Patients are being put at risk by “brutal disinvestment” in general practice and are now often waiting two weeks for appointments, the chair of the British Medical Association’s GPs‘ committee will warn on Wednesday.

In a speech at the annual BMA conference, Chaand Nagpaul will warn that general practice is “imploding”. He will say that a reduction of £450m in funding, in real terms, over the past three years, coupled with a 40m increase in annual demand for appointments over the past five years has put the future of many surgeries, and that of the entire NHS, at risk.

“The simple fact is that demand has far outstripped our impoverished capacity, denying patients the care and access they deserve. We’re forced into providing a conveyor belt of care at breakneck speed, up to 60 times in a day, added to by an open-ended volume of phone calls, home visits, repeat prescriptions, results, reports and hospital correspondence. This is unmanageable, exhausting and unsustainable, and puts safety and quality at risk.”

Nagpaul will say waiting times for appointments are getting longer as the result of increasing pressures. “Waiting times are inevitably getting longer because the increased demand has not been matched with increased capacity,” he will say. “GPs will rightly prioritise urgent problems. What is being squeezed are patients with routine problems.

“This is paining GPs. We want to provide prompt and good care but it’s just proving impossible. It’s common that patients wait over a week, some two weeks. The Royal College of GPs has done a survey which shows that waits will increase to two weeks in a large number of practices in the coming year.”

Speaking before the address, he said thousands could be left without a readily accessible local GP altogether because of the abolition of the minimum practice income guarantee (MPIG). The MPIG supports surgeries facing challenging circumstances that require extra funding but is being phased out over a seven-year period that began in April. Some practices have lost a third of their funding as a result of its abolition, jeopardising their very survival, said Nagpaul, who is calling for the decision to scrap the MPIG to be put on hold.

He accused the government of having gone back on a promise to help 98 practices identified by the NHS as at risk of closure. “They said last year they would provide support and now these practices are finding they have no support,” he said. “They have reneged on their promise.”

He said that surgeries particularly at risk were those that often delivered care to vulnerable communities, be they in rural areas, inner cities or universities with large, transient populations. Though there may be perceived to be more alternatives for those living in urban areas, no practices have spare capacity, according to Nagpaul, who said the closure of surgeries would put even more pressure on those left to pick up the pieces.

The BMA is launching a campaign called Your GP Cares to pressure the government into providing more GPs, practice nurses and buildings. The number of GPs as a proportion of all doctors in England has fallen from from 34% to 26% in two decades and many existing GPs are making plans to retire early, Nagpaul says, while junior doctors are increasingly shunning the profession, with 451 training places unfilled last year, because of the workload and stress associated with the job.

He will say in his speech that the fight for the survival of general practice is the fight for the survival of the NHS itself, as just a 6% reduction in GPs seeing patients would double the numbers attending already overstretched A&E departments if they went there instead.

Source: The Independent