NHS meeting hears about stresses on frontline staff

A meeting of the Herts & West Essex Integrated Care Board heard about the stresses faced by frontline staff as the organisation tries to improve delivery of primary healthcare services.

Clinicians were responding to plans by NHS England to provide same-day assessments when a clinical need was identified.

Dr Robert Mayson, of Hailey View Surgery in Hoddesdon, told the meeting: "... you're trying to fit too many potatoes in this poor, heaving, breaking sack.

"It makes the GPs feel more undervalued and we feel like we're just not doing a good enough job, because access is broken. It's not our fault, we're seeing more patients because of issues that are creeping in from other parts of the system.

"We have patient expectations and for NHS England, to have those comments on expectation and ambitions, it means the Department of Health has it and and the Government has it. They say one thing on the news and patients say, 'Oh, you've got to assess me within 24 hours'.

"This is what is actually really fundamentally wrong, given the resources in primary care which have gone down. We've reduced our staff cost because we can't afford them anymore, but we’re being expected to increase our appointments and access. It's utterly ridiculous.

"Actually, we need our system to start supporting the real issue, not just the political machinations. I'm afraid two weeks for a routine appointment is utterly ridiculous in this climate.

"Plus most people don't need a routine appointment in two weeks, if it's routine it can be anything from a month to three months."

Report reveals discontent

A recent report commissioned by the NHS revealed that "there are real signs of growing discontent with primary care - both from the public who use it and the professionals who work within it" 

"People waiting for an appointment with their GP prioritise different things. Some need to be seen straightaway while others are happy to get an appointment in a week's time.

"Equally, for some patients it is important to be seen face to face while others want faster, more convenient ways of accessing treatment and there is emerging evidence of a growing appetite (even before COVID-19) for patients to access care digitally.

"The 'NHSE Delivery Plan for Recovering Access to Primary Care' (NHSE May 2023) has two central ambitions:

⦁ To tackle the 8am rush and reduce the number of people struggling to contact their practice. Patients should no longer be asked to call back another day to book an appointment, and we will invest in general practice to enable this.

⦁ For patients to know on the day they contact their practice how their request will be managed.

"If their need is clinically urgent it should be assessed on the same day by a telephone or face-to-face appointment. If the patient contacts their practice in the afternoon they may be assessed on the next day, where clinically appropriate.

"If their need is not urgent, but it requires a telephone or face-to-face appointment, this should be scheduled within two weeks.

"Where appropriate, patients will be signposted to self-care or other local services (e.g., community pharmacy or self-referral services)."

What are General Practices?

General practice surgeries are small to medium-sized businesses contracted by the NHS to provide frontline medical services. Most general practices are run by a GP partnership. This involves two or more GPs, sometimes with nurses, practice managers and others working together as business partners, pooling resources, such as buildings and staff, and together owning a stake in the practice business. GP partners are jointly responsible for meeting the requirements set out in the contract for their practice and share the income it provides.