Discover and read the best of Twitter Threads about #GPcrisis
Most recents (21)
GP ‘plan’ - phone lines but no REAL people
2000 Fewer GPs than 2015 when Jeremy Hunt promised 5000 more by 2020
GP Practices & Pharmacies are closing
Contracts that don’t pay enough
Being navigated to a struggling service will increase unhappiness for all
2000 Fewer GPs than 2015 when Jeremy Hunt promised 5000 more by 2020
GP Practices & Pharmacies are closing
Contracts that don’t pay enough
Being navigated to a struggling service will increase unhappiness for all
Steve Barclay rightly says GP practices are providing 2 million more appts a month than 2019
Consulting with half the population of the UK a month
GPs have done this with below inflation funding for the past 5 years
GPs are leaving in increasing numbers
Contracts handed back
Consulting with half the population of the UK a month
GPs have done this with below inflation funding for the past 5 years
GPs are leaving in increasing numbers
Contracts handed back
GP is one of the most technologically advanced in #NHS
Embraced online forms of communication during the pandemic
Provide 20% more appts than 2019
Govt obsession with face-face appts undermines this very initiative
Tech is NOT the problem
GP numbers, funding, bureaucracy are
Embraced online forms of communication during the pandemic
Provide 20% more appts than 2019
Govt obsession with face-face appts undermines this very initiative
Tech is NOT the problem
GP numbers, funding, bureaucracy are
When part-time is really full-time
When GP hours are counted
Official figures for GP working hours are counted in sessions
A session is 4hrs 10 mins or half a day
9 sessions is 37.5hrs or full-time officially
But there is a problem
🧵1
When GP hours are counted
Official figures for GP working hours are counted in sessions
A session is 4hrs 10 mins or half a day
9 sessions is 37.5hrs or full-time officially
But there is a problem
🧵1
A GP session or half day can actually exceed 6hours
For the majority it is between 5-6hrs
This means the hours counted are underestimated by 1-2 hours session
So GP hours are not officially accurate
2🧵
For the majority it is between 5-6hrs
This means the hours counted are underestimated by 1-2 hours session
So GP hours are not officially accurate
2🧵
GPs working 6-8 sessions are officially counted part-time
The vast majority are often exceeding Full-time hours
3🧵
The vast majority are often exceeding Full-time hours
3🧵
DOCTORS ARE LEAVING UK
We live in a global market for health care workers
If the UK continues to undervalue Doctors they will leave in increasing numbers
Pay, conditions & workload is a RETENTION issue
GMC Report 👇🏻
gmc-uk.org/-/media/docume…
#GPCrisis #PayRestoration
We live in a global market for health care workers
If the UK continues to undervalue Doctors they will leave in increasing numbers
Pay, conditions & workload is a RETENTION issue
GMC Report 👇🏻
gmc-uk.org/-/media/docume…
#GPCrisis #PayRestoration
GPs leaving
GP Partners
GPs earn a fantastic income compared with most
But it’s been the about the same since 2004
Maybe that’s fine
But have invested in Primary Care & continued to provide care by employing more staff, supplementing costs & on average lost 40% income
#teamGP Thank you!
GPs earn a fantastic income compared with most
But it’s been the about the same since 2004
Maybe that’s fine
But have invested in Primary Care & continued to provide care by employing more staff, supplementing costs & on average lost 40% income
#teamGP Thank you!
GP - Salaried income
This has increased yearly but lags far behind inflation
There is not enough funding in General Practice to pay staff in line with inflation
Partners have subsidised any increases
This has increased yearly but lags far behind inflation
There is not enough funding in General Practice to pay staff in line with inflation
Partners have subsidised any increases
Some will be planning to call the GP for an appt
Many will end up on hold or queuing outside
1.4 million/day consult a GP practice
Since 2015 we have lost 2000 GPs - enough for 1m patients
NO GP WANTS THIS
FUND & SUPPORT GPs or LOSE THEM
#GPCrisis Blame MPs not GPs
Many will end up on hold or queuing outside
1.4 million/day consult a GP practice
Since 2015 we have lost 2000 GPs - enough for 1m patients
NO GP WANTS THIS
FUND & SUPPORT GPs or LOSE THEM
#GPCrisis Blame MPs not GPs
GP APPOINTMENTS
Despite the pressure & reduced numbers GPs have provided more appts than ever
39% are seen in a day & 82% within 2 weeks of being booked
More Face to Face than before 2019 but many more options, with tele, e-consults & text added
GPs can’t provide more
Despite the pressure & reduced numbers GPs have provided more appts than ever
39% are seen in a day & 82% within 2 weeks of being booked
More Face to Face than before 2019 but many more options, with tele, e-consults & text added
GPs can’t provide more
With GP numbers falling & no support from NHSE & Government
Practices are failing, some are closing becoming unviable with Partners forced to hand back contracts
Without significant change 20% of Practices are potentially at risk
Practices are failing, some are closing becoming unviable with Partners forced to hand back contracts
Without significant change 20% of Practices are potentially at risk
🆘GP Crisis🆘
GP is the most monitored, regulated, inspected area of #NHS
Tick boxes for referral, monitoring, appts, appraisal, learning, training
It has more targets - CQC/NHSE/GMC/Gov
8000 too few GPs - more leaving
1.4m appts/day
#GPCrisis
GP is the most monitored, regulated, inspected area of #NHS
Tick boxes for referral, monitoring, appts, appraisal, learning, training
It has more targets - CQC/NHSE/GMC/Gov
8000 too few GPs - more leaving
1.4m appts/day
#GPCrisis
🆘GP Crisis🆘
Too many targets in order earn the money to provide care for patients
Means many appts are provided just for targets - not necessarily for the care patients really need
2🧵
Too many targets in order earn the money to provide care for patients
Means many appts are provided just for targets - not necessarily for the care patients really need
2🧵
🆘GP Crisis🆘
The CQC inspection process duplicates much of the monitoring done in GP
Adds levels of bureaucracy to over burdened GPs
GPs pay for the inspection
Little support is given
Would be better replaced with a support service helping practices improve
🧵3
The CQC inspection process duplicates much of the monitoring done in GP
Adds levels of bureaucracy to over burdened GPs
GPs pay for the inspection
Little support is given
Would be better replaced with a support service helping practices improve
🧵3
The media is putting more focus on #NHSCrisis
You see reports from wards, hospitals, Emergency Departments, Ambulances of the immense pressures faced by my colleagues in secondary care
But what does this crisis look like in #primarycare?
A thread 🧵...
You see reports from wards, hospitals, Emergency Departments, Ambulances of the immense pressures faced by my colleagues in secondary care
But what does this crisis look like in #primarycare?
A thread 🧵...
I've been a GP for 15 years
GP + #primarycare has always been busy
Balancing access, demand + capacity has always been a challenge
But honestly, things are different now.
We don't have trollies in corridors or ambulances queuing outside.
But this doesn't mean there's no #GPCrisis
GP + #primarycare has always been busy
Balancing access, demand + capacity has always been a challenge
But honestly, things are different now.
We don't have trollies in corridors or ambulances queuing outside.
But this doesn't mean there's no #GPCrisis
This is not something that has happened overnight
The current "perfect storm" of flu, covid, respiratory illness and lack of social care has exposed and exacerbated long term cracks that have become gaping holes in the system...
So what are the issues in GP?
The current "perfect storm" of flu, covid, respiratory illness and lack of social care has exposed and exacerbated long term cracks that have become gaping holes in the system...
So what are the issues in GP?
GP is changing because the needs of community care have changed over the past 30 years
So in addition to Practice Nurses & GPs there are many other clinicians in the team
Thread 🧵👇🏻
So in addition to Practice Nurses & GPs there are many other clinicians in the team
Thread 🧵👇🏻
1.4million people a day consult a GP practice
Demand has increased (120% compared with 2019) but GP numbers have fallen (1800 fewer since 2015)
In order to manage demand additional systems have been needed as well as using different methods to consult, & additional clinicians 2/
Demand has increased (120% compared with 2019) but GP numbers have fallen (1800 fewer since 2015)
In order to manage demand additional systems have been needed as well as using different methods to consult, & additional clinicians 2/
With 7m awaiting hospital treatment, 10m awaiting follow-up appts, an additional 500k are on long term sick leave since 2019
In addition advances in medical care mean many more are on medications, & have regular reviews of care
People live longer, population has increased
3/
In addition advances in medical care mean many more are on medications, & have regular reviews of care
People live longer, population has increased
3/
People are waiting hours for ambulances/A&E appts⬆️⬆️
Although 999 calls up, those conveyed to A&E similar to previous yrs, as are A&E attendances
GP appts are up 120% cc 2019
So where is the problem?
Beds? Occupancy? Discharge? Covid?
What is the fix?
#NHSCrisis 1/🧵
Although 999 calls up, those conveyed to A&E similar to previous yrs, as are A&E attendances
GP appts are up 120% cc 2019
So where is the problem?
Beds? Occupancy? Discharge? Covid?
What is the fix?
#NHSCrisis 1/🧵
Out-patient attendances just returned to 2019 levels
But 7m awaiting treatments
Treatments and investigations below 2019
Hospitals working more slowly
What’s the problem? 2/🧵
But 7m awaiting treatments
Treatments and investigations below 2019
Hospitals working more slowly
What’s the problem? 2/🧵
1/14 I hesitated at voicing my opinion on this rather contentious issue…
But I feel that without individual testimonies, we will fail to understand why some GPs (myself included) feel mainstream primary care is no longer for them.
#GPCrisis
@HelenRSalisbury @MartinRCGP @rcgp
But I feel that without individual testimonies, we will fail to understand why some GPs (myself included) feel mainstream primary care is no longer for them.
#GPCrisis
@HelenRSalisbury @MartinRCGP @rcgp
2/ Obvs the relentless vilification from the MSM hasn’t helped, esp the claim by some that the number of ‘part-time’ GPs is the problem.
Those on the inside know that a typical day is 11-12hrs long & a ‘half-day’ is regularly 7-8, but hey, let’s not let facts get in the way.
Those on the inside know that a typical day is 11-12hrs long & a ‘half-day’ is regularly 7-8, but hey, let’s not let facts get in the way.
3/ & I don’t suppose those of us who volunteered to work f2f in acute #COVID services within the community in spring 2020 will forget that our pleas for effective #PPE were repeatedly ignored & dismissed by govt, PHE, NHSE, HSE & senior advisors.
@CMO_England @MattHancock @UKHSA
@CMO_England @MattHancock @UKHSA
Despite the #gpcrisis we've gone from: Struggling with unmanageable 'demand', exhaustion & low morale.
⬇️
A thriving & hopeful team with excellent patient feedback.
How? Dozens of factors.
This thread describes 1 subtle essential ingredient
#TeamGP
1
link.medium.com/JpbZd1BQHnb
⬇️
A thriving & hopeful team with excellent patient feedback.
How? Dozens of factors.
This thread describes 1 subtle essential ingredient
#TeamGP
1
link.medium.com/JpbZd1BQHnb
Primary care is over worked and overwhelmed. The GP crisis is exasperating for staff and patients. GP numbers continue to tumble. Part of the solution is before our very eyes: the receptionist. But perhaps not as we know them.
2
2
How much of a GPs frantic day is spent solving problems that could have been better solved by someone else? Either by a GP who knows them better, another service or an additional PCN role? GPs also waste time untangling messy tasks like old referrals, prescriptions/ sick notes
3
3
1/ Morning @JamesMelville 👋….I see you and your #CovidDisinformation pals on @talkRADIO are still at it.
Could I suggest that you speak to someone who actually knows what’s going on in the #NHS before debating a really important topic live on the radio?
@JuliaHB1
Could I suggest that you speak to someone who actually knows what’s going on in the #NHS before debating a really important topic live on the radio?
@JuliaHB1
2/ If you don’t know/understand all the issues at play in our perfect storm of #COVID19UK, #GPCrisis & #NHSCrisis then as journalists, your duty is to find out rather than whip up more anti #NHS sentiment.
We’ve got more than enough of that to deal w/ already, I can assure you👇🏼
We’ve got more than enough of that to deal w/ already, I can assure you👇🏼
3/ A quick example ➡️
Yesterday a 17yr old (X) attended a local WIC with mild upper respiratory tract symptoms.
X had a through examination, a detailed explanation, reassurance & good safety-netting, all documented.
Yesterday a 17yr old (X) attended a local WIC with mild upper respiratory tract symptoms.
X had a through examination, a detailed explanation, reassurance & good safety-netting, all documented.
Thank you Dan, once again you’ve explained with absolute clarity one of the most significant failings of @10DowningStreet ‘s catastrophic #COVID19UK management.
@danielgoyal
1/22 - Sorry🙏🏻💙
@danielgoyal
1/22 - Sorry🙏🏻💙
My name is Dr Ellen Welch.
I am your GP.
I am one of those female, part time, working entirely remotely GPs you have probably read about in the Daily Mail. Shame on me.*
I very much miss the contact with both patients and colleagues.
I am your GP.
I am one of those female, part time, working entirely remotely GPs you have probably read about in the Daily Mail. Shame on me.*
I very much miss the contact with both patients and colleagues.
But I can still help you this way. In fact-you may get a solution to your problems quicker than you did before the pandemic. I can still organise face to face appointments too.
It’s so disheartening that the message broadcast to the public is one of GPs being closed and lazy.
It’s so disheartening that the message broadcast to the public is one of GPs being closed and lazy.
What should have been communicated is how GPs have been forced by the pandemic to work entirely differently-and this is unlikely to ‘go back to normal’ -possibly ever again- but that is not necessarily a bad thing.
My name is Laura McDonnell
I am your GP.
I am privileged to be entrusted with caring for you across your life course.
I deal with your acute problems, respond to emergencies and manage multiple, complex, chronic complaints.
I am your GP.
I am privileged to be entrusted with caring for you across your life course.
I deal with your acute problems, respond to emergencies and manage multiple, complex, chronic complaints.
I am your specialist in listening to your concerns and genuinely interested in helping you to optimise your health and well-being.
I care for the public health of my community providing vaccinations to keep you and your families protected.
I care for the public health of my community providing vaccinations to keep you and your families protected.
I am a team player and could not do my job without the support of all my colleagues.
I am a teacher who trains young GPs and share with them my enthusiasm for a profession that I love.
I am a teacher who trains young GPs and share with them my enthusiasm for a profession that I love.
My name is Chloe Barter
I am your GP.
I know when you are feeling unwell and scared navigating telephone lines, e-consults , queues and hospital waiting lists can feel daunting.
I am your GP.
I know when you are feeling unwell and scared navigating telephone lines, e-consults , queues and hospital waiting lists can feel daunting.
We will always try our best to be your advocate and help you get the help your require but you can help us too.
For minor illness - seek advice from you practice website or NHS.uk or talk to a local pharmacist.
For minor illness - seek advice from you practice website or NHS.uk or talk to a local pharmacist.
When you contact the surgery, our reception team will ask you to help by sharing your concerns to help them direct you to see the best health professional for your needs; that could be a pharmacist, ANP, physio, paramedic practitioner, healthcare coach, social prescriber or a GP
My name is Dr Anu Kapila.
I am your GP
I earned this privilege after 14 years of studying and training. I pledged to “dedicate my life to the service of humanity” when I recited the Declaration of Geneva (2017) with my colleagues.
I am your GP
I earned this privilege after 14 years of studying and training. I pledged to “dedicate my life to the service of humanity” when I recited the Declaration of Geneva (2017) with my colleagues.
The safety of my patients and colleagues remains my priority.
Today I will make over 200 clinical decisions (patient encounters, prescriptions, blood and scan results and hospital letters).
Today I will make over 200 clinical decisions (patient encounters, prescriptions, blood and scan results and hospital letters).
Every decision matters and deserves to have an appropriately allocated time slot…but there just isn’t enough time or resources.
Regardless, I will still strive to provide the best care for my patients.
Regardless, I will still strive to provide the best care for my patients.
The Doctors’ Association UK were saddened to read a series of tweets sent by Allison Pearson yesterday.
Over the last year The DAUK have frequently spoken of the GP crisis resulting from chronic underfunding and a decimated workforce. But instead of focusing on these issues.. 1/
Over the last year The DAUK have frequently spoken of the GP crisis resulting from chronic underfunding and a decimated workforce. But instead of focusing on these issues.. 1/
Ms Pearson chose to detract from her abusive comments about GPs and instead shared anecdotes of tragedies that have occurred as a result of the crisis we describe.
We believe our patients deserve better.... 2/ #gpcrisis
We believe our patients deserve better.... 2/ #gpcrisis
There were so many more headlines that could’ve been chosen rather than the “lazy GPs” agenda - it’s not true. GPs are routinely working 12hr days yet still the service is overwhelmed. A review of general practice is needed to improve patient care
1/6
Problems in #NHS today are not caused by #COVID19 but worsened by it. As proof-here’s some quotes from @ChrisCEOHopson 5 years ago on #marr
Hint:not about face2face appointments then & isnt now, whatever some in media say (#GPCrisis)
-be good if Sajid Javid points this out!
Problems in #NHS today are not caused by #COVID19 but worsened by it. As proof-here’s some quotes from @ChrisCEOHopson 5 years ago on #marr
Hint:not about face2face appointments then & isnt now, whatever some in media say (#GPCrisis)
-be good if Sajid Javid points this out!
2/6
All areas of the #NHS have been under pressure this summer from GPs to hospitals to ambulance services to mental health services. Covid cases will increase this winter (seasonal variation) and this extra workload will cause prolonged & deepened pressure
#marr #phillips
All areas of the #NHS have been under pressure this summer from GPs to hospitals to ambulance services to mental health services. Covid cases will increase this winter (seasonal variation) and this extra workload will cause prolonged & deepened pressure
#marr #phillips
3/6
Attacks on GPs in the last few weeks have been aimed at drawing attention from supply issues stopping routine blood tests and hospitals bursting at the seams in summer - real problems that attacking GPs doesnt solve (substitute junior doctor for GP 5 yrs later)
#GPCrisis
Attacks on GPs in the last few weeks have been aimed at drawing attention from supply issues stopping routine blood tests and hospitals bursting at the seams in summer - real problems that attacking GPs doesnt solve (substitute junior doctor for GP 5 yrs later)
#GPCrisis
This was difficult to discuss for many reasons @wilsonstsurgery & occurred when highlighting pressures on primary care.
The #GPcrisis is ongoing & worsening. We can’t normalise abuse of GPs & receptionists. 1/7
The #GPcrisis is ongoing & worsening. We can’t normalise abuse of GPs & receptionists. 1/7
No matter what the frustrations are, we are ultimately here to help patients. To be abused makes a hard job even more difficult.
The experiences of so many surgeries and it’s many staff simply cannot continue to be ignored.
2/7
The experiences of so many surgeries and it’s many staff simply cannot continue to be ignored.
2/7
The pressure on primary care staff is due to many reasons including:
➡️ Chronic under-resourcing and poor staffing of primary care
➡️ Later presentations of pts with worsening conditions
➡️ Secondary care delays resulting in primary care holding increasingly complex pts
3/7
➡️ Chronic under-resourcing and poor staffing of primary care
➡️ Later presentations of pts with worsening conditions
➡️ Secondary care delays resulting in primary care holding increasingly complex pts
3/7
I can see many NHS GPs laying bare their souls on Twitter. @NHSEngland please take note of what is being said
#GPCrisis is occurring because of bad math
From a purely economic viewpoint there are 35k GPs providing clinical care for 70 million people who will all have had some GP clinical care just by being born. The government used to pay for it but now resources stretched too thin
