COVID-19 risk assessments could devastate fragile GP workforce in parts of England

COVID-19 risk assessments could devastate the threadbare primary care workforce in some of England's most underdoctored areas, analysis by GPonline reveals.

Face-to-face consultations too risky for some doctors (Photo: mtreasure/Getty Images)
Face-to-face consultations too risky for some doctors (Photo: mtreasure/Getty Images)

More than one in three GPs in England are from black, Asian or minority ethnic (BAME) groups and around a quarter of the full-time equivalent (FTE) workforce is aged over 55, official data show.

But analysis by GPonline reveals that in some of the country's most underdoctored areas - where the overall number of patients per FTE GP is highest - the proportion of doctors in BAME and older age groups is far above the national average.

The findings suggest that a substantial proportion of doctors and other healthcare staff in these areas could be advised to step back from face-to-face care, undermining capacity in areas where workload is already high - and at a time when numbers of patients coming into surgeries are rising.

COVID-19 risk

GP practices have been ordered to complete risk assessments on all staff at potentially increased risk from coronavirus by 22 July. Any member of staff in a black, Asian or minority ethnic (BAME) group must be assessed - along with staff who may be at risk due to factors including age, weight, underlying health conditions, disability or pregnancy.

Some practices are already facing 'severe financial disruption' because of costs incurred during the pandemic - and these costs could now spike for practices forced to bring in extra locum cover if risk assessments leave their permanent workforce unable to meet demand.

GP leaders have repeatedly demanded the urgent rollout of a general practice COVID-19 support fund promised by the government - but this has yet to materialise and it remains unclear what costs will be covered.

BMA GP committee chair Dr Richard Vautrey said: 'It’s vital that all doctors are not putting themselves in harm’s way - especially those who may be at more risk than others due to age, ethnicity or other factors. And that’s why risk assessments are so important.

Face-to-face consultations

'Regardless of the local situation, higher-risk doctors should not feel compelled to put themselves further at risk because of the impact it would have on staffing - and it’s crucial that CCGs support practices to maintain services if doctors need to step away from patient-facing roles.

'This includes providing and funding locum cover, and ensuring that practices have access to appropriate IT hardware and software for remote consultations and home working.

'The well overdue COVID-19 relief funding would also go a long way to solving some of these issues, which underline so clearly why the government must urgently provide practices with the resources they need. Without doing so, they are not only letting down practices, but also their patients.'

Analysis by GPonline shows that some CCG areas have a potentially volatile mix of high numbers of patients per FTE GP, a high proportion of BAME GPs, and a high proportion of GPs aged over 55.

CCGs under pressure

Barking and Dagenham CCG, in east London, has the fourth highest number of patients per FTE, fully-qualified GP in England - with 2,763 patients per GP on average.

It also has the highest proportion of BAME GPs in England, with 93% of the FTE GP workforce for whom ethnicity has been recorded in BAME groups - while just under a third of its GP workforce is aged over 55, putting the CCG also in the top 10 nationally on this measure.

Thurrock CCG, in nearby Essex, is also in the top 10 CCGs in England on all three measures, while neighbouring Basildon and Brentwood CCG has the 8th highest proportion of GPs over 55 and is just outside the top 10 for GPs in BAME groups and overall patients per GP.

Waltham Forest CCG - also nearby in north-east London - is in the top 10 for patients per FTE GP and GPs over 55, and has the 13th highest proportion of GPs who are BAME.

Luton and Milton Keynes CCGs are also high on all three measures - and at the other end of the country more than half of the workforce in Hull CCG are from BAME groups and it is in the top 10 for GPs aged over 55 and overall patients per GP.

Warnings over the risk for areas with large numbers of staff unable to provide face-to-face care come as RCGP surveillance data suggest that the number of of GP consultations provided face-to-face in the week ending 28 June is up more than 50% compared with the start of April.

An NHS England spokesperson said: 'Quite rightly, there have been adjustments in some working practices throughout the pandemic, including a spike in the uptake of online and telephone triage in medical practices to help reduce COVID-19 transmission, while continuing to protect and support both patients and staff.

'The NHS has been absolutely clear that staff risk assessments should be treated as a key priority and GP practices can put mutual aid and cover arrangements in place where necessary in discussion with their CCG.'

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