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You can find the current article at its original source at http://www.theguardian.com/commentisfree/2014/aug/08/gp-practices-struggling-healthcare-system-halifax-surgery

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GP practices are struggling but it should not be the patients who take the strain GP practices are struggling but it should not be the patients who take the strain
(12 days later)
In Halifax, 10,000 people have received a letter from their GP practice telling them not to contact the surgery for a same-day appointment unless it is an emergency. The letter says that “GP practices are at breaking point” and that the practice is having to deal with an “unsustainable number of patients each day”. It concludes the system is no longer safe for the doctors or patients.In Halifax, 10,000 people have received a letter from their GP practice telling them not to contact the surgery for a same-day appointment unless it is an emergency. The letter says that “GP practices are at breaking point” and that the practice is having to deal with an “unsustainable number of patients each day”. It concludes the system is no longer safe for the doctors or patients.
This follows a petition presented to the prime minister this week by GPs in east London, which says 22 practices may be forced to close if funding changes go ahead.This follows a petition presented to the prime minister this week by GPs in east London, which says 22 practices may be forced to close if funding changes go ahead.
So is it true that general practice in this country is unsafe? First, let’s look at the letter itself. It doesn’t say you will only be seen if it’s an emergency: it is an announcement of changes to the appointment system. If I understand it correctly, it means that if you have an urgent problem, it will call you back the same day. If it’s not urgent, you will still be called back but it may be a few days later. If there are no routine appointments to offer, you will be asked to call again.So is it true that general practice in this country is unsafe? First, let’s look at the letter itself. It doesn’t say you will only be seen if it’s an emergency: it is an announcement of changes to the appointment system. If I understand it correctly, it means that if you have an urgent problem, it will call you back the same day. If it’s not urgent, you will still be called back but it may be a few days later. If there are no routine appointments to offer, you will be asked to call again.
Many surgeries say something similar and rely on the individual to assess the urgency of their condition. This isn’t perfect because some people know exactly which buzzwords to use to ensure their call rings alarm bells and gets them instant attention – chest pain, drowsy child with high fever, slurred speech. Others can be having a stroke, heart or asthma attack and will downplay the symptoms for any number of reasons – they have learning difficulties, are drunk, have dementia or are unduly worried about “bothering the doctor”.Many surgeries say something similar and rely on the individual to assess the urgency of their condition. This isn’t perfect because some people know exactly which buzzwords to use to ensure their call rings alarm bells and gets them instant attention – chest pain, drowsy child with high fever, slurred speech. Others can be having a stroke, heart or asthma attack and will downplay the symptoms for any number of reasons – they have learning difficulties, are drunk, have dementia or are unduly worried about “bothering the doctor”.
In the case of the savvy person, no harm is done except for taking up an emergency slot unnecessarily. But the reticent callers may be in danger as they struggle to put their case across on the phone.In the case of the savvy person, no harm is done except for taking up an emergency slot unnecessarily. But the reticent callers may be in danger as they struggle to put their case across on the phone.
A face-to-face consultation is what most people want, and many need. A recent study showed that offering phone consultations doesn’t cut doctors’ workloads. In fact, more people ended up needing a second consultation to deal with their problem – the number of patients being dealt with by practices increased 33% when a doctor called back; and 48% when a nurse did so.A face-to-face consultation is what most people want, and many need. A recent study showed that offering phone consultations doesn’t cut doctors’ workloads. In fact, more people ended up needing a second consultation to deal with their problem – the number of patients being dealt with by practices increased 33% when a doctor called back; and 48% when a nurse did so.
The British Medical Association agrees that GPs are “firefighting to provide services their patients need”. It is campaigning for investment to boost numbers of GPs and practice staff, and to improve premises.The British Medical Association agrees that GPs are “firefighting to provide services their patients need”. It is campaigning for investment to boost numbers of GPs and practice staff, and to improve premises.
But general practice in the UK is not unsafe and is unlikely to become so. In a patient survey this year, 75% said their overall experience of making an appointment was good and 86% had a good experience of their GP surgery. A recent report by the Washington-based Commonwealth Fund acknowledges that the UK system is generally excellent and good value for money, saying that out of the 11 countries it looked at, “the United Kingdom ranks first overall, scoring highest on quality, access and efficiency”.But general practice in the UK is not unsafe and is unlikely to become so. In a patient survey this year, 75% said their overall experience of making an appointment was good and 86% had a good experience of their GP surgery. A recent report by the Washington-based Commonwealth Fund acknowledges that the UK system is generally excellent and good value for money, saying that out of the 11 countries it looked at, “the United Kingdom ranks first overall, scoring highest on quality, access and efficiency”.
GPs are certainly having to work hard and deal with funding cuts, like most public sector workers. In some areas, demand is particularly high as socioeconomic problems worsen and social services struggle to cope. The same areas may find it harder to attract GPs, so even if practices want to employ more staff, they can’t. The Inverse Care Law still applies; those who need healthcare most get it least.GPs are certainly having to work hard and deal with funding cuts, like most public sector workers. In some areas, demand is particularly high as socioeconomic problems worsen and social services struggle to cope. The same areas may find it harder to attract GPs, so even if practices want to employ more staff, they can’t. The Inverse Care Law still applies; those who need healthcare most get it least.
But this shortfall between supply and demand is for government and doctors to sort out. It seems unfair to put the onus on customers. And we are customers, not patients. The NHS is not a free service or a charity. We pay for it and have a right to consistent and reliable provision of healthcare. If a supermarket checkout queue gets too long, it doesn’t tell us to stay at home or guilt-trip us for having turned up in the first place. It puts extra people on the tills. That’s what needs to happen in Halifax too. But this shortfall between supply and demand is for government and doctors to sort out. It seems unfair to put the onus on customers. And we are customers, not patients. The NHS is not a free service or a charity. We pay for it and have a right to consistent and reliable provision of healthcare. If a supermarket checkout queue gets too long, it doesn’t tell us to stay at home or guilt-trip us for having turned up in the first place. It puts extra people on the tills. That’s what needs to happen in Halifax too.