GP practices prepare for winter workload spike

More than three quarters of GPs believe their practice will struggle this winter because pressure on hospitals will leave patients ‘bouncing in and out’ of surgeries, spiking GP workload

This is an edited version of an article first published by GPonline.

Of 141 GP partners who took part in a GPonline opinion poll, 81% predicted that their practice would struggle this winter. Only 12% felt their surgery would be able to cope and the rest were uncertain. Across all 480 GPs who responded to the poll, 76% said their practice would struggle.

Problems referring patients to hospital and rushed discharges at A&E departments were among key concerns highlighted by GP partners as likely to drive up pressure on practices.

Practices already face extra workload ‘dumped’ on them by hospitals, with LMCs warning last week that acute trusts were ignoring contract requirements not to transfer work inappropriately to primary care and demanding fines when rules are breached.

NHS waiting times

But GPs fear measures adopted by hospitals struggling to turn around record waiting times – with more people waiting over four hours in A&E than at any time since 2004, soaring numbers waiting over 18 weeks for hospital treatment and cancer treatment targets missed – will drive up GP workload further still.

Dr Richard Vautrey, BMA GP committee chair, said: “All parts of the NHS are currently facing intense year-round pressures, and GPs feel the impact of this every day as the first point of contact for most patients seeking care. Many practices are facing a tough winter ahead and are finding it difficult to recruit the staff needed to cope with increased demand.

“It is worrying that many GPs feel patients are being discharged from hospital too early, and that this is having a knock-on impact in primary and community care. Too often patients lack the social care needed to enable them to be properly supported at home after hospital discharge. This reflects the fact that the system as a whole is simply not sufficiently resourced to cope with the level of demand we’re currently seeing.

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Hospital discharge

“That’s why we need urgent investment put into our health service and social care to ensure that it not only survives the upcoming winter, but is also sustainable in the long-term, both for hardworking staff and the patients we serve.”

One GP responding to the survey said: “With hospital services crumbling, demand for [GP services] is going through the roof. We cannot afford more locum cover, even where that is available. Patients will have to wait to be seen and the consequences of that may be severe”.

Another GP partner said: “My concerns are that secondary care has a ‘discharge ASAP’ policy whereby they dump their workload on primary care. As steps to prevent admissions, we have targeted flu clinics, agreed and inspected care plans.”

Winter pressure

Earlier this month, the BMA warned that trusts and GP practices were ‘almost certain to ensure the most pressurised winter on record’ and demanded extra funding as well as an end to pension taxes that had severely damaged the medical workforce.

More than 90% of GPs think the NHS will struggle to cope this winter and that patients will be put at risk.

NHS England has said measures to reduce pressure on the NHS this winter include increasing public flu vaccination levels, education campaigns to help people stay well and choose the right services, and increasing access to NHS 111 service.

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