Why it’s so hard to get a doctor’s appointment in Sheffield: GP lifts lid on ‘frantic’ NHS pressure
Amid increasing complaints from patients about difficulties securing appointments with GPs in Sheffield during and after lockdown, one doctor in the city has opened up about the pressures practices face.
Dr Ben Allen, GP Partner Birley Health Centre, wrote a public ‘apology and explanation’ and posted it on social media, in which he outlined the reasons why GPs were struggling with workloads, and also sought to dispel some of the ‘myths’ circulating about the care GPs are able to give.
Now, Dr Allen has spoken to The Star to give a more in-depth doctor’s perspective on the issue.
"Within patient circles people are saying we can’t get hold of the GP and they don’t care anymore and there are never any appointments. There is a sense they think the service has changed and that is because GPs are not trying or don’t seem to care that much,” Dr Allen said.
"But then when people come from outside to work with us, or on work experience or a placement, they can’t believe how busy it is here. They say they thought it was relaxed at a GP surgery but in fact most days the pace of work is frantic.
"Doctors are getting frustrated with patients and patients getting frustrated with doctors, when really, neither are at fault here.
"It is caused by a number of different pressures that have been brewing over decades. The nature of medicine has changed.
"People are living longer and with a greater level of medical complexity than ever before, which we are not used to.
"There is not going to be a sudden crisis; things are slowly getting worse and worse.”
Dr Allen explained that while doctors are not to blame for the difficulties patients have with getting to see their GP, he felt that by apologising for the situation everybody found themselves in it would help people understand.
He said: “The reason for the apology I wrote was because I think it is important to have a sense of humility about it. GPs are exhausted from working so hard and they feel they don’t have anything to apologise for, and I get that. They have not done anything wrong.
"But I understand that at times the service patients get might not be what they were hoping for when they feel really ill and not to get what they think they need can be quite upsetting and having to wait for appointments can be quite distressing.
"So I felt the need to apologise, not because it is our fault it is like that, but because of how that is perceived and experienced. It is saying sorry this is how is it, but explaining why it is like that.”
The key issue GPs face, Dr Allen said, is the ever-increasing workload coupled with the lack of funding.
"I am not trying to blame anybody, but GPs’ work does need more funding,” he said. "GPs are given around £150 per year for each patient, and every year the workload increases but any small increase to funding does not nearly keep pace'.
"The workload is increasing and so that needs funding to make it doable. At the moment it is not doable. In hospitals, if you do more operations you get more funding.
"But we still have the same contract for around £150 per person but the amount of work we need to do to fulfil that contract gets more challenging every year.”
Dr Allen also explained that the situation has worsened due to the backlog that has arisen over the course of lockdown, and the sharp rise in demand for GP services now that lockdown has eased.
"There has been a massive increase in demand but we can’t say where that is coming from,” he said. “It could be that people saved up problems during lockdown or it could be because the wait for hospital care is so long [due to pressure caused by Covid on hospitals] and we are responsible for caring for people who are waiting for operations.
"There is also certainly a backlog of chronic disease management cases - people with diabetes, asthma, blood pressure issues, medication reviews and mental health cases.
"There is lots of stuff we have not been able to do over the last year or two and we need to be proactive about clearing that backlog.”
And the issues raised by the high demand have been compounded by the requirement for GPs to provide the staff to carry out the vaccine rollout.
This concern has led to the decision by many GPs not to do vaccinations for younger people so they can begin to clear their backlog of other cases.
Dr Allen explained: “The main problem we face is that we are having to use all our staff to do vaccines who usually do our normal work. That is an unavoidable problem.
"We’ve had GPs giving vaccines, nurses giving vaccines, and the practice managers have been pulled out to run this. That is the big problem.
“Phase one of the rollout was the over 50s and people with vulnerable conditions. GPs generally said yes to doing that as it was important that these people were vaccinated locally.
"But a lot - including us - have said no to doing phase two, which is the under 50s. These people are in general more able to get to mass vaccination centres or participating pharmacies.
“Also, the Government relaxed our usual targets in phase one so we could focus on vaccinations, but for phase two they said we would need to do vaccinations, in addition to do all of our normal work as well.
"We decided that we would not be able to do all our normal work as well as the vaccinations. We have to think about what is best for the population and the service we can provide.”