GPs want 25 appointment daily 'safe' limit but campaigners slam move

Just when you thought it couldn’t get any harder to see a GP! Doctors want ‘safe limit’ of 25 appointments a day – but campaigners warn patients will flood A&E and accuse practices of ‘doing what they like’

  • GP leaders voted to introduce limit over hidden workload and safety concerns
  • Some GPs are reportedly currently having to cram in up to 50 patients a day

GPs were today accused of ‘doing what they want’ following their calls to adopt a ‘waiting list’ for patients. 

Delegates attending a British Medical Association (BMA) conference of GP leaders last week voted in favour of introducing a ‘safe limit’ of 25 patients a day.

Family doctors have reported cramming in up to 90 appointments per day in some areas, warning rushing patients through in conveyor belt-like scenes risks missing serious illnesses. 

The crisis is fuelled by soaring demand coupled with dwindling numbers of GPs, as many choose to retire early, go private or even move abroad.

Adopting a safe limit would effectively make thousands of patients wait longer to be seen by a GP because everyday appointment space would be axed. 

GP workforce data for May 2023 shows there are 27,200 fully-qualified GPs in England. This is down from 27,627 one year earlier. GP numbers peaked at 29,537 in March 2016

During the same BMA conference of Local Medical Committees (LMCs), delegates voted to ‘encourage the establishment of waiting lists for routine GP appointments’. It was argued that using such lists would ‘go some way toward’ illustrating the sheer demand and hidden workload practices currently face. Outcomes of the LMC meeting inform the union’s negotiating stance before it enters talks with the government and NHS over the annual GP contract

During the same BMA conference of Local Medical Committees (LMCs), delegates voted to ‘encourage the establishment of waiting lists for routine GP appointments’.

It was argued that using such lists would ‘go some way toward’ illustrating the sheer demand and hidden workload practices currently face.

Outcomes of the LMC meeting inform the union’s negotiating stance before it enters talks with the government and NHS over the annual GP contract.

But campaign groups today accused the Government of ‘losing control’ of the situation.

Dennis Reed, from Silver Voices, which campaigns for elderly Brits, said if the voted measure was ever given the go ahead it would represent ‘yet another bureaucratic barrier put in the way of access to GPs’. 

READ MORE: Patients are ‘dying from remote GP consultations’ as major study warns virtual and phone appointments can miss serious illnesses 

He told MailOnline: ‘Our term “the elusive GP” is now a reality in many parts of the country.

‘Little wonder that so many patients are now giving up on primary care and going straight to the local hospital.’

Experts have claimed difficulties getting a GP appointment are already overwhelming A&E units battling their own crises. 

Mr Reed added: ‘The Government has lost control of the situation and GP practices are doing what they like’.

The BMA already recommends GPs should not deliver more than 25 appointments a day to ensure safe care. 

But the conference ruled that it must become a ‘red line’ in the upcoming contract negotiations.

It also demanded that NHS England ‘make suitable provision for all practices across England to divert urgent workload when their daily safe working limits have been reached’. 

Latest NHS data shows there were 31.1million GP appointments in September, with figures soaring to the fourth highest on record. 

Fewer than half were on the same day (40 per cent) and a third (34.5 per cent) had to wait more than a week. 

Latest data for England shows 71 per cent of GP consultations are face-to-face, while 24 per cent are over the phone. 

Dr David Wrigley, deputy chair of the BMA’s England GP Committee, told MailOnline: ‘The BMA supports policies that look to ensure a safe level of patient contacts a day for GPs. 

‘This is reflected in our safer working policies and guidance which recommend no more than 25 patient contacts per day. 

‘Practices, as has always been the case, are able to refer patients to other services. 

‘Safer working will form a key part of negotiations with NHS England for the 2024/25 contract and beyond.’

The BMA already recommends GPs should not deliver more than 25 appointments a day to ensure safe care. But the conference ruled that it must become a ‘red line’ in the upcoming contract negotiations. Graph shows the ratio of GP patients to practices since 2015, with an average of 9,755 patients per surgery in May 2023

What does the latest GP appointment data show?

Appointments: 31.1million

Attended: 89 per cent 

Seen by GP: 44 per cent

Seen by nurse: 22 per cent 

Face-to-face appointment: 71 per cent

Phone call appointment: 24 per cent

Same day: 40 per cent

Up to one week wait: 26 per cent

One to two week wait: 13 per cent

Two to four weeks wait  22 per cent

NHS England data for September 

He added: ‘Until GPs feel safe in their day-to-day clinical work, it will be impossible for general practice to retain its workforce. 

‘Only when waiting lists and workload issues are properly addressed can we deliver the highest quality of care and ensure better outcomes for patients.’

Professor Kamila Hawthorne, chair of the Royal College of GPs, said: ‘No two appointments in general practice are the same and patient contact numbers will vary depending on which clinical healthcare staff member is seeing the patient, practice and patient circumstances, and clinical judgement. 

‘Practices will manage this in the best way they can, based on their knowledge of their local patient population. 

‘However, there comes a point where demand exceeds capacity and GPs can no longer guarantee safe care to their patients so we urgently need to find a range of solutions to this.’

In the wake of the pandemic GP patient satisfaction has plunged to its lowest level on record. 

Patients have continually expressed their frustration over access, particularly with regards to in person face-to-face appointments. 

GPs say they overwhelmed due to the pressures of the rising and ageing population, a lack of government funding and a shortage of doctors. 

Ministers have also silently binned a promise to hire 6,000 more GPs, which was a major part of Boris Johnson’s election-winning manifesto. Just 2,000 more family doctors have been recruited since 2019. 

Worsening the staffing crisis is the fact that many current GPs are retiring in their 50s, moving abroad or leaving to work in the private sector because of soaring demand, NHS paperwork, and aggressive media coverage. 

GP surgeries have also faced rising levels of harassment, assaults and verbal abuse targeted at staff in recent months. 

It comes after a major study today warned online and telephone GP appointments can miss serious illnesses and put patients at risk of deadly errors.

The elderly and others with urgent conditions face wrong diagnosis and potentially fatal delays to care that would be less likely if seen face-to-face, analysis suggested.

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