Written evidence submitted by Mr Paul Lee (FGP0239)

 

I wish to provide evidence to this inquiry in so far as I both access (or try to access) GP services and am married to a GP.

 

Q. What are the main barriers to accessing general practice and how can these be tackled?

A. The primary cause is clearly a shortage of GPs for the demand being placed upon them. To tackle this means either increasing the number of GPs, reducing the demand placed upon them, or both. The current attitude towards GPs, driven by the tabloids and apparently supported by the Government is operating in the opposite of providing more GPs. How would you feel if you’ve just finished yet another intense 13 hour day, only to see the Tabloids calling you “Part Time”, Sajid Javid backing them, and patients posting messages through the post box calling GPs cowards?

Q. To what extent does the Government and NHS England’s plan for improving access for patients and supporting general practice address these barriers?

A. Very little.

Q. What are the impacts when patients are unable to access general practice using their preferred method?

A. The patients’ expectations of what the NHS is able to provide is unrealistic giving the resources the NHS has. Pressure is inevitably moved from one place to another creating even more of a mess and breaking down the relationship of trust between NHS, GP and patient.

Q. What role does having a named GP—and being able to see that GP—play in providing patients with the continuity of care they need?

A. A key one. All care for a given patient is routed through their GP. This is a good thing. It is clearly more efficient for a named GP to know a patients needs readily, rather than each new GP having to root through mountains of notes.

Q. What are the main challenges facing general practice in the next 5 years?
 

A. Preventing total collapse of Primary Care and everything else that spins from it. There needs to be a complete re-evaluation of both expectation and delivery of primary care. Simplification and removal of over-paid middle-micro-managers would be a good start. They divert funding away from where it is needed and add little value.

Q. How does regional variation shape the challenges facing general practice in different parts of England, including rural areas?

A. Once you have a shortage of Professionals, they will naturally choose to take posts in a place that suits them most. It is obvious that this then leads to an imbalance of staffing levels in different areas.

Q. What part should general practice play in the prevention agenda?

A. A big one?

Q. What can be done to reduce bureaucracy and burnout, and improve morale, in general practice? 

A. Remove over-complication, micro-management and middle-men. Simplify. Let GPs do what they know best.

 

Q. How can the current model of general practice be improved to make it more sustainable in the long term?

A. Simplification. A re-adjustment of expectation, and allowing GPs to work reasonable hours for reasonable reward. You need to reverse the Govrnment driven down-ward spiral.

In particular:

Q. Is the traditional partnership model in general practice sustainable given recruitment challenges, the prioritisation of integrated care and the shift towards salaried GP posts?

A. Is there a shift towards salaried posts? If so, what is the reason for that? GPs driven to the edge and seeing it as a way out? That doesn’t sound like much of a solution to me.

Q. Do the current contracting and payment systems in general practice encourage proactive, personalised, coordinated and integrated care?

A. No. Not by a million miles.

Q. Has the development of Primary Care Networks improved the delivery of proactive, personalised, coordinated and integrated care and reduced the administrative burden on GPs?

A. No. PCNs seem more like a stepping stone to Privatisation to me, and the extraction of yet more funds that could and should be used for care, but instead are being taken as profit.

Q. To what extent has general practice been able to work in effective partnerships with other professions within primary care and beyond to free more GP time for patient care?

A. This question shows that the level of understanding in Government, of a GPs day-to-day workload is nil. I would wholeheartedly suggest that spending some time with GPs at their workplace would be massively enlightening. Until you do that, then you will continue in complete ignorance of how badly broken General Practise is.

 

 

Yours sincerely

Paul D. Lee

 

Dec 2021

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