Out-of-hours GP ser­vices ... that don’t have any GPs

Daily Mail - - News - By Kate Pick­les Health Correspond­ent

‘Sys­tem is close to col­lapse’

MIL­LIONS of pa­tients across the UK are be­ing left with­out a GP at night, an in­ves­ti­ga­tion has re­vealed.

At least six health boards were forced to op­er­ate out- of-hours ser­vices with­out a sin­gle fam­ily doc­tor on oc­ca­sion last year.

Sick pa­tients were tended to by paramedics or an ex­pe­ri­enced nurse in­stead, health bosses ad­mit­ted.

A na­tional snap­shot shows the num­ber of night shifts where a doc­tor was un­avail­able has al­most tre­bled from 57 in 2017 to 146 in 2018.

Mean­while, se­ri­ous in­ci­dents in out-of-hours care – where care has fallen way be­low that ex­pected – have risen by a quar­ter.

Ex­perts have blamed a short­age of GPs and lack of cash to tempt al­ready over­worked doc­tors into cov­er­ing an­ti­so­cial hours.

‘ The GP work­force across the United King­dom is un­der se­vere strain, with the num­ber of doc­tors con­tin­u­ing to fall, de­spite re­peated govern­ment pledges to re­cruit more,’ said Dr Richard Vautrey, of the Bri­tish Med­i­cal As­so­ci­a­tion.

‘Com­bined with rapidly in­creased de­mand from a pop­u­la­tion with more com­plex health needs, this staffing short­fall means work­load has reached un­man­age­able lev­els.

‘Given the in­creased work­load, it is no sur­prise that many GPs do not have the ca­pac­ity to do ad­di­tional overnight shifts.’ Bud­gets for out-of-hours ser­vices have flat-lined, while the num­ber of pa­tients need­ing to be seen has in­creased, he added.

‘Con­sis­tent and sus­tained in­vest­ment in GP ser­vices com­bined with re­newed ef­forts in re­cruit­ment are ab­so­lutely vi­tal to de­liver safe ser­vices,’ Dr Vautrey said.

The fig­ures fol­low an in­ves­ti­ga­tion by GP mag­a­zine Pulse. Of the 79 health au­thor­i­ties which re­sponded to the Free­dom of In­for­ma­tion re­quests, seven ad­mit­ted to hav­ing to run at least one shift with no doc­tor in the last two years be­cause of staffing pres­sures.

The majority oc­curred at one of three re­gions in Wales, along­side two clin­i­cal com­mis­sion­ing groups, or CCGs, in Eng­land and two in Scot­land.

Hy­wel Dda Uni­ver­sity Health Board, which cov­ers 384,000 pa­tients, ad­mit­ted it had no GP cover 125 times last year – al­most three times the 42 times it op­er­ated with­out a GP in 2017.

In Eng­land, two CCGs re­ported strug­gling to fill outof-hours shifts in 2018. Tower Ham­lets, which looks af­ter 331,000 pa­tients in East Lon­don, ex­pe­ri­enced the prob­lem three times in 2018, and North East Lin­colnshire, which cov­ers 169,000 pa­tients, had two in­stances last year.

In Scot­land, one health board – NHS Borders, which has a pop­u­la­tion of 115,020 – re­sponded with fig­ures show­ing the prob­lem is wors­en­ing. Across 2016 and 2017 it had only two oc­ca­sions of no GP cover, ris­ing to eight in 2018.

Abertawe Bro Mor­gan­nwg Uni­ver­sity Health Board and Aneurin Be­van Uni­ver­sity Health Board, both in south Wales, also strug­gled to fill GP shifts on sev­eral oc­ca­sions in 2018.

Col­lec­tively, more than 2.1mil­lion pa­tients were left with­out an out-of-hours GP at least once.

Rachel Power of the Pa­tients As­so­ci­a­tion called on a forth­com­ing NHS work­force plan to recog­nise the se­ri­ous­ness of this sit­u­a­tion. She said: ‘ Out- of-hours ser­vices have been trou­bled over the last decade, but these find­ings sug­gest the sys­tem is close to col­lapse.’

The prob­lems stem from a con­tract ne­go­ti­ated un­der Labour in 2004 that al­lowed fam­ily doc­tors to opt out of re­spon­si­bil­ity for pa­tients at evenings and week­ends. It was handed to com­mis­sion­ing units which sub­con­tracted it to pri­vate firms and groups of doc­tors, known as co-op­er­a­tives.

A wide­spread short­age of GPs has also meant many who are still work­ing have be­come un­will­ing to do anti-so­cial shifts. The Royal Col­lege of GPs es­ti­mates the health ser­vice in Eng­land is 6,000 doc­tors short of what it needs. It cur­rently has just over 34,000.

Data pro­vided by 109 CCGs and health boards across Bri­tain show 108 se­ri­ous in­ci­dents were re­ported across 44 CCGs and health boards in 2018, against 84 in 2017.

The De­part­ment of Health said its Long Term Plan ‘makes clear our com­mit­ment to the fu­ture of gen­eral prac­tice – backed by an ex­tra £4.5bil­lion more a year for pri­mary and com­mu­nity care by 2023/24. Last year a record 3,473 doc­tors were re­cruited into GP train­ing.’

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