GPs warn about risks to patient safety

Negotiations between the government and general practitioners are underway, but if the mood amongst British Medical Association members is anything to go by, the negotiations will be tough. The leader of the BMA’s GPs, Dr Chaand Nagpau, speaking on Saturday 30th January at the Special Conference of Local Medical Committees warned that patient safety is being compromised as general practice faces an “emergency” situation caused by GP services being starved of resources and staff.

Patients are being short-changed on a daily basis, with nine in ten GPs stating that workload pressures are damaging the quality of care to patients. This is a disgrace in a system in which the government promotes quality and safety as central to the NHS.

It’s not safe nor sustainable for GPs to see patients with complex multiple morbidity in ten minutes, many of whom will be on over ten different medications, and with heightened risk of medical error. It’s not safe for GPs to have up to seventy patient contacts daily in the style of a conveyor belt, and on top of that plough through hundreds of clinic letters, pathology results and reams of repeat prescriptions.

It’s not safe for GPs to be examining patients while simultaneously having to take urgent calls from hospitals, district nurses and social workers, and also be called for an emergency home visit at the same time. It is not safe for practices struggling with unfilled vacancies to be forced to carry on registering patients when they haven’t the doctors or nurses. And it’s not safe to fuel the political hyperbole of routine seven days services, taking GPs away from ill elderly housebound patients in greater need. To put it simply, it is not safe to carry on the way we are, and which is why this conference is highlighting that general practice is quite literally in a state of emergency.”

Dr Nagpaul also criticised the Care Quality Commission (CQC), which the BMA believes is adding further stress to general practice, saying:

It’s tragic that GPs and practices live in a climate of fear, in which the CQC takes no account of your circumstances, and blames, names and shames you even if you’re running on empty with skeleton staff, or locked into inadequate premises not of your own choosing. Eight out of ten practices said preparing for CQC inspections was “very stressful” at a time of already rock bottom morale, and eighty percent of GPs stated they’re more likely to want to leave the profession as a result.

A BMA survey also showed CQC refusing to reschedule inspections even in extenuating circumstances when the lead partner or practice manager was off sick, adding further stress and tarring practices with a public label based on visiting them on the wrong day. Yet CQC has the double standard of unilaterally cancelling inspections at a moment’s notice.

Calling on the government to act to stop the crisis overwhelming general practice, Dr Nagapaul added:

We are sick of hearing just words. We don’t want to hear about last year’s money rebadged as a new resource. We don’t want to be to be told about what may or not happen in 2020. What we need to know is what the government is going to now do to enable one million patients daily to receive a safe and sustainable GP service today.

I’m constantly told by ministers that the greatest battle is getting money out of the Treasury. ​My message to the Chancellor is to use his financial nouse- stop penny-pinching and be pound wise, grab yourself a bargain while there are GPs out there because once they’re gone they’re gone. General practice costs £136 for all-in unlimited care and home visits per patient per year, which is less than the price of walking through a single outpatient clinic door once.

I urge government to do the right thing for patients and equally the right thing for a GP workforce whose goodwill continues to be shamefully exploited. And to protect and nurture a discipline that’s not just the jewel in the NHS’s crown but a beacon of personalised continuity of care internationally. And to make 2016 the year in which we begin the revival of UK general practice so that we have a future generation of GPs to look after a future generation of patients.”

Read the full speech here: Chaand Nagpaul Speech

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