The rationing of educational numbers and budgets over prolonged period of time has resulted in us being somewhere we should never be,. The Victorians would be ashamed of our short term thinking..
The scale of the GP crisis has been revealed in a survey showing that 11.7% of all GP posts in the country are vacant.
The vacancy rate has increased by more than five times since 2011, when it was 2.1%, and by 2.6% since last year’s rate of 9.1%.
Official figures show that the total number of full-time equivalent GPs is 34,055, compared to 34,712 the year before.
Dr Maureen Baker, chair of the Royal College of General Practitioners, responding to the survey by Pulse, said: “General practice is currently facing intense resource and workforce pressures, caused by years of underinvestment in and undervalue of our service.
“This survey brings home just how important it is that we do everything in our power to recruit more GPs, urgently implement schemes to retain existing ones, and make it easier for trained family doctors to return to practice in the UK following a career break or period working abroad.
“General practice is the bedrock of the health service. We keep the NHS sustainable and our patients safe, so it’s vital that we have enough GPs and practice team members to do so for years to come.”
She called for the recommendations in the General Practice Forward View, which seeks to tackle the shortage of GPs with increased funding and recruitment, to be “implemented urgently”.
However, GPs rejected the proposals at the British Medical Association (BMA) Local Medical Committee conference and voted on the possibility of industrial action unless the government implements the BMA’s Urgent Prescription for General Practice to address the pressures on GPs.
Dr Chaand Nagpaul, chair of the BMA General Practice Committee, said: “The government must ensure that practices that are suffering recruitment problems will be supported and relieved of admin pressures and be allowed to close their lists. The most important thing is that practices do not feel forced to practice unsafely.”
GP consultations increased by 15% in 2010-15, and the growing demand has had consequences across general practice. One in 10 GP practices describe their finances as unsustainable, and UK GPs have the highest rates of stress in the world.
The Pulse survey also found that 73% of practices have had to recruit at least one GP in the past month and 47% have had to recruit a partner.
The average time to recruit a partner is now 6.6 months, compared to 5.7 months last year, and 23% of practices spend more than a year searching, compared to 18% last year.
Lives are being put at risk across Lincolnshire because of a chronic shortage of GPs.
That is the startling admission from one of the county’s leading medical professionals.
In an exclusive interview, Dr Sharrock says record numbers of doctors are leaving the profession because of an ever-increasing workload.
The county has a shortfall of around 70 full-time doctors, he said.
Dr Sharrock admits that the shortfall – combined with a reluctance of junior doctors to move to Lincolnshire – means some parts of the county are ‘not safe’ for patients.
And Dr Sharrock has accused the Government of having an ‘underlying agenda to make the NHS fail’.
He warns the collapse of the NHS would lead to the introduction of an American-style privatised system.
His views come just a week after details of a LLMC report raised worries about the perilous state of GP cover in the county.
Dr Sharrock is involved in top level talks with NHS England to boost funding in Lincolnshire and to attract new doctors.
However, he admitted time is running out.
He said: “It is a crisis. If we continue the way we are now, more and more older and experienced doctors will retire and fewer people will come into the profession.
“You’ll have an increasing workload with an older, iller population and fewer GPs to do the work.
“To say lives are at risk is not over-egging it. In some places in the county, GP practices are fine but there are sections of the county where I would say it is not safe for patients.
“Doctors are so overworked and the workload is so high it’s not safe for them to continue.
“That means it is not safe for patients.
“My practice [in Spilsby] is safe but if the workload continues to go up, it won’t be too long before it also becomes unsafe.”
Dr Sharrock revealed steps are being taken to improve the situation including
l A major recruitment drive to attract doctors from Spain and Eastern European;
lA £20,000 ‘bonus’ payment to junior doctors to move to Lincolnshire;
lA PR campaign promoting living and working in Lincolnshire to doctors.
Dr Sharrock added: “It’s a rural county and young people want to be near to big cities.
“Traditionally, people don’t even know where Lincolnshire is. “We have worked very hard on marketing Lincolnshire and that is starting to pay off.
“Some GPs are coming here because our recruitment campaign – but not enough.
“Demographically, we have isolated deprivation. In places like Mablethorpe, Skegness and Boston, we have a high figure of deprivation.
“We have the fattest patients in the country. We have an ageing population.
“All those factors are known by the medical profession.
“If you are a young doctor, you accept you are going to work long hours but are you going to go somewhere where you work even longer?
“An aging population, an isolated location, deprivation – it is not attractive,”
He admitted GPs were increasingly ‘upset’ that patients could not secure appointments.
He also warned the reliance on medical ‘hubs’ across Lincolnshire was likely to increase, meaning patients will often not see their own doctor but have to drive 10-20 miles to see someone.
Dr Sharrock says the level of funding to general practices has fallen in recent years and lags well behind countries like Germany, France and America.
He claims that in some Lincolnshire practices, locums are earning more than practice partners.
Dr Sharrock added: “Locums know there is a massive shortage of doctors so they can charge what they want.
“I know at least two practices where partners are not taking money home – because they have to fund locums and all the other costs. That can’t go on.”
He believes recruiting doctors from Europe will help but not solve the situation.
Dr Sharrock added: “I met with the medical director of NHS England last week and we are looking at recruiting doctors from Europe.
“If you recruit doctors from the UK, it is a bit like moving deck-chairs around on the sinking Titanic.
“You are just moving one doctor and leaving a vacancy elsewhere.
“We are looking at Spain where they have an excess of doctors.
“We are looking at Eastern Europe because obviously places like Skegness, Boston and Spalding have a high Eastern European population.
“We are in touch with a recruitment company who can hopefully find doctors who want to come to Lincolnshire.
“NHS England are very positive about that.
“However, we need to bring these doctors here and train them. It’s not going to be cheap.
“They need to be able to speak English and have the right knowledge of the NHS – apart from clinical skills.
“What we are looking to do is set up training hubs where we have say three or four doctors from Eastern Europe.
“They would have some clinical work along with training to improve their language and skills. But we can only do that with the support of NHS England.
“The Government has recognised that there is a shortage of GPs. Health Education England has incentivecised coming to Lincolnshire. They have given a £20,000 bonus to any trainee who wants to come to Lincolnshire.
“However, that means trainee schemes in neighbouring areas will struggle. Where we’ve gained, other places will have exactly the same problem as us.”
Dr Sharrock says GPs regularly conduct up to 100 consultations a day.
He believes a safe figure would be 60 consultations and warns it is only a ‘matter of time’ before mistakes are made.
He added research showed doctors spent 27 per cent of their day completing work which was not their responsibility.
Dr Sharrock called on people to lobby MPs for better funding and added: “What puts pressure on MPs is thinking people aren’t safe.
“People are at risk now in certain places because they can’t get timely, efficient healthcare.
“I’ve had discussions with many of our MPs. They are worried and are supportive of our efforts.
“However, my concern is there is underlying agenda of Government to make the NHS fail.”