GPs rise to challenge of burgeoning workload

by Tim Tonkin

Demand for GP services in England has soared, with doctors completing millions of additional face-to-face appointments despite challenges to working practices posed by COVID-19.

Last reviewed: 29 October 2020
practice general

GP appointment figures for September published today show 6.5 million more appointments in total last month than in August, including 4.7 million more face-to-face appointments and 1.5 million additional telephone consultations.

The data shows that while there were 5.5 million fewer in person appointments this September than in 2019, the number of same day consultations that took place was 1.8m higher than in August and 1.5m more than in September last year.

The increase in the numbers of patient consultations of all types provided came in the same month that NHS England and NHS Improvement wrote to all GPs and clinical commissioning warning that practices should continue ‘providing face to face appointments for those who need them’.

Demand met

BMA GPs committee chair Richard Vautrey said that the latest figures showed how well GPs had coped with the constraints posed by the coronavirus pandemic, and that general practice remained very much ‘open for business’.

He added that the figures further put paid to any notion that GPs had not been adequately meeting patient demand for face-to-face appointments.

He said: ‘Today’s figures show that GP practices are very much open for business. Indeed, there were a million more patient appointments in September this year, compared to last.

‘Doctors want to do all they can to keep patients, themselves and staff free from infection, but despite this 56 percent of GP appointments were face to face in September. Whilst this is 25 percent less than the same time last year, it is an extraordinary achievement during the pandemic.

‘More people were also able to have an “on-the-day” appointments, with almost two million more same day appointments in September this year compared with August. This represents an increase of 1.5 million more same day appointments taking place this September than in pre-pandemic figures September 2019.'

Safety paramount

He added: ‘These figures clearly demonstrate that GPs and their practice teams are continuing to work extremely hard as they do all they can for their patients in these most challenging of times. The continued use of triage arrangements, telephone and digital consultations are essential to keep both patients and staff as safe as possible and avoid the risk from overcrowded waiting rooms.

‘However physical appointments will always be a vital part of general practice and as these results demonstrate practices will see patients when it’s necessary, and we must never lose sight of that.  There is now an urgent need for the government to do far more to support practices to enable them to maintain this vital work.’

  • There were 4.7m more face-to-face GP consultations in September than in August this year
  • Last month also saw 10.2m telephone appointments, 148,975 home visits and 124,282 video or online consultations
  • The number of patients waiting more than a week for an appointment fell from 8.3m in September 2019 to 6.6m in September this year

'An affront'

While acknowledging that the pandemic had presented significant challenges to the ways in which GPs went about their work, the association described the suggestion that practices had suspended in-person consultations as ‘an affront to the committed GPs who have continued to go to work throughout the pandemic’.

As with the rest of the health service workforce, GPs have had to contend with new and complex working arrangements, increased demand and longer hours as a result of the pandemic.

The latest BMA Covid tracker survey section aimed specifically at general practice found that 46 per cent of GPs affected by depression, anxiety, stress or burnout resulting from work said their mental health was worse now than before the start of the pandemic.

Seventy-three per cent told the survey that they were quite or extremely anxious about working during the autumn and winter months, while 64 per cent described their levels of fatigue or exhaustion from working higher than normal.

The impact of the pandemic on general practice, particularly in light of the figures showing increased patient demand for appointments, has led Dr Vautrey to today [29 October] write to NHS England & NHS Improvement executive director Ian Dodge.

In his letter, Dr Vautrey calls for general practice to be given urgent support, both in the form of tangible measures and through a public show of solidarity and appreciation for the ongoing efforts of GPs.

He said: ‘At a time where the profession is exhausted and fearful for the future (for both themselves and their patients), it is more important than ever for the leaders of the NHS to show their appreciation and to stand behind general practice.

‘A public message of support, as well as tangible measures to cope with both COVID-specific and general increased primary care demand, is not only vital for practices to maintain services to their, and your, patients, but would also go a long way to improving the morale of the profession and preventing a lasting deleterious impact.’