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Secondly they have not increase the Primary care budget, the people who voted them in 2010 now are 12 years older with multiple co-morbidities . The Gov still allocates to your GP surgery between 120-140£ per year for ALL your medical care - unlimited appointments/ blood tests/ consultations. Etc. All other extra fundings have been directed to other allied organisations in community such as PCN/ HUBs..etc that is why sometimes when one calls his/her surgery they are directed there instead of an appointment with GP - this is where the government invested
The latter of this second point is incredibly important for people to understand. We see plenty of headlines that people can't get to see a GP but this has been done intentionally by the powers that be and the government of the last 12 years. This isn't what the vast majority of GP partners or practices want. We as GPs want to patients to be seen by the most appropriate person and in most cases, with an aging population with polypharmacy this will be a GP. Someone with a medical degree, years of experience ranging from care of the elderly to paediatrics, who can manage your medication, referrals and understands when escalation and referral is needed.
Unfortunately, the funding to core primary care services hasnt increased. The money has gone towards hiring allied health professions under the Additional Roles Reimbursement Scheme (ARRS). These are PCN diecticians, paramedics, social prescribers, mental health practitioners and pharmacists. The funding isn't there to hire additional doctors. As someone who has to supervise these additional roles at times (though with no other vested interest eg GP partner) I can tell you they are pretty poor value. Sure you can hire two for price of a salaried GP but the doctor can manage a whole lot more, including admin, scripts, referral, medicine management, audits, clinical governance. As an example the MH practitioner appointments are barely 50% utilised, they have 30 minute appointments and can't prescribe. They then will task me to prescribe a medication (which means I'm taking all of the clinical risk) without ever seeing or speaking to them. (Often I refuse) so will end up having to speak to the patient anyway which is 10 minutes which I could have just done in the first place.
Without this increase in funding to hire GPs nothing will improve. The current GPs are overwhelmed with not only their current workloads but then burdened by the extra that being put on them. I've seen situations where patients have ended up seeing several people first before the GP leaving them feeling frustrated and ultimately delaying diagnostic tests and appropriate treatment.
I've been a GP for 4 years and doctor for 14 years and I'm completely disillusioned by the current state of things. A topic for another day perhaps but the career progression for 'newly' qualified GPs is broken. Full of nepotism and back scratching, my area is saturated with new GPs, lack of partnership opportunities, workloads of salarieds GPs means that I, like many will simply locum, do private work and look at Canadia and Australia. Not too much of a rant I hope but cathartic nonetheless.
www.theguardian.com
