Doctor’s warning over “perfect storm” GP recruitment crisis

Watton Medical Practice. Watton Medical Practice.

Adam Gretton Health correspondent adam.gretton@archant.co.uk
Monday, July 7, 2014
6:30 AM

Senior doctors have warned that more health practices will be forced to de-register patients in East Anglia because of a national GP recruitment crisis.

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GPs’ are under ‘unsustainable pressure’

Dr Ian Hume, a GP from Diss and BMA spokesperson for Norfolk, said: “General practice across Norfolk and Waveney is struggling to cope with a recruitment crisis that’s now affecting the care of local patients.

“GPs across the region are under unsustainable pressure from rising patient demand and falling resources, and are increasingly frustrated by the number of constraints impacting on services and undermining our ability to do our best for those who need us.”

“Whilst demand is continuing to rise, the government has failed completely to provide the support that local GP practice’s need, to offer their patients the time and care they require.

“One practice in Norfolk has recently had to reduce their patient list by 1,500 patients because of a lack of doctors. The last thing the GPs there want to do is let any of their patients down, but they are in an impossible situation where they are unable to recruit GPs to fill the three vacancies they have, and therefore cannot continue to provide safe care for all the 13,000 patients on their list.

“This is not an isolated example; several practices are having to restrict the registration of new patients, which has a consequent effect of putting more pressure on neighbouring practices, many who are already struggling. In all honesty, I have been in practice for 25 years and never seen the situation so precarious.”

“We are unable to cope with the current pressure on the health service, and understand entirely why our patients are discouraged by the difficulty getting appointments and delays in the treatment they need.”

Patients spoke of their anger last month after Watton Medical Practice told 1,500 people that they would have to register with another practice because the surgery was unable to hire two new doctors.

However, fears have been raised that more medical practices in Norfolk will have to de-register some of its patients as a result of a “perfect storm” with senior GPs retiring early and not enough new blood joining general practice.

Officials from the British Medical Association (BMA) said that since January, Norfolk and Waveney’s local medical committee, which covers 120 practices, has advertised 56 vacancies for GPs, with around half of those remaining unfilled.

Tim Morton, a partner at Beccles Medical Practice and chairman of the Norfolk and Waveney Local Medical Committee, said it was a “certainty” that more surgeries would have to strike patients off their list because of a lack of doctors. He added that GPs were regularly working 11 to 12 hour days and job adverts used to attract up to 50 applicants, but practices would be lucky to get one applicant nowadays.

Pensioner has no intention of moving

A Norfolk pensioner said she had no intention of leaving her medical practice after managers told her that she needed to register with a different surgery.

Lily Dove, of Ashill, was one of 1,500 Watton Medical Practice patients to be told last month that she would be de-registered because the surgery did not have enough GPs. The 95-year-old has been given extra time, until July 18, to move to a new practice. However, Mrs Dove said she was not moving and did not want to go to the surgery in Swaffham.

In a letter to the EDP, Mrs Dove said: “I have no intentions of de-registering and I do hope that commonsense will prevail. I fail to understand why the management team at Watton didn’t close the patient list some time ago and direct prospective new patients to all the other surgeries. I do not think that it is discriminatory to expect to have proper medical care and at my age to be treated with a little more respect.”

The surgery in Gregor Shanks Way, Watton, has struggled to recruit new doctors over the last year and has seen its ratio of 13,000 patients to doctors increase above what is deemed to be clinically safe by the NHS. However, NHS England has ruled out building a second surgery in the growing Breckland town.

Katie Norton, director of commissioning in East Anglia, said: “We are committed to supporting all Watton Medical Centre patients who are being asked to register with an alternative practice, and we will be doing everything we can to minimise disruption. It should be noted that NHS England has no plans to commission a second surgery in Watton as the existing practice, with sufficient GP resources supported by other clinical staff including nurse practitioners, would be able to provide services to the local population.”

“We have a perfect storm of a crisis. We have a predominately mature GP workforce, most are in their 50s and late 50s and they are retiring early because of the pressures of the workload. They would have carried on working to 65, but they say they do not need the hassle. At the other end we have an output from medical schools and GP training schemes who look at the workload and can not cope with it and decide not to commit to a career in general practice.”

“The problem with Watton is that it is having a domino effect. If you have one practice failing to recruit and getting longer waiting times and demoralised workforce, the surrounding practices are overwhelmed as well. Watton is just one example and there are examples of several like that,” he said.

A spokesman for NHS England - the organisation responsible for commissioning primary care - said they did not know how many GP vacancies there were in the region. However, 36 GPs retired in Norfolk over last two years, according to figures from a Freedom of Information request. Only eight GPs in the whole of Suffolk and Cambridgeshire retired in 2013/14 and 2012/13.

Nationally, there are 451 unfilled vacancies, according to the BMA.

Andrea Patman, head of primary care for NHS England East Anglia, said: “NHS England is committed to ensuring patients have access to high quality healthcare and believes that general practices in East Anglia continue to offer high quality primary care services to their patients. The area team does however recognise that recruitment of GPs is a national problem. We will continue to work with our GP practices and in close collaboration with the local Clinical Commissioning Groups and Health Education England to help recruit and retain the very best GPs, recognising the opportunities that this area has to offer.”

What are your experiences of primary care in Norfolk? Email adam.gretton@archant.co.uk

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