Perhaps Pembrokeshire will be the first area to “go private” and abandon the health service?

It is no surprise to us GPs in Pembrokeshire that we are the area with easily the most lack of coverage of Out-of-Hours care by GPs. The Times reported this as “Struggling out-of-hours care leaves patients without a GP” (Chris Smyth on May 3rd) . It will be interesting to see the outcome measures for West Wales over the next 5 years, in life expectancy, emergency admissions and satisfaction. Perhaps this unpopular area will be the first to “go private”?

Paul Gallagher in the “I” 3rd May 2019 reports: GP shortages leaving out-of-hours services with no doctors

Pulse investigation reveals number of urgent care shifts in which a GP was not present rose from 57 in 2017 to 146 last year.

Chronic shortages of doctors meant at least six UK regions ran out-of-hours (OOH) services with no GP on shift last year, an investigation has revealed.

The total number of urgent care shifts in which a GP was not present rose from 57 in 2017 to 146 last year, according to data supplied to Pulse magazine by 79 clinical commissioning groups (CCGs) and health boards in response to Freedom of Information requests.

GPs said the national staffing shortage was to blame, while warning the potential safety risks now associated with stretched OOH services meant GPs were often no longer willing to work for them.

NHS commissioners said they were using other healthcare professionals, such as advanced nurse practitioners and paramedics, to help fill staffing gaps.

In Wales, Hywel Dda University Health Board’s out-of-hours service reported the highest number of occasions without a family doctor on shift last year. The region, which covers 384,000 patients, had no GP cover 125 times last year – almost triple the 42 times it operated without a GP in 2017.

In England, two CCGs reported struggling to fill out-of-hours shifts in 2018: Tower Hamlets in east London, serving 331,000 patients, experienced the problem three times in 2018, and North East Lincolnshire, which covers 169,000 patients, had two instances last year.

Worsening in Scotland

In Scotland, one health board – NHS Borders, which has a population of 115,020 – responded with figures showing the problem is worsening. It had only two occasions of no GP cover in 2017, a figure that rose to eight last year.

Meanwhile, the number of serious incidents recorded by out-of-hours providers has risen by more than a quarter in the space of a year, according to Pulse’s findings. Data provided by 109 CCGs and health boards across the UK to FOI requests show 108 serious incidents were reported across 44 CCGs and health boards in 2018, against 84 serious incidents in 2017.

Dr Simon Abrams, a Liverpool GP and chair of Urgent Health UK, which represents out-of-hours providers, said: “We’re in a national recruitment crisis. If you’ve got a day job there’s a lot of pressure that makes being available to do out-of-hours even less likely than it used to be.”

This entry was posted in A Personal View, General Practitioners, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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