GPs report rising workload linked to record hospital waiting times

Eight in 10 GPs say rising waits for NHS hospital treatment have driven up workload at their practice, as primary care suffers the knock-on effects of a growing crisis in secondary care.

Hospital waits have added to pressure on GPs (Photo: sturti/Getty Images)

A total of 84% of 474 GPs who took part in the latest GPonline opinion poll said they had noticed an increase in waiting times for hospital treatment in their area over the past year. Of these GPs, 95% - 80% of all respondents - said practice workload had increased as a result.

Among 140 GP partners who completed the survey, 92% said waiting times for hospital treatment had increased - and 95% of these doctors said it had driven up practice workload.

The findings show how pressure on hospitals is funnelling down to primary care, creating increased demand for appointments and extra work as patients seek the help of their family doctor while waiting for hospital treatment.

Last month, GPonline revealed that over 75% of GPs feared that their practice would struggle this winter because of a knock-on effect from hospitals, with one GP saying problems referring people to hospital would lead to patients ‘bouncing in and out’ of surgeries.

Longer waiting times

Clinicians taking part in the survey said longer waiting times were placing additional burden on practice staff, with many saying that patients placed on hospital waiting lists were returning to surgeries.

‘As demand rises and capacity falls, treatment waiting times increase. Patients waiting for secondary care then have more primary care attendances to support them while waiting [for hospital appointments],’ one GP said.

‘Hospital waits are routinely over a year now for neurology, pain clinic... not to mention huge waits for super-specialist clinics. Workload increases flow downstream [to GP practices] as patients continue to struggle with symptoms and anxiety, while they wait for diagnoses we cannot definitively make,’ said another.

Other GPs said they were having to ‘chase referrals’ and hospital appointments to help unhappy patients left on waiting lists - all contributing to increasing workloads.

Increased GP workload

'Patients are increasingly reporting postponement of outpatient appointments and surgery by hospitals. I'm finding that I write more letters to expedite action than I used to, and managing problems using advice and guidance systems extensively,’ one GP said.

‘[We’ve had] increased patient complaints about long waiting times who ask us to try to push things forward. There is only so much advocating one can do and this constant chasing of appointments and referrals takes up time that could be used to see other patients,’ added another.

One GP reported increased patient complaints around waiting times and said the problem had caused colleagues to leave practices.

‘Complaints made by patients about hospital waiting times are bounced back to the GP practice, which adds more to the workload. I'm seeing patient complaints escalate, which I've seen resulting in GPs ceasing to work in that practice.’

Another expressed concern about patient safety as they said delays had led to the deterioration of people's heath.

'Patients are waiting far too long for follow ups, even cancer patients. I have several times found patients have seen their cancer progress significantly because of cancellation of follow up appointments. This resulted in me having to write to the hospital to beg early appointments. This situation is unsafe.'

NHS underfunding

Responding to the survey results, BMA GP committee chair Dr Richard Vautrey, said: 'It is a concern, though not a surprise, that so many GPs are reporting an increase in workload due to longer hospital waits. After more than a decade of underfunding the NHS as a whole simply does not have the resources to cope with the level of demand.

'As such it is inevitable that GPs, often the first point of contact for patients, feel the knock-on effect of pressures on the wider health system. We desperately need urgent investment across every area of the health service both in primary and secondary care to ensure we have the staff and resources so that hardworking doctors can deliver the level care our patients deserve.'

NHS data revealed last month that waiting times for hospital services were at record levels, showing that around 4.5m people - the highest number ever - were waiting for non-emergency care in hospitals.

Meanwhile, GPs delievered a record 30.8m appointments in October 2019 - by far the highest figure recorded in a single month since NHS Digital began collecting data 18 months ago.

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