GPs 'running on empty' as LMC issues third red alert in a month

An LMC has issued its third countywide red alert in four weeks as primary care contends with spiralling workloads, with GPs warning that they are ‘running on empty’ with ‘no let up in the system’.

GP consulting room
(Photo: Robert Johns/UNP)

Devon LMC said that demand across the county was ‘exceptionally high’ and activity had 'once again increased'.

Its 29 July General Practice Alert State (GPAS) report, which measures pressure across primary care in the area, said that activity in the west of the county was the highest recorded since the system began two years ago. The indicator showed practices in that part of Devon were currently dealing with 40 clinical contacts per thousand patient.

Devon LMC is one of only a handful of LMCs across England that has a well-established system for monitoring pressure on general practice. The LMC issued its first ever red alert last month, which means that escalating pressure is leaving GP practices struggling to deliver comprehensive care.

The system shows that practices dealt with 215,150 patient contacts in the week to 29 July, an increase on the 195,000 patient contacts per week earlier in the month when the LMC issued the first red alert.

A spokesperson for Devon LMC said that current contracts and funding arrangements for practices 'were not set up to deal with this volume' of work.

Increases in demand

The LMC's latest report says that practices in the county had reported 'noticeable increases in volume and demand' and 'increasing incidents of patient abuse and aggression'.

The problem of increasing demand has been exacerbated by decreasing numbers of GPs and nurses, which has been driven by early retirements.

A spokesperson for Devon LMC said: ‘The last 18 months has seen a depletion of the general practice workforce. Prior to the pandemic workforce planners were concerned about demographic troughs amongst GPs and nurses where the ageing population of those professionals was presenting a potential cliff edge over the next decade. Older clinicians are starting to retire early which is exacerbating the problem.’

They also raised concerns that current workload pressures could lead increasing numbers of support staff to resign, adding further pressure to practices.

The spokesperson said. 'Receptionists, administrators and practice managers are all under huge amounts of pressure. Not only are they exhausted due to the volume of work but they are the ones subjected to intolerable levels of abuse and they are starting to leave.'

'Running on empty'

One Devon practice told the LMC: 'Those of us that are left working are running on empty. There is no let-up in the system. Holiday period is on us and there are no locums. The figures do not reflect the true picture as there is only so much, we can do in an already extended day. A patient complained that the GP rang at 8pm but that is the time he got to the call.'

Another said: 'The practice is working [at its] limit. Unexpected issues will topple our current resilience to maintaining reasonable appointment waits and compromise our ability to give timely responses. Significant concerns regarding emergency department backlogs and 111 activity being "returned" to GPs.'

They added that there was a 'crisis looming' with introduction of enhanced access in October, when PCNs will be expected to provide additional appointments to patients in 'network standard hours' - 6.30pm to 8pm on weekdays and 9am to 5pm on Saturdays.

Another practice in the area said they had two GPs on long-term sick leave and another two due to leave shortly because of workload pressures. They said that 'incidents of patients abuse and aggression towards staff' were rising alongside demand.

Last month GP leaders warned that current levels of workload in general practice across the country were unsustainable and unsafe as the profession continues to haemorrhage doctors.

Analysis by GPonline this week suggests that general practice in England may be delivering as many as double the number of appointments it is funded for.

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