GP SERVICES/OUT OF HOURS/111

GP appointment waiting times 'risk to patient safety', warns RCGP (Pulse: 24 July 2017)

Patients across England face waiting longer than a week for a GP or practice nurse appointment on more than 100 million occasions by 2022, according to new analysis from the RCGP.

The figures, from the GP Patient Survey, reveal that if current trends continue, the number of instances when patients will have to wait a week or more to see a GP or practice nurse will jump from 80 million in 2016/17 to 102 million in 2021/22.

The analysis comes after Pulse has revealed that the average wait for a GP appointment is around 13 days, despite measures introduced by the NHS to alleviate pressures on general practice.

The RCGP points out that the situation across England is patchy, with patients in some areas facing long waiting times even to see a practice nurse.

In 21 CCG areas, covering 5.6 million patients, waiting times for an appointment with a GP or practice nurse are at least a week for more than a quarter of the time, the figures reveal.

Some of the worst areas to secure a GP appointment include Corby (36%), Fareham and Gosport (34%), Swindon (31%) and Central London (Westminster) (31%) where currently more than three in 10 patients wait a week or more for an appointment with their GP or practice nurse.

Even in places where access is better there are still thousands of patients waiting a week or more for an appointment, says the RCGP. In Bradford City, for example, where access to general practice is best, one in 10 patients (9%) still has to wait a week or more.

The RCGP warns that if the situation does not improve there is a genuine risk to patient safety. It is now calling on the Government once again to deliver on the pledges made in NHS England’s GP Forward View as a matter of urgency, to ensure that patients get the timely, quality care they need, when they need it....read more

 

General practice is being ground down so that private providers can take over (The Guardian: 24 July 2017)

“A GP, eh? Well I guess there are worse things you could do.”

That was the only careers advice I got in my final year at medical school.

The Royal College of General Practitioners (RCGP) has previously raised awareness of bad mouthing of GPs during medical school training.

The college highlighted the fact that many consultants teaching in medical schools talk about general practice as a second-rate career option to hospital medicine and that this is one of the reasons we are short of GPs.

I’ve no doubt that bad press does nothing to improve recruitment to our ranks, but the pressures on the family doctor service, which has led to the closure of dozens of practices across the country, has also played its part in making general practice less attractive to medical graduates.

GP surgeries are not part of the NHS in the way hospitals are. Most surgeries are still small businesses. In most cases the doctors own or rent their premises, they employ and pay their own staff and have all the usual responsibilities of running a business in addition to their work as doctors.

What many patients do not realise is how much general practice is being squeezed at both ends at the moment. Income for general practice is falling in real terms year-on-year, while the costs of running a practice are spiralling out of control.

Furthermore, 90% of all patient contacts in the NHS occur in general practice and in 2017-18 we were predicted to receive 7.29% of the NHS budget – general practice is exceptionally good value for taxpayers’ money. The RCGP is currently campaigning for general practice to receive 11% of the NHS budget....read more

 

Outstanding trust extends overnight urgent care closures (HSJ: 26 June 2017)

A foundation trust rated outstanding has extended the temporary overnight closure of its urgent care centres for a further three months.

Northumbria Healthcare Foundation Trust announced last week it was going to extend the temporary arrangements to maintain nursing levels at its specialist emergency care hospital.

Highly trained nursing staff have been moved to the trust’s Cramlington site

The trust said in November the opening hours of the centres at Hexham, North Tyneside and Wansbeck general hospitals would reduce from 24 to 16 hours from December.

The trust said at the time the 8am to midnight opening hours are part of its winter resilience planning so highly trained nursing staff could move to its Cramlington site, where there has been a surge in demand.

The trust said the temporary arrangements were extended from March to June and have now been extended again through to September.

It said it would be “inappropriate” to deploy staff back to the three urgent care centres because demand continued to be very high at Cramlington, while overnight urgent care attendances were low.

But the trust stressed it was still a temporary measure, despite now being extended for six months beyond initial plans.... read more

 

Deer Park Medical Centre: Campaigners to fight on after closure (BBC: 24 March 2017)

Campaigners have said they will fight to reopen an Oxfordshire doctor's surgery forced to close.

Witney's Deer Park practice will close later, leaving 4,000 people to look for new doctors. Oxfordshire Clinical Commissioning Group said it had not found a new provider to run the practice after its contract with Virgin Care ended.

Health secretary Jeremy Hunt ruled it would not be safe to keep it open with no provider in place.

Campaigner Yvonne De Burgo said: "We intend to fight on, to get it back open and running as good as it was before, either with Virgin Care or not.

"We have all had to go elsewhere and we haven't wanted to, and we are not getting as good a service as at Deer Park.

"That's not the fault of the other practices, they are just overwhelmed, they could only barely cope before."

Witney MP Robert Courts had said the "vital community asset" needed to stay open.

The decision to shut the practice has been referred to an independent reconfiguration panel, but it is not due to report back until 11 April....read more

 

LMCs stepping up plans for GPs to do more private work by end of this year (Pulse: 24 January 2017)

GPs leaders in England are pushing ahead with plans to develop new structures that will enable GPs to carry out more private work in a bid to increase GP funding, Pulse has learnt. 

The chair of Oxfordshire LMC told Pulse that they have been in discussions with LMCs across England about implementing new structures by the end of the year that will allow GPs to charge fees for carrying out non-contractual work.

Current rules prevent GPs from charging their own patients for care, but Oxfordshire LMC chair Dr Prit Buttar said they have developed models using third-party companies that would ’allow practices to take on what they want’.

The LMC said last year it was developing a ‘Plan B’ to take GPs out of the NHS, following the lead of Northern Ireland, where the GPC is set to vote on collecting practice resignations later this month.

It was, in part, a response to the UK GPC abandoning plans to ballot practices on mass resignation from the NHS, after receiving reassurances from NHS England that it was willing to consider the GPC’s proposals to alleviate pressures on GPs.

Dr Buttar told Pulse that the plans for GPs to provide more private services at the expense of NHS work have moved forward, and he expected to have a model for alternative working in place by the end of 2017....read more

 

Seventh practice in under two years set to close in English city (Pulse: 18 January 2017)

Yet another GP practice has closed in Brighton, bringing the total number of closures up to seven in less than two years, covering more than 30,000 patients. 

Some 2,300 patients have been left with instructions to temporarily rely on a local walk-in centre after the GP principal at single-handed Lewes Road Surgery handed back their contract.

It follows four practices in the city closing last year, while two more closed in 2015 - with one GP partner telling Pulse it was 'like a bereavement'.

Local leaders said that it is creating further pressure in an area that already has 'significant capacity problems'.

NHS England said in a letter to patients that Lewes Road Surgery principal Dr Amrut Shah was 'stepping down with immediate effect' following 'discussions over Christmas'.

It further admitted that it was likely patients may have to register elsewhere by the end of this month to 'guarantee' their 'ongoing care'....read more

 

NHS spends millions on private companies that block GP referrals, investigation finds (The Independent: 4 January 2017)

The NHS is spending millions on private companies that stop GPs referring patients to hospitals, an investigation has revealed.

Controversial "referral management centres" are supposed to cut costs and improve the quality of GP referrals – but three quarters of NHS bodies that told the British Medical Journal (BMJ) they used the schemes could not say whether they had saved money overall.

The centres can block or redirect GP referrals for procedures such as hip and knee replacements, treatment for allergies and cataract surgery to manage outpatient activity at local hospitals.

At least £57m has been paid out to them since April 2013, according to the 69 per cent of Clinical Commissioning Groups (CCGs) using the schemes which gave details of their operating costs.

Doctors expressed concern that paying third parties to screen GP referrals – around a third of which are run by private companies – was of questionable effectiveness.

“[CCGs] are leaping at these schemes without any clear evidence of benefit and that they’re just hopeful that it might reduce their costs,” Dr Richard Vautrey told the journal....read more

 

13 GP practices to close in single county (Pulse: 6 December 2016)

Plans are underway to close 13 of the 18 GP practices in Fermanagh, Northern Ireland, leaving patients having to travel '30 to 40 miles' to see their GP, the GPC has warned.

The proposals are under development with two practices already having closed recently, and four more closing in the next few months.

This is worse than had been previously feared, when it was reported that a third of the practices in the county would close, due to the retirement of potentially a third of the 66 GPs in the rural region.

With no GPs available to fill the slots, it has been predicted that three-quarters of Fermanagh’s practices will close within five years. ...Read More.

 

16,000 patients set to lose their GP practice over holiday period (Pulse: 29 November 2016)

Some 16,000 patients will lose their GP practice over the holiday period, as five practices are set to close across England.

Four practices, with a combined patient list of 10,700, are due to close in Lincolnshire on 16 December.

The Burton Road, Pottergate, Arboretum and Metheringham surgeries had been managed on a temporary basis by Lincolnshire Community Health Services NHS Trust since previous provider Universal Health Limited went into liquidation this summer.

Universal Health said the practices became financially unviable due to recruitment problems, which had left them increasingly dependent on locum doctors, with NHS England running an unsuccessful tender for the APMS contract. ...Read More.

 

'Domino effect' fears as GP practice closes after third provider walks away (GP Online: 28 November 2016)

An MP has called on NHS managers to resolve problems with primary care in her constituency after the announcement that a practice will close just a year after a new provider took over.

The 5,000-patient St Martin’s practice in south Bristol will close in January after the provider Crest Family Practice handed back its contract.

Crest is the third provider in three years that has said the practice is unsustainable.

The original GP partners at the practice are understood to have handed back their GMS contract two years ago because of workload pressures and recruitment problems. ...Read More.

 

Relentless GP workload is a threat to our patients' safety, says RCGP (Royal College of General Practitioners: 25 November 2016)

Professor Helen Stokes-Lampard has responded to a new survey out today from the British Medical Association which highlights the relentless workloads in general practice and the danger this is posing to our patients' safety.

She said: “This echoes much of what the College has been saying for some time now –  the relentlessness of the workload in general practice is a threat to our own health and our patients' safety.

“GPs will see a total of 1.3m patients today alone, and rising patient demand means GPs are carrying out more consultations than ever before - currently 370m a year and 60m more per year than even five years ago. ...Read More.

 

GP urgent home visits to ease A&E crisis (The Telegraph: 25 November 2016)

GPs are under pressure to provide emergency home visits to ease the crisis in overstretched A&E departments, NHSdocuments reveal.

Local doctors groups are being asked to establish “A&E Delivery Boards” and to draw up rotas of medics able to respond to 111 requests for urgent care at home.

The boards are ostensibly responsible for easing winter pressures, but the new NHS England best practice guidelines state the measures should remain in place all year round because of the unprecedented demand on hospitals.

Last month a Daily Telegraph investigation revealed that patients are being forced to wait for up to nine hours in ambulances because of the gridlock in A&E departments. ...Read More.

 

GPs decry Capita's privatised backup services as 'shambles' (The Guardian: 14 September 2016)

Family doctors have criticised the “shambles” that has ensued after the firm Capita was handed a £700m contract to provide important backup services to GP surgeries across England.

GP practices have been hit by a host of problems with patients’ medical records and they have begun suffering shortages of syringes, “fit notes” for patients to give to employers and pads on which to write prescriptions since Capita took over last year.

The British Medical Association has criticised Capita sharply for presiding over “multiple failures” in the support it gives England’s 8,000 GP practices.

In some cases, GPs have had to hold their first appointment with a new patient without their medical records to guide their decision-making, because Capita has not transferred them in time. Even some urgent requests to process records quickly because a patient had a medical emergency have not been acted upon. ...Read More.
 
 

Out-of-hours services 'broken' as single GP regularly covers 370,000 patients (Pulse: 8 September 2016)

Out-of-hours services in Northern Ireland are on the verge of collapse, with individual GPs regularly having to cover populations of 370,000 overnight on their own, GPs have warned.

Those in the South and West are being hit the hardest and are almost at the point of having to close completely, RCGP NI said.

Dr Frances O’Hagan, who is chair of Southern LMC chair and works for the out-of-hours service, described the service in the South as ‘broken’.

She said one GP was left to cover a population of 406,000 patients - although the health board claimed the figure was 369,000 - spread over a large geographical area, rather than the three required on 12 overnight shifts in August....read more

 

NHS child mental health services are failing the next generation, say GPs (The Guardian: 4 July 2016)

Up to four in five children with mental health problems are being denied access to treatment they urgently need in some parts of England, NHS figures show.

Overall six in 10 children and young people across England do not receive treatment for problems such as anxiety and depression, despite the risk of them coming to harm as their condition worsens.

The new data has renewed fears that vulnerable under-18s are suffering the effects of increasing rationing of psychological help on the NHS, despite high-profile government pledges to improve the service for children.

Family doctors and mental health campaigners voiced concern at the figures, which were obtained by the GP website Pulse. Dr Dominique Thompson, a GP in Bristol who specialises in young people’s mental health, said the figures showed that NHS children and adolescent mental health services (CAMHS) were “failing the next generation. We risk our CAMHS becoming a source of national shame if they continue to be so poorly resourced.”....read more

 

Average waiting time for GP appointment increases 30% in a year (Pulse: 10 June 2016)

The average waiting time for a routine GP appointment has almost hit two weeks, a Pulse survey has revealed.

The survey, answered by 831 respondents, found that the average waiting time for an appointment was just under 13 days – an increase from 10 days last year.

The respondents said that they expect the average time to be around 17 days next year. GP leaders said that this proves that the crisis in general practice is having a real effect on patients.

It comes as practices are having to stop providing appointments in advance – only accepting emergency appointments – due to workload pressures. Around 41% of GPs who answered the question said that the wait was longer than two weeks, with 15% saying it was longer than three weeks.

The situation has deteriorated since last year, when the average wait for an appointment was 10 days, and only 26% of GPs said the wait was longer than two weeks....read more

 

Four practices set to close leaving 10,000 patients displaced (Pulse: 7 June 2016)

Four practices in Brighton and Hove which together service over 10,000 patients are to close after having funding pulled through the review of PMS contracts.

Pulse reported in January that The Practice Group handed back its contract for the five practices after PMS funding was cut by 20%.  Although the provider agreed to continue providing services past its contract in March, NHS England has now announced that the practices will close.

According to a letter sent to stakeholders from NHS England, patients at three of the practices will be automatically transferred to other GP practices when theirs closes in July, September and November. The includes 4,000 patients of The Practice Whitehawk Road who will be able to attend a GP practice run from the same building. However, the 2,000 patients at The Practice North Street will have to register for a new GP themselves after the practice closes in July. The fifth practice currently run by the Practice Group is for homeless people, and NHS England is re-procuring this service....read more

 

GP practice forced to stop patients booking appointments in advance (Pulse: 6 June 2016)

A GP practice in Carlisle has stopped allowing patients to book appointments in advance because of the immense pressure it is facing.

Fusehill Medical Practice has introduced a telephone triage system, with a doctor speaking to all patients before they can book an appointment, and appointments only available on the day.

Partners at the practice have said that they have had trouble with the pre-bookable appointment system, and recruitment problems are worsening the situation.

It is the latest practice to do so, following a similar measure being taken by a practice in Swindon....read more

 

Practice 'loses £55,000' as CCG cuts £1m enhanced service without warning (Pulse: 1 June 2016)

A CCG has cut more than £1m in practice funding after decommissioning an enhanced service designed to improve care for vulnerable patients, without consulting the LMC. 

Walsall LMC said that practices had employed staff as a result of the enhanced service run by NHS Walsall CCG, which involved elderly patients receiving extra health checks, care plans and medication reviews and had 100% sign up from local practices.

But the CCG has pulled the £1.13m funding - which was worth £55,000 for one practice - leaving practices having to make staff redundant.

The CCG said that this was because the scheme was 'not able to demonstrate value for money'.

However, the LMC said that it was primarily decommissioned because the CCG has a £20m budget gap.

The enhanced service was initially funded via the £5 per patient that CCGs were supposed to redirect from hospital budgets to support GP practices in reducing avoidable hospital admissions, as part of the Avoiding Unplanned Admissions DES....read more

 

GPs like me can't help mental health patients in 10 minutes – it's cruel (The Guardian: 16 May 2016)
 

The word compassion in all Latin derived languages combines the prefix, with (com) and the root, to bear or suffering (passio). For a doctor and all health professionals this is a given prerequisite. We suffer with our patients. It is the essential penance we shoulder in return for the wondrous joy of helping those in need.

I am a GP, and as such I act as one of the gatekeepers to the health service. People of any age and problem can walk through our door. Wherever possible we either treat or reassure. If not then we direct the patient to another NHS service for help.

In general practice we see a large number of patients in need. Few people more so than those struggling with mental health problems. There are 10 times more people suffering with major depression compared to 1945. It is utterly heartbreaking to see a depressed person who is struggling, only to reply to them: “Sorry, but the counselling you need is at least a six-week wait”. To this patient, six weeks is 42 days (and nights), 1,008 hours, 60,480 minutes or 3.63 million seconds.

These seconds are not ordinary seconds. Life feels like constantly walking in oversized wellies through knee-high wet mud. It is backbreaking, emotionally draining, gloomy and painful. As their GP, I have to condemn my patient to at least 3.63 million seconds of further torture without hope. I feel so helpless and cruel....read more

 

Penalties for under-resourced doctor concerns (BMA News: 16 May 2016)

GP practices rated outstanding or good by the CQC (Care Quality Commission) have benefited from more funding than those deemed inadequate or requiring improvement, the BMA can reveal.

A report released today highlights the pattern between practices with higher average funding per patient and better inspection ratings — raising concerns that under-resourced doctors are being penalised.

The report calls for fairer funding across the country and appeals to the Government and NHS England to ensure all practices are given at least the same funding as the average practice rated outstanding.

‘This analysis shows there is a clear link between the amount of funding a GP practice receives and the rating it is allocated by the CQC,’ BMA GPs committee chair Chaand Nagpaul says.

‘Despite this, the CQC takes no account of resources available to a GP practice when it grades its care, even if this leads to GPs and their staff being publically shamed with an “inadequate” or “needs improvement” rating.’...read more

 

'Red risks' identified for 111 provider switch (HSJ: 11 May 2016)

NHS 111 and GP out of hours services in east Kent are to be run by one organisation – but there are already fears about the transition to the new provider.

Primecare, which is owned by Allied Healthcare, will provide an integrated service from October, including a care navigator service to help more complex patients remain at home. The current providers are South East Coast Ambulance Service Foundation Trust for 111 and social enterprise IC24 for out of hours GP services.

The four east Kent CCGs say Primecare will initially run the combined service for three years, with an option to extend for another two. It said Primecare came top in a rigorous evaluation by patients and commissioners, who looked at safety, quality, service delivery and overall cost effectiveness.

However, a report to the CCG boards last month on the mobilisation of the new contract has five “red rated” risks including the risks related to this being Primecare’s first 111 contract, staff not transferring across from current operators and a new call centre not being ready in time. Even after planned mitigation, the risk around the new call centre remains at red....read more

 

Deep South: Kernow’s troubles continue (HSJ: 11 May 2016)

There are a number of organisations in the South West beset with difficulties, financial and otherwise. But Kernow Clinical Commissioning Group, along with Southern Health Foundation Trust, probably ranks among the most troubled.

The CCG’s problems first came to light in December when it revealed that it was not – as it had previously reported – forecasting half a million pound surplus, but a £14m deficit for 2015-16.

The shortfall ended up even worse than that – according to the latest information from the CCG, it finished with a £17.4m deficit (it actually overspent by £21.4m but was able to improve its position slightly because of a £4m surplus the previous year)....read more

 

16,000 patient practice on short-term contract as six APMS providers pull out (Pulse: 5 May 2016)

A 16,000 patient practice has been left on a short-term interim contract after six of the seven APMS providers invited by NHS England to tender for the contract pulled out saying it was unviable.

The partners at The Mandeville Practice in Aylesbury, Buckingham handed back their contract last year after being unable to replace a recently retired senior partner, and finding locum costs unsustainable.

Since April, the practice has been run by local APMS provider Practice U Surgeries Ltd, on an 18-month contract.

Former partner Dr Gill Beck says it has been left with ‘no security for its future’, adding that commissioners were now getting to grips with how the practice can be run long-term without destabilising adjacent practices.

Local GP leaders said the practice that was no longer viable under the traditional funding model and which would become a ‘poisoned chalice’ if recruitment problems continued.

Speaking on the current state of general practice at the BMA’s Special Representative Meeting (SRM) this week, Dr Beck told delegates: ‘Within 18 months of my retirement from that practice, my partners handed in their contract.

‘Seven private companies came round to look at this, to see if they would take it over. Six withdrew saying it was financially unviable. My practice has gone to a one-year contract with a private organisation with no security for its future.’..read more

 

More than 170 GP surgeries have closed in 3 years because of 'financial pressures' (The Mirror: 23 March 2016)

More than 170 GP surgeries have closed in three years with doctors citing the increasing financial pressures of running modern day practices .

The British Medical Association says it’s worried about further closures, as demand on GPs increases; while the Royal College of GPs says such closures can have a negative impact on patients.

An investigation by BBC Radio 5 live Daily found that 171 GP surgeries closed in England in the three years to October 2015. A Freedom of Information request revealed a third of these are due to contracts being terminated or not renewed - and another third due to mergers.

The numbers are echoed by the national data provider, the Health and Social Care Information Centre, which show the overall number of surgeries in England has fallen since 2010...read more

 

DH rescue package delayed as suggested £110m funding branded 'inadequate' (Pulse: 7 March 2016)

The health secretary’s promised ‘package of measures’ to ease the pressures on general practice has been delayed after wrangling over the size of the promised funding.

Pulse has learnt from insiders that the Department of Health has proposed a £110m rescue package of measures for GPs, including a refreshed retainers scheme and more than 100 ‘golden hellos’ to tempt GP trainees to work in hard-to-recruit areas.

The GPC refused to confirm the amount that has been discussed with DH officials, but told Pulse that they were pushing for a much larger investment to ease the pressures on general practice in England.

The wrangling comes after a disastrous 'new deal' for general practice last year that was widely criticised by GPs as a massive over-sell.

Jeremy Hunt said in January that he would announce the new package of support for general practice in January saying he wanted to do more to ‘support the profession’.

He promised that it would be discussed with the RCGP and the GPC and released in February, but it has been delayed until later this month or April...read more

 

One in ten GP practices 'at risk of closure', warns BMA (Pulse: 3 March 2016)

More than 800 GP practices in England are at risk of having to close due to being ’financially unsustainable’, a major BMA survey has shown.

The survey of 2,830 practices found that 294 practices (10%) regard themselves as financially unsustainable within the next year.

It also shows that almost half of practices in England (46%) say they have at least one GP planning to retire, or leave UK general practice, in the next 12 months;The GPC says it has conducted the survey to supply evidence of the ‘state of emergency’ general practice is in, and the results follow the Special LMC Conference in January, which called on the GPC to consider canvassing the profession on potential mass resignation in six months...read more

 

NHS spend on general practice falls to 7.2% from April, despite uplift (Pulse: 25 February 2016)

Health secretary Jeremy Hunt will fail to deliver this year on his promise to increase the proportion of funding going into general practice, despite the 3.2% funding uplift for practices, a Pulse analysis has revealed.

NHS England budget allocations have revealed that from April, general practice will receive only 7.23% of the NHS budget – down from this year’s share of 7.31%.

This is despite the health secretary promising to increase the proportion of funding received by general practice and both the GPC and RCGP pushing for the proportion of spending on primary care to increase to at least 11%...read more

 

One in three GPs predict closure by 2020 unless seven-day plans are scrapped (Pulse: 19 February 2016)

A third of GPs believe that their practice will stop providing services to patients by 2020, according to new research.

A survey of GPs, carried out by think-tank Ockham Healthcare, further found that 90% believe the introduction of seven-day routine access to general practice will only worsen the current crisis.

In a new paper, the think-tank said that an ‘urgent response’ was needed the situation and called on the Government to abandon its seven-day access plans and begin to listen to GPs.

Like Pulse’s long-running Stop Practice Closures campaign, it also called for additional funding to be released to GP practices...read more

 

Out-of-hours provider forced to rely on one GP for 850,000 patients overnight (Pulse: 18 February 2016)

An out-of-hours provider in Norfolk has admitted GP shortages have forced it to run services with only one GP for 850,000 patients on at least one overnight shift.

It comes as the CQC confirmed it was planning to carry out an inspection of the service – run by Integrated Care 24 (IC24) – at the request of former care minister and local MP Norman Lamb.

The problems have emerged as the local CCG stepped in to investigate complaints about the quality of the service provided during the month of January.

NHS Norwich CCG said it carried out an ‘unannounced visit’ to IC24 after reports of concerns, including that a ‘depleted GP workforce’ was impacting on the quality and clinical safety of the service and that ‘assessors were made aware of situations when only one or two GPs were available for Norfolk and Wisbech’...read more

 

NHS 111 investigated over claims ‘teenagers answered urgent calls’ and ‘exhausted medics pictured asleep on job’ (The Independent: 16 February 2016)

The NHS 111 service is being investigated in the South West following allegations that teenagers had been drafted in to take urgent calls and photographs emerged of “exhausted” medics asleep on duty.

A number of 17-year-olds were allegedly employed by the South West Ambulance Trust last year to meet call handling targets. They had been authorised to take patients’ names and details and to offer basic advice on locating chemists and health services, but ended up answering urgent calls..read more

 

GP contraceptive services cuts are 'impacting on patient care' (Pulse: 15 February 2016)

Public health experts have warned that cuts to GP-run contraceptive and sexual health services will lead to worse access and lower quality of care for patients.

The Faculty of Sexual and Reproductive Health (FSRH) said the loss of GP contracts, as exposed by Pulse last week, had ‘worrying implications’ for the provision of long-active reversible contraception (LARC) in particular.

In a statement the Faculty said it had been contacted by a number of concerned GPs since Pulse's article was published and that its 'members are saying these cuts are impacting directly on patient care’.

Pulse's investigation revealed that GPs are losing contracts to provide LARC services in both York and London, while in one area of Devon, GP practices are facing a cut in the number of LARC fittings GPs are funded to perform – meaning they will have to drop the service altogether...read more

 

One in five London practices could close, warn LMCs (Pulse: 15 February 2016)

Almost one million people in London could lose their GP in the next three years, an LMC survey of GP practices in the capital has shown.

Londonwide LMCs, which received responses from 644 of London’s 1,330 GP practices, found that one in five (20%) cannot rule out handing back their contracts.

Out of these, 19 practices - which together cover 116,491 patients - said they are planning closure within the next three years, while a further 20 practices said they were considering closing within three years.

The number of patients who face losing their GP rises to over 900,000 when those respondents who said they ‘could not rule it out’ were included, according to Londonwide LMCs calculations...read more

 

Leaked report reveals scale of crisis in England's mental health services (The Observer: 13 February 2016)

A leaked report by a government taskforce has painted a devastating picture of England’s mental health services, revealing that the number of people killing themselves is soaring, that three-quarters of those with psychiatric conditions are not being helped, and that sick children are being sent “almost anywhere in the country” for treatment.

Details of the damning assessment have come to light just as the prime minister is planning to herald a transformation of mental health services.

The report, due to be published on Monday to coincide with an announcement by the prime minister on funding and new initiatives, lays bare a system that is routinely failing people from every walk of life.

While the prime minister is expected to trumpet his focus on mental health – six years after he pledged to put mental wellbeing at the centre of his government – his own taskforce condemns years of underinvestment and lays a significant portion of the blame on the current administration...read more

 

100 GPs sign letter on Pulse telling Prime Minister general practice is 'not safe' (Pulse: 5 February 2016)

Over 100 GPs have co-signed a letter warning Prime Minister David Cameron that general practice is no longer safe for patients, and telling him to start treating NHS staff with more respect. 

The letter from Tower Hamlets GP partner and LMC member Dr Naomi Beer, published on Pulse only last night, argues that the NHS is not safe in Mr Cameron’s hands and urges him to start listening to GPs to find a remedy to the situation.

Dr Beer, whose practice launched a campaign to stop closures resulting from MPIG cuts in 2014, said Mr Cameron must stop ‘misrepresenting evidence’ to ’suit his ideologies’, while treating NHS staff ‘with contempt’.

She says Mr Cameron ’appears blind and deaf’ to what is happening around him, with ’doctors and nurses who are burned out, shattered, sick and exiting’ and this is why GPs at the Special LMC Conference last week voted to ‘if it comes to it, tender mass resignation’...read more

 
 
Archive of older stories 2015 and before
 
 
 

 

more on quality:

HOSPITAL CARE/A&E

PRIVATE AMBULANCES

RATIONING

PRIVATE CLINICS

DELAYS IN HEALTHCARE 

Trends in reported problems

cost cutting

cuts in services

accountability

financial insecurity

 

Examples of problems (by provider)

BMI/Netcare - childrens surgery halted 

Care UK - patients discharged before they are treated

Carrillion - 6 patients feared sight loss

Harmoni (Care UK) - out-of-hours service alleged "unsafe"

Netcare -Celia Collet tells of her poor care

Serco - not enough staff and "fiddled" figures

NHS lab failings

PIP - breast implant scandal

Virgin - understaffing at Kings Health Centre

 

VIEWS ON OUT OF HOURS

BLOG: The True History of GP Out of Hours Services, by Dr Eric Rose

 

  

 

 

Share your examples about the impact of NHS changes - in a community d/base

 

 

Recent reports:

Quarterly survey of NHS financial directors by The King's Fund - February 2013 report

 

‘Making it better? Assuring high-quality care in the NHS

NHS Confederation discussion paper on the quality of care in NHS following the Francis report - February 2013

 

Care Quality Commisson State of Care report 2011/12

Annual survey by the Care Quality Commission

“Overall CQC is finding that the increasing complexity of conditions and greater co-morbidities experienced by people are impacting on the ability of care providers to deliver person-centred care that meets individuals’ needs. It is also seeing increasing pressures on staff, both in terms of the skills required to care for people with more complex conditions and in terms of staff numbers.”

 
 
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