GP leaders warn profession 'on its last legs' amid 'barrage of vitriol'

GP leaders have condemned attacks on the profession in the national media over access to face-to-face care - warning that a chronic workforce shortage in general practice has left the profession 'on its last legs'.

RCGP chair Professor Martin Marshall (Photo: Pete Hill)
RCGP chair Professor Martin Marshall (Photo: Pete Hill)

RCGP chair Professor Martin Marshall hit out last week against a 'constant barrage of vitriol' against general practice in parts of the national media.

The college chair launched a defence of remote consultations in general practice after coroners' reports highlighted a potential link between remote consultations and delayed care. He said face-to-face appointments - which have accounted for more than half of all patient contacts through the pandemic - would always remain fundamental to general practice.

But he said remote consultations 'meant that GPs and their teams were able to carry on working and providing essential services when many other parts of the NHS had to shut down' during the COVID-19 pandemic.

Remote GP consultations

The east London GP warned that media coverage of the coroners' reports was 'contributing to a worrying narrative that has been gradually building up over the course of the pandemic: that remote consultations are substandard, harmful to patients and are being used by ‘lazy’ GPs as an excuse for not seeing patents face to face in the surgery'.

Professor Marshall warned: 'As well as being inaccurate and untrue, this narrative in itself is harmful as it undermines public trust and confidence in remote consultations when thousands of patients are being assessed effectively and safely in this way in general practice every day - and have been since long before the pandemic.'

BMA GP committee chair Dr Richard Vautrey warned that general practice was 'on its last legs' after coming into a pandemic that has driven up pressure to unprecedented new heights with 'too few family doctors, a limited wider workforce, inadequate spaces, and a tonne of unmet government promises'.

The BMA's top GP added: 'Government pledges to deliver more GPs remain unmet and as workload pressures now increase at an alarming rate due to the pandemic and the growing backlog of care, it is no wonder that many practices are struggling to provide patients with the good care that GPs want to deliver, and that patients expect and deserve.

GPs under pressure

'The current situation is grave; the profession is on its last legs and the government must take this seriously and invest in general practice as a matter of a priority. Not only are we seeing more and more of our already limited workforce leaving the profession due to burnout, but we are now at a point where patients will suffer if the government do not urgently address the concerns that the BMA and many other medical bodies have been raising for far too long now.'

Professor Marshall pointed out that the initial shift to remote consultations as the pandemic struck was in line with government advice and a vital step to maintain the safety both of patients and staff in general practice.

Commenting on reports from Greater Manchester coroner Alison Mutch into patient deaths, the RCGP chair hit back at claims that remote consultations were 'substandard'.

Ms Mutch reported on a patient who died after being discharged from hospital without receiving an X-ray on what turned out to be a fractured femur. The inquest heard that a subsequent GP appointment would have been face-to-face pre-COVID, and the coroner wrote: 'The evidence indicated that a physical examination would probably have resulted in Mr Leech being referred back to hospital at an earlier stage.'

COVID-19 death

Another report by Ms Mutch highlighted the death of a patient from COVID-19 after a telephone consultation. The coroner wrote that 'a face-to-face appointment and testing in such a scenario may well have led to identification of COVID-19 and different treatment'.

Dr Marshall said: 'The unexpected death of any patient receiving NHS care is always shocking and while we cannot comment on individual cases, our condolences go to anyone who has lost a loved one during the pandemic.

'However, we are concerned about a growing public perception that remote consultations are somehow substandard compared with seeing a GP in person. GPs work incredibly hard to deliver the same high-quality, care for their patients, whether a consultation is remote or face-to-face.

'Thousands of patients are being assessed effectively and safely in general practice every day via remote consultations – and have been since long before the pandemic. Another misconception is that they are quicker when many actually take up more GP time.'

He added: 'We understand and share the frustrations of patients who are facing long waits for appointments or when they can’t even get through to the surgery, and GPs share them too.

'The real issue is not about GPs seeing patients remotely versus face-to-face, but about the GP workforce not being big enough to meet the needs and expectations of a growing and ageing population. This was the case before the pandemic and the past 18 months have further exacerbated it.

'Successive governments have failed to invest in our service for more than a decade and GP numbers have declined while our workload has escalated in volume and complexity.'

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