General practice in Cornwall on brink of a crisis

General practice in Cornwall is on the brink of a crisis.

That’s the warning from Kernow Local Medical Committee (LMC) which represents the profession.

The LMC says local GP surgeries have been overwhelmed by issues such as increased workload – including delivering the majority of the Covid-19 vaccination programme on top of the day job.

Exceptionally long waits for ambulance transfers by South Western Ambulance Service NHS Foundation Trust (SWAST) from community settings to hospitals mean GPs are also having to manage acutely unwell patients in need of hospital care for longer.

Due to the Covid-19 pandemic the Royal Cornwall Hospitals NHS Trust (RCHT) and University Hospitals Plymouth NHS Trust (UHP) are also struggling with outpatient capacity issues, leaving longer waiting times for patients to be seen or reviewed, leading to GPs spending more time and appointments fielding patient enquiries.

These issues are compounded by longstanding GP and practice nurse shortages after years of under-resourcing nationally.

Despite grappling with the challenges faced, local general practice remains open and has been throughout the Covid-19 pandemic, thanks to its clinicians and staff.

National figures confirm general practice is offering more appointments than ever. Across Cornwall in July, GPs provided 326,570 appointments and 59% of patients were seen face to face in GP surgeries.

But fears are growing that later in the year many local GP surgeries won’t have the resources or resilience to deal with the existing challenges, plus additional pressures like a huge increase in Covid-19 numbers, a significant rise in respiratory virus cases and a predicted hike in flu cases of at least 50%.

Dr Nick Rogers, the LMC’s new Chair, said: “The LMC is supporting increasing numbers of GP practices and GPs across Cornwall with issues like resilience, workforce and workload.

“The LMC is calling for urgent support from our local health system partners to help manage demand, stabilise the workforce and release capacity for the emerging work associated with Covid-19 and flu and to find ways to plan ahead for crisis points.”

Dr Rogers, also a GP Partner at Falmouth Health Centre, added: “This is a very serious situation – but I would like to reassure patients that general practice in Cornwall is open, is seeing patients face to face and has been throughout the Covid-19 pandemic, and will continue to do so.

“We are working as hard, fast and safely as possible to deliver the best outcomes for our patients, set against the challenges faced.”

Despite the overwhelming pressure on local GP practices, results from the recent national 2021 GP Patient Survey show:

• 87% of patients in Cornwall rated their overall experience of their GP practice as ‘good’ – 4% higher than the national average.
• 87% of patients in Cornwall were satisfied with the appointment (or appointments) they were offered – 5% more than the national average.
• 73% of patients in Cornwall found it easy to get through to someone at their GP practice on the phone – 5% better than the national average.
• 92% of patients in Cornwall found the receptionists at their GP practice helpful – 3% above the national average.
• 79% of patients in Cornwall found it easy to use their GP practice’s website to look for information or access services – 4% greater than the national average.

The LMC would like to reassure the public that:

• All GP practices remain open for patients.
• If you require an appointment, then the most appropriate appointment will be offered and discussed with you. The appointment may be face-face, by telephone, e-mail or another route. The GP practice will do everything to protect your safety and that of its staff.
• GPs and practice staff are working hard to keep you safe by running your local Covid-19 vaccination programme. Please make sure you book an appointment when asked to do so.
• People can find the most appropriate healthcare service to meet their needs by looking online at NHS Service Finder. If you need help now, and you're not sure what to do go to 111.nhs.uk or call 111. If you think it's an emergency call 999.

Patients are also asked to help their GP practice deliver effective, safe and timely care by:

• Considering whether you need to consult the GP practice. Some issues can be addressed through simple remedies and first aid, self-care at home, a visit to a pharmacy or a call to 111.  
• Being aware that the busiest time on GP practice telephone systems is 8am-10am. We suggest that, if you are contacting your GP surgery for a routine enquiry or are not seeking an appointment, they will be able to address your concern more quickly outside times of peak demand.  
• Respecting your GP practice’s frontline staff. We know that queuing on the phone is incredibly frustrating but frontline staff, including receptionists, are here to help.
• Making your views known by joining a Patient Participation Group which allows for constructive feedback between your GP surgery and its patients in an official and regulated capacity.

Nationally, the Royal College of General Practitioners (RCGP) has warned an emergency rescue package is needed for general practice if patients are to receive the care they need once the Covid-19 pandemic is over.

The RCGP has issued a report, General Practice in Crisis: An Action Plan for Recovery, with priority actions for the Government to take to improve care for patients in general practice – including recruiting thousands of additional GPs and practice staff.