Drastic plans to reshape the NHS with an emphasis on primary and community care is putting increasing pressure on already overstretched GPs, professional bodies have warned.
A new report by the Royal College of GPs says there is already a “severe crisis” in general practice as resources fail to keep up with general demand.
Now plans can be revealed to ‘upskill’ staff and bring in GP assistants to cope with an expected rise in the number of patients to be cared for outside of an acute setting.
Across Yorkshire, schemes have been laid out for other medical staff such as community pharmacists and physicians’ assistants to deal with many currently coming through GP’s doors.
But experts have warned that while there is absolutely a need for urgent change, much investment will be needed to make it a reality.
“The idea of transferring even more work onto the shoulders of already overstretched professionals is going to be even more difficult to sustain without causing more problems,” said Dr Richard Vautrey, Leeds GP and deputy chairman of the BMA’s GP committee.
“The theory of being able to deliver more in the community is indisputable. The challenge is in going to be able to deliver that.”
Plans for the reorganisation of the NHS to help save £22bn nationally are putting a greater focus on general practices taking appointments currently done in hospitals - while GPs will focus on patients with the most-complex long-term illnesses and are less likely to see others with more minor ailments. New technologies are being introduced, and patients are to be encouraged to look after their own health more.
In South Yorkshire and Bassetlaw, even treatments like chemotherapy ‘could be given outside hospital’, while Yorkshire is to be a trial area for new GP assistants, who will handle administrative jobs and carry out basic clinical tasks. The idea of using surgery receptionists as ‘care navigators’ to provide initial assessments of people’s medical needs rather than automatically booking people in for GP appointments is being explored in Wakefield.
There is also a drive to use technology to reduce pressure on surgeries, with ‘virtual appointments’’ over phone and email.
But there are fears the Government’s target of recruiting 5,000 more doctors to the profession by 2020 will not make up for the expected loss of many senior GPs going into retirement.
Dr Krishna Kasaraneni, GP workforce lead for the British Medical Association, said those plans go some way to dealing with the ‘reality’ of falling numbers of GPs.
He said: “We are facing the cliff edge of a significant proportion of GPs retiring in the next five to ten years.
“The reality is the amount of work in General Practice has increased significantly in the last few years. The workload is going up and you need a workforce to deliver it. But there are certain aspects that only a GP can do. You can’t replace a GP with two nurses and a pharmacist.”
It comes as the Royal College of Nursing warns Yorkshire’s NHS must not be forced to rely on ‘nursing on the cheap’ as vacancies of qualified staff mount.
NHS organisations in the county are trialling the use of ‘nursing associates’ being brought into the NHS in support roles for fully-qualified nurses.
The Department of Health has introduced 1,000 trainee nursing associates this year at 11 test sites, with a further 1,000 to follow later this year. Some of the new trainees are being used in Leeds, Bradford and Airedale.
But the RCN has warned the new staff ‘must not be used as substitutes for registered nurses’, with 24,000 unfilled nursing vacancies across the country.
Nationally, the number of trainees applying to be nurses has fallen by 23 per cent after the Government axed a bursary scheme, while there has been a 90 per cent reduction in the number of EU nationals applying to work as nurses following the Brexit vote.