Written evidence submitted by Dr Simon Hornby (FGP0084)

 

GP Issues

I am a Salaried GP working in the NHS. I feel that there are many issues with the current model of healthcare in the NHS and the system needs to change in order to provide appropriate care in the years to come. The current model is not fit for purpose and will result in huge numbers of medical staff leaving if changes are not implemented for the better.

  1. Patient expectations are too high for every medical issue. This leads to high contact rates, increase return callers and duplication of workload.
  2. 10 min appointments are insufficient to deal with patients effectively and GPs should be given 15 mins minimum to deal with patients. This would reduce problem 1.
  3. Access to healthcare has never been easier owning to increased remote consulting and e-consults. This increases demand placed on clinicians and reception staff as the work just keeps coming in, even when the practice is closed.
  4. Most patients do not need to be seen F2F for their problem to be dealt with effectively. Literature states 50-70% of primary care can be done remotely and yet Politicians and Press seem defiant in their stance that GPs should see most patients F2F. A large proportion of patients I contact do not want to see me F2F as they’re working, have transport problems or have childcare requirements.
  5. Mental health therapy and treatments are poorly resourced and inadequate resulting in multiple repeat consults with GPs for the same issues e.g. low level anxiety and mild-moderate depression. This inevitably results in more medication prescribing due to lack of other options.
  6. Most NHS GPs do not work 5 days a week, but they do work full time hours (36h per week). I work 3 days a week but 12 hours each day. I also work doing non-NHS GP jobs on the other 2 days. This portfolio model of working is not recognised by politicians and press who think we should be in the NHS consulting room every day.
  7. Increase bureaucracy and box ticking with QOF, IIF, incentive schemes etc. This all takes away from clinical time and requires the employment of other staff to manage that workload.
  8. Throwing more money at the NHS to employ more staff will not work. There is only a finite number of staff and those people are already working extra shifts to cover gaps. Paying them more to work even more will result in widespread burnout.
  9. Recruiting into ARRS jobs inevitably results in those highly trained individuals moving from community or secondary care into primary care. That reduces the pool of staff in those other areas. Increased numbers of training posts for Pharmacists, Podiatrists, Physiotherapists, Nurse and GPs is essential to bridge that gap, but that takes years not months to fulfil.

Dec 2021