GPs seeing up to three times the recommended safe level of patients per day

CREDIT: This story was first seen in iNews

GPs are seeing up to 70 patients a day – almost three times the recommended safe level – in a sign of the extreme pressures in primary care, iNews reports.

A survey of 900 doctors by Pulse magazine found that each deals with an average of 41.5 patients a day with more than one in five GPs having more than 50 daily patient contacts, including face-to-face and telephone consultations, home visits and e-consultations.

Some GPs told Pulse they have 70 contacts a day.

GP Dr Mary McCarthy, vice-president of the European Union of General Practitioners (UEMO) and a member of the British Medical Association’s (BMA) general practitioners committee, told Pulse: “Around 25 contacts is safe.”

She said the higher numbers of contacts in the UK is ‘pretty dreadful’, adding: “I think GPs have little insight into how hard they are working. The demand is fueled partly because patients are pushed to the GP for any problem there is.”

Doctors across Europe told UEMO that 25 contacts was suitable, with 25-30 minute appointments as standard in some countries. The UK’s recommended consultation time is 10 minutes.

The BMA’s GP Committee has called for a limit to the number of consultations a GP carries out each day, but nothing has come of it.

The Royal College of GPs (RCGP) said family doctors have a ‘relentless’ workload.

One GP in East Anglia said a typical day included 42 contacts with 30 odd calls as duty doctor in the afternoon, which could soar to 50 plus phone calls on ‘bad days’.  “I have actually tendered my own resignation as it is making me unwell to work at this pace,” they said.

Another doctor, who reluctantly left 13-14 hour days as a partner for a more manageable workload as a salaried GP and 31-40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another said that on one exceptional ‘horrendous’ Monday he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Professor Helen Stokes-Lampard, RCGP chairwoman, said: “This survey backs up what the college has been saying for years – that many GPs and our teams are regularly working way beyond what could be considered safe for patients, and potentially jeopardising our own health and well-being.

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“GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it, but the workload at the moment is relentless and it’s taking its toll. It is not necessarily the number of consultations we are making on a daily basis, it’s the content of those consultations, and our patients are increasingly presenting with more complex, chronic conditions – many of which require much longer than the standard 10-minute consultation.

“As well as clinical work, we have other urgent duties, such as prescription reviews, hospital letters, ensuring records are up to date – and there is a limit beyond which we worry that we are not practising safely. Our workload needs to be addressed – it has risen at least 16 per cent over the last seven years, yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, chairman of the BMA’s general practitioners committee, said: “We know that unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely.

“This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care. The BMA has called for practices to be empowered to set their own capacity limits for safe working, which includes limiting the number of consultations per day. Fewer consultations would mean longer contact time with patients, leaving doctors better able to ensure safe, high-quality care, that many feel is not possible within the current 10-minute consultation.”

A Department of Health and Social Care spokesperson said: “We know GPs are under pressure – that’s why we are committed to an extra 5,000 doctors in general practice by 2020 — supported by investment of an extra £2.4 billion a year to improve care and deliver better patient access. There is the highest number of GPs in training ever – more than 3,000 – and a further 1500 additional medical school places will be available by 2019 to further ease the burden.”

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