Agenda item

(To receive a report from the Lincolnshire Local Medical Committee (LMC), which provides the Committee with an update on access to general practice services.  Dr Kieran Sharrock, Former Medical Director Lincolnshire Local Medical Committee and Deputy Chair of the BMA Practitioner Committee England will be in attendance for this item)

The Committee considered a report from the Lincolnshire Local Medical Committee (LMC), which provided a report on access to general practice services.

The Chairman invited Dr Kieran Sharrock, former Medical Director of Lincolnshire Local Medical Committee and Deputy Chair of the British Medical Association (BMA) Practitioner Committee for England, to remotely, present the item to the Committee.

The Committee was advised that nationally the demand for general practice appointments was higher than it had ever been, but the workforce in general practice was declining.  It was reported that this mismatch had led to practices not having the capacity to provide the access which patients that the system would like.

It was reported that general practices had a backlog of care caused by the pandemic, and that hospital trusts also had long waiting lists due to the pandemic, which was impacting on general practice, as patients were seeking further support with their increased health needs which were unable to be managed by secondary care.

The report advised that as of January 2022, in England there were 1,608 fewer fully qualified full-time GPs compared to 2015.  It was highlighted that to compensate for the reduced number of GPs and nurses, practices, and Primary Care Networks (PCNs) now employed other health professionals to manage patients’ conditions.  These professionals were qualified to manage conditions in their sphere of practice but did not have the holistic skills of a GP.

The Committee was advised of the Lincolnshire position, with reference being made to Lincolnshire having a deficit of available professionals; practices in rural and coastal communities being less able to recruit; and that the additional roles funding was limited by national pay scales, which was a disadvantage to PCNs.  Details on page 46 of the report provided the Committee with the number of total appointments and face to face appointments conducted by Lincolnshire’s general practices for December 2019 and December 2021.  The figures highlighted that despite a reduced workforce, Lincolnshire’s general practices had increased their appointments by 6% since pre-pandemic.

The Committee was advised that increasing workload was causing GPs and other clinical staff to leave the profession early, and that from a recent poll, one third of GPs had reported they were suffering from depression, burn out or mental distress.  Further details relating to a recent poll of GPs was shown on page 47 of the report for the Committees consideration.  It was also highlighted that a lack of workforce planning, and other factors had resulted in GPs feeling that the health service was now unsafe for patients and practitioners.

During consideration of this item, the Committee raised some of the following comments:

·       The frustrations and problems encountered by patients not being able to get an appointment with a GP. The Committee noted that receptionists were designated as care navigators trained to identify a patients need and direct them to the most appropriate person.  It was highlighted that unfortunately there were not enough professional people to deal with the demand, and that patients tended to prefer the holistic care provided by a GP.  The Committee was advised that since the pandemic appointments had increased, some of which were face to face, some were telephone conversations, and some were conducted via video link.  The Committee was advised that 60% of consultations across the trust were conducted face to face.  Some members highlighted that some patients were still unable to get through to a receptionist due to the high volume of calls.  It was highlighted that practices were doing three times the amount of work, and did not having the right number of staff to meet the demand; 

·       Concern was expressed at the lack of national planning by the government with regard to recruitment;

·       Some clarity was sought regarding digital data and whether the figures included Covid-19 vaccinations.  Confirmation was given that it excluded Covid-19 vaccinations;

·       The usefulness of on-line consultations for GP practices.  The Committee was advised that modelling information was available from the BMA and that the Lincolnshire Clinical Commissioning Group would have data concerning workforce investment;

·       Average working time for a GP was 38.3 hours per week.  The Committee was advised that a recently published report by the Policy Exchange into general practice had advised that GPs should do no more that 25-30 clinical contacts a day to maintain safety, but NHS figures were showing that GPs were doing on average 47 contacts a day, and as a result several GPs and other clinical staff were leaving the profession;

·       That more resources and funding was needed along the east coast to support the practices to provide services;

·       Whether a workforce plan existed for Lincolnshire.  The Committee was advised that there was a Lincolnshire People Board, and that the PCN represented GPs on the said Board.  The Committee was advised that this was something the Lincolnshire CCG would be able to help with; and

·       The changes to GP service as a result of GP contracts;

On behalf of the Committee the Chairman extended his thanks to Dr Sharrock for his presentation.

RESOLVED

1.      That Lincolnshire GP practices be recognised for increasing the number of appointments by six per cent since before the pandemic.

2.      That an update on GP provision be considered by the Committee in six months’ time.