NEWS: Workload crisis risks patient safety

As reported by RCGP, over 76% of GPs report that excessive workloads are compromising patient safety, urging immediate government action

With the General Election only weeks away, RCGP Chair Professor Kamila Hawthorne described the situation as ‘deeply alarming’ and is calling for whoever forms the next government to recognise the crisis in general practice and dedicate funding to ensure that the GP workforce is boosted with recruitment and retention initiatives.

More than 2,000 RCGP members responded to the survey, that highlights pressures on general practice are compromising the standard of care that patients are receiving, revealing that six in ten (60%) GPs report that they don’t have enough time to adequately assess and treat patients during appointments – furthermore, 62% feel they don’t have enough time during appointments to build the relationships with patients they need to deliver quality care.

These worrying figures are set against a backdrop of intense pressures in general practice – demand for GP appointments has surged while the workforce has shrunk since 2019. In May, GPs and their teams delivered 30.5 million appointments – approximately 5.24 million more than May 2019 – with approximately 480 fewer fully qualified, full-time equivalent GPs than in December 2019.

The average number of patients per fully qualified GP continues to rise and is now 2,289, something Prof Hawthorne has said is ‘not sustainable or even manageable’ as it impacts the time GPs are able to spend with patients.

Meanwhile, six out of ten job-seeking GPs have struggled to find a vacancy to apply for in the past year. The RCGP has pointed to funding being directed towards additional roles such as physiotherapists, pharmacists and physician associates, instead of prioritising the recruitment and retention of GPs and has called for funding to be made available to recruit more GPs to see patients.

Pressures on general practice have wide-reaching consequences for other parts of the health service. General practice handles the vast majority of patient contacts in the NHS and when GP teams are unable to meet demand, this reverberates across the health service, including in Emergency Departments.

Care is also more expensive in secondary care with the estimated cost of a GP appointment approximately one tenth the minimum cost of treatment at a major Emergency Department. The RCGP’s survey found that 71% of GPs believed that their practice could alleviate pressure from hospitals if it had more staff and resourcing.

Accordingly, the College is calling on the next government to increase the share of NHS funding that general practice receives in order to protect the whole health service.

Professor Kamila Hawthorne, Chair of the Royal College of GPs, said: “Our number one priority is the safety of our patients, and it is alarming to hear how many GPs feel this is being compromised by the immense workload pressures they are working under. The fact that so many of our members say they’re not able to provide the high quality, safe care their patients deserve shows that it is patients who are bearing the brunt of the crisis in general practice.

“We desperately want to spend more time with our patients – to treat the whole person, and provide the continuity many of our patients need, but our time is so constricted. Each fully qualified, full-time GP is now, on average, responsible for 149 more patients than they were five years ago. This is not sustainable, or even manageable, and has a huge impact on how much time we can spend with our patients. General practice is a safety-critical industry and the intense pressures that have been accumulating over recent years are now having grave consequences for the health and wellbeing of our patients.

“General practice is the bedrock of the NHS, when we are struggling every other branch feels the strain. Given the proper support we could be working with patients to identify illness early and embedding prevention in the community – all of which would alleviate pressures on the rest of the health service. Instead, thanks to decades of underfunding and poor workforce planning, we can barely keep our heads above water.

“We know how much our patients value our services and we want to deliver. But to do this we need to ensure that general practice is properly staffed. Which is why we’re calling on the next government to dedicate funding for recruitment and retention initiatives to ensure that there are enough GPs to safeguard the future of general practice. This is the only real route to improving our patients’ access to safe, timely and appropriate GP care, and all political parties need to take heed.”