GPs trapped between rising demand and hospitals still refusing referrals

Practices are coming under increasing pressure because patient demand is rising back to normal but many hospitals are still not accepting referrals, GP leaders have warned.

BMA GP committee chair Dr Richard Vautrey
BMA GP committee chair Dr Richard Vautrey

Polling carried out for the NHS last month suggested that millions of patients were not calling their GP practice because they did not want to add to workload during the COVID-19 pandemic.

NHS chiefs have urged patients not to avoid seeking help, amid concerns that serious illness could be going untreated - with evidence of a sharp drop in activity including A&E attendances, hospital admissions for heart attacks and referrals on the two-week cancer pathway.

Surveillance data from the RCGP last month suggested that clinical activity in general practice had dropped by around 25% since the pandemic began - although the college cautioned at the time against using this figure as a barometer for pressure on primary care.

GPs under pressure

Speaking to GPonline this week BMA GP committee chair Dr Richard Vautrey said general practice was now 'seeing signs that the pressures we had before the pandemic are starting to rebuild'.

'The picture is changing quickly and it varies around the country,' he said. 'But the experience in the last few days is that contacts and calls, requests for consultations are rapidly increasing again.

'We are seeing from practices around the country that there is an increase in activity again. There are now many more contacts at my practice than we have had in the past few weeks.'

However, the Leeds GP warned that advice from NHS England that GPs should refer as normal and that hospitals should accept referrals had yet to cut through.

Hospitals were given permission to suspend routine procedures from mid-April to shift their focus to expanding capacity to cope with the pandemic. But with the impact of coronavirus in the UK now believed to be past its initial peak, trusts have been told to restart non-COVID-19 services - including routine procedures where possible - over the coming weeks.

COVID-19 pandemic

But Dr Vautrey said: 'What we still haven’t seen, despite the commitments made, is a starting of hospital activity in a way that allows us to make the referrals we need to be making. We have not seen that change yet.'

He said the public were receiving mixed messages and called for electronic referrals to be switched back on across the country. 'If the public communication is that the NHS is open and the reality is that patients contact us and we are still saying: "Computer says no", that is not helpful. We need to be able to make referrals.'

GPonline revealed this week that three quarters of GPs feared patients could come to harm because of delays to treatment, with around one in three reporting urgent referrals had been rejected during the pandemic.

GPonline also revealed last month that some patients referred on the urgent two-week cancer pathway had been waiting more than a month to be offered an appointment.

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