Some 74% of 186 GP partners responding to the survey said they were concerned that their practice will be unable to cope during the 2018/19 winter period, citing concerns over workforce problems, heavy workload and underfunding.
Among all GPs, more than two thirds (67%) of 513 respondents said their practice would struggle to cope and 92% thought the NHS as a whole would have the same problem. Those findings reflect results from GPonline’s 2017 winter survey, when 68% of all GPs said they thought their practice would struggle and 90% said the NHS as a whole would have problems.
GPC chair Dr Richard Vautrey said it was not surprising that GPs had serious concerns about workload this winter.
‘When practices have been working flat out all year it’s not surprising that so many have serious concerns about the winter ahead,' he said. 'It’s why there is a need not just for short term fixes but for a long term funding solution that enables practices to expand their teams to be able to help manage their workload and better respond to growing patient needs.’
RCGP chair Professor Helen Stokes-Lampard said: 'These figures are further proof of what we have been saying for a long time – that winter pressures are not confined to hospitals and GPs are working flat out to try and cope with demand. With flu season approaching its peak and more cold weather on the way, it’s unlikely that there’ll be any let up anytime soon.'
Winter pressures
GP leaders warned last month that practices would be 'stretched to the limit' this winter. The warning came in the wake of a BMA analysis of pressure on emergency care services, which found that the NHS delivered 'worse levels of care' through summer 2018 than in five out of the past eight winters.
GPs responding to GPonline's poll revealed that their practices had taken steps to mitigate the pressures they may face this winter, including making more same-day appointments available, introducing 'more aggressive triage' and hiring extra staff.
Despite this, many were concerned they would still be unable to cope and some said they were already having problems dealing with demand.
One GP partner said: ‘We have taken every available step possible within the financial constraints we have, but [are] already seeing massive pushback from struggling hospitals unable to cope which additionally impacts on us. We are increasingly being asked to provide more and more emergency care.’
Another added: 'We are already seeing more acute illness which we are struggling to cope with. We cannot prepare as we are already working to capacity and have staff off sick.'
'We are already working flat out even before winter pressures kick in,' another GP partner said. 'We have tried to recruit locums and offered extra sessions to salaried GP but there aren't enough doctor hours available to plug potential gaps.'
Flu vaccines
GPs were also highly critical over the way the flu vaccination campaign was organised this year, which involved a staged delivery of the adjuvanted (aTIV) vaccine - recommended for patients aged 65 and over for the first time in 2018.
This left many practices facing supply problems due to stock being delayed and/or subject to high demand and struggling to catch-up to ensure patients were immunised.
One GP partner responding to the survey said: ‘We had our flu clinics early to avoid onset of winter pressures but this was restricted due to availability of vaccines therefore we are still vaccinating.'
Another added: ‘Since the disaster of last winter… Four things have changed: funding has been cut further by government, morale is lower, there are fewer staff, NHS England has screwed up the delivery of the annual flu vaccination programme. It's going to be a disaster. People will die.’
In a GPonline poll in February 2018 more than three quarters of GP partners said their practice had struggled to cope during the 2017/18 winter period. Of the 506 GPs responding to that survey, one in four said that they had seen a patient come to harm as a result of pressues on the NHS last winter.
Professor Stokes-Lampard added: 'As difficult as winter is for GPs and their teams, however, the truth is that general practice is now experiencing crises all year round as pressures on our service intensify and our resources and investment are stretched ever thinner.
She said that the promised funding under the GP Forward View needed to be delivered as a matter or urgency, 'as well as an extra £2.5bn a year as part of the forthcoming NHS long-term plan for general practice.'
NHS England was approached for comment.
