptably lengthy waits to see their GP because the government eliminated a requirement for individuals to be noticed within 48 hrs.

Andy Burnham, the shadow well being secretary, mentioned it had become a lot tougher to get a GP appointment under the coalition.

“The big difficulty with this new strategy is that it will not benefit hundreds of thousands of people,” he stated.

“For the huge bulk who are outdoors of this scheme, items will carry on acquiring worse and they are being told to assume to wait a week for a GP appointment.

“No wonder more and far more individuals are turning to A&ampE, which has just had its worst year in a decade.”

Beneath the ideas, a lot more surgeries will offer seven-day opening and 8am-8pm appointments. There will also be greater use of Skype, email and telephone consultations for those who would uncover it easier.

There will also be funding for more personalised care for 800,000 older and vulnerable individuals, who will get a lot more assist, a named GP responsible for their care and very same-day access to a GP when they need it.

Cameron will say: “Back in October, I said I wanted to make it less complicated for folks to get appointments that fit in all around a hectic doing work week and loved ones commitments.

“There has been a fantastic response from doctors, with plenty of innovative suggestions, and we will now see more than seven million sufferers provided weekend and evening opening hrs, alongside a lot more accessibility to their family members medical doctor on the mobile phone, by means of e mail or even Skype.”

Simon Stevens, chief executive of NHS England, said the plans would assist totally free household medical doctors to spend much more time with their sickest patients.

Dr Chaand Nagpaul, chairman of the British Healthcare Association’s GP committee, explained the government should be cautious that additional accessibility to surgeries is not supplied at the cost of availability for the most vulnerable.

He additional: “Outside of individuals signed up to the pilot, there will even now be close to seven,000 GP practices across the country who will not be obtaining extra support to improve patient entry or keep existing solutions. Furthermore, given that this funding is only for a single yr, there is no assurance of these changes becoming reasonably priced in potential many years.”

Doctors" surgeries to offer out-of-hrs appointments and Skype checkups

GPs" surgeries to open all hours in £50m reforms

The GP Access Fund will suggest that patients at one,147 practices across England will be capable to see their medical doctor outside standard working hrs. Photograph: Ferenczy Europress/FEB

Hundreds of thousands of sufferers will be ready to see their GPs in evenings and on weekends with £50m of government funding created offered to lengthen opening times, it is to be announced.

David Cameron, the prime minister, will say on Monday that far more than 7.5 million men and women will be supplied elevated entry to GP companies through extended opening times and new consultation methods making use of Skype, e mail and cellphone.

The £50m GP Accessibility Fund will indicate that sufferers at 1,147 GP practices across England will be ready to see their family members medical doctor outdoors standard working hours, like late-night and weekend appointments or use 1 of the modern consultation tools for convenience.

It was initially imagined that close to 500,000 folks would benefit from the modifications but due to substantial levels of interest it has been rolled out to cover more GP companies.

Cameron will also announce strategies to improve care services for the elderly.

About 800,000 folks above the age of 75 and those with a lot more severe wellness complaints will get tailored care, co-ordinated by just a single neighborhood GP.

The overall health minister, Norman Lamb, informed the Telegraph: “It truly is quite challenging for folks with hectic lives to get appointments with GPs so let’s just get smarter with the use of technologies.”

He said: “We have received to break away from this treadmill of the 10-minute appointment which drives GPs crazy and which leaves patients often annoyed.”

Lamb additional that as older men and women became far more tech-savvy the use of email and video chat for consultations would aid people who were also hectic to attend face-to-face consultations.

GPs" surgeries to open all hours in £50m reforms