Call for GP investment and realistic expectations as report flags poor patient experiences

GP leaders have called for investment in staff and infrastructure to improve patients' experience of primary care - and insisted officials must do more to keep expectations realistic in the face of soaring workload.

NHS admin concerns (Photo: Oli Scarff /Getty Images)
NHS admin concerns (Photo: Oli Scarff /Getty Images)

The call for funding and honesty with the public over what to expect from NHS services comes after a report by the King's Fund, Healthwatch UK and patient charity National Voices into the role of admin in quality care.

The report analysed comments from patients on the care.opinion website and found that admin processes and/or reception staff were mentioned in 42% of cases. Most of the comments about NHS admin related to primary care, the review found - and just over half were negative.

Negative comments related to issues including appointment booking, or admin processes that had gone wrong such as prescription requests not being processed.

GP workload

The report warns that administrative or reception staff can be 'perceived as uncaring' - adding that this can 'add to anxiety and deter people from engaging with their healthcare', while where staff are perceived as friendly this can 'help ease this anxiety and give people a sense of reassurance and control especially when administrative mistakes are made'.

The report on patients' experiences of NHS admin comes as general practice is under unprecedented pressure - and at a time when campaigners have highlighted 'daily abuse' of staff in general practice from frustrated or angry patients.

Analysis by GPonline of data from the RCGP's research and surveillance centre has shown that the profession is currently dealing with a third more clinical administrative work than before the COVID-19 pandemic.

BMA GP committee chair Dr Richard Vautrey said GPs had long called for a reduction in unnecessary bureaucracy - and that understaffing and outdated IT infrastructure at a time of intense pressure contributed to situations that are frustrating for both patients and primary care staff.

Face-to-face appointments

In the wake of public demands from NHS England for GPs to see all patients face-to-face - which have led to a breakdown in relations between the BMA GP committee and NHS leaders - Dr Vautrey also called on the government and NHS England to be honest with the public over what can be expected of a health service stretched to breaking point.

The report argues that administrative work should be 'acknowledged as a critical feature of a healthcare system that is truly fit for purpose'.

It calls for research into the causes of poor NHS administration at a national and local level, the impact of COVID-19 on NHS administration, work around digital healthcare and exclusion, admin links between different parts of the health and care system and on how patients can be involved in work to improve processes.

The report says: 'NHS administration is a gatekeeper and enabler to healthcare, and when it falls short patients receive low value care, valuable resources are wasted and trust is eroded in the system.

Patient care

'Too often it falls on the patient or carer to remind the NHS how they are entitled to be treated. This risks exacerbating health inequity as people are not equally able to overcome administrative obstacles and mitigate the effects of these.'

The report says it is vital that 'reform programmes in the NHS, for example around primary care or elective waits, pay detailed and sustained attention to the kind of administrative processes that are needed to facilitate good care'.

Dr Vautrey told GPonline: 'We’ve long argued for the need to reduce unnecessary admin and bureaucracy within general practice that take valuable clinicians time away from caring for patients.

'As recent appointment data has shown, practices staff are under unprecedented workload pressure, but what is not always immediately obvious to patients and the wider public is the ‘hidden’ work not accounted for in such data, including the vast amount of administration.

'With a depleted workforce, there are fewer staff to take on this extra work, and ultimately this will impact on the service and care that patients feel they are able to access, so alongside a reduction in unnecessary bureaucracy, practices simply need more staff and resourcing to cope.

'Furthermore, there needs to be investment to update clunky and outdated IT systems, so that frustrating processes can be streamlined and time spent waiting around for screens to load can be replaced with seeing and talking to patients.

'Meanwhile, the last year has seen practices following national infection control guidance and introducing new ways of working, and while we appreciate that this can be frustrating for some patients, this has been in place to protect patients and practice staff. With this in mind, and amid rising demand for services, the government and NHS England need to support general practice and have an honest conversation with the public about the pressure practices are under and what they should expect from the NHS right now.'

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