Reforms ‘have damaged’ GP services
Friday 20th September 2013, 12:11AM BST.
Family doctors feel increasingly fed up, overworked, tied up in red tape and worried that “dubious” Government targets are stopping them treating needier patients, a survey has found.
A poll by the British Medical Association (BMA), completed by 3,629 GPs working in England – around 10% of the total – showed 86% had suffered a drop in morale over the past year.
All bar a handful (97%) complained of an increase in “bureaucracy and box ticking” because of changes to GPs’ contracts which were the subject of a dispute between the Government and the BMA union.
They imposed higher targets for monitoring of certain conditions under the Quality and Outcomes Framework (QOF) scheme that ties funding for GP practices to work in specific areas such as heart disease, high blood pressure and diabetes.
Ministers said the reforms would benefit patients with long-term conditions and dementia but health professionals said they were not based on clinical need and forced doctors to spend time testing perfectly healthy individuals.
More than four in five GPs (82%) said the increased demand for appointments related to QOF meant other patients were being squeezed out.
Almost as many (76%) said they had “less time” for patients’ other clinical needs, 89% suggested the higher targets would not improve patient care and nearly half said they were less able to be engaged with local clinical commissioning groups because of the increased workload.
The survey also found a widespread expectation that the changes, which came into force in April, would see funding reduced over the next year – with 90% predicting a drop in resources.
Dr Chaand Nagpaul, chair of the BMA’s GP committee, said: “The results of this survey demonstrate that an increase in bureaucracy, box ticking and administration has damaged GP services and patient care, mirroring a government-funded report into GP’s working lives that made similar findings.
“GP practices are already struggling with declining funding and rising patient demand, especially from an ageing population.
“Recent changes to the GP contract have created additional and unnecessary workload that is diverting valuable time away from treating patients.
“Recently introduced targets included encouraging GPs to carry out a large number of lengthy and clinically dubious questionnaires that ask how many hours patients spend on gardening, cooking and DIY.
“They are also offering appointments to all healthy 35 to 40-year-olds simply to check their blood pressure.
“GPs are very worried that the time taken for this programme and questionnaires is resulting in fewer appointments for other patients who are in need of care.
“Despite this difficult environment, GPs are working harder than ever before.
“There is a wealth of experience and talent in general practice that could be harnessed positively for patient care.
“The BMA wants to work with the government to deliver real benefits to patients and remove the administrative burden that is putting pressure on already overstretched GP services.
“We particularly need to see how we can free up more time to deliver the personalised care that patients deserve and meet the challenges from an increasing number of older patients who need coordinated and effective care.”
A Department of Health spokesman said: “We know that GPs are working extremely hard. We have asked Health Education England to move towards getting 50% of medical students to become GPs.
“It is essential we strengthen general practice so we can provide the excellent care our patients need. We want to make sure our most vulnerable and elderly people stay in good health for longer and are kept out of hospital.
“We have asked GPs for their views on how we can remove some of the barriers to offering better, more integrated care. We want GPs to work with us on fundamental changes to the system so that it works for them and patients.”