GP Appointment Availability

Simon Fell Excerpts

Tuesday 26th October 2021 Westminster Hall

[Simon Fell (Barrow and Furness) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Robertson. I thank my hon. Friend the Member for Beaconsfield (Joy Morrissey) for securing the debate; if ever there was a timely debate, this is it. It is always a pleasure to follow my hon. Friend the Member for Bolton West (Chris Green), who often speaks sense. [Laughter.] And did so today, I should say! That was not a back-handed compliment.

About a month ago, I got an email from one of my constituents who is a nurse working in general practice. She was very angry and frustrated with what she sees day to day, dealing with the general public and some of the challenges there. One line from that email really stuck with me:

“We used to clap for our carers, but now it feels like we get a slap for our carers.”

That really illustrates some of the challenges that those working on the frontlines in primary care are facing. It is a very difficult environment, and no one working in public service should have to be in that sort of environment day in, day out.

Many hon. Members have talked about the frustrations faced by constituents trying to access services; my constituents are in exactly the same boat. My inbox is not exactly quiet on that issue. I have experienced it personally, too: calling the surgery at 8 o’clock in the morning and not getting an appointment; being told through various messaging campaigns to send photos in and get diagnoses that way, but with no clear route of access for how to do that. That drives frustration. People are being told that they can go to the pharmacy and, for what it is worth, I think that is an excellent thing to be doing. We should be triaging people. However, we need better communication about why people should be going to the pharmacy, what symptoms they should be displaying and what questions they should have to go there instead of calling 111 or going to their GP.

The work that GPs and those in general practice are doing is just phenomenal. We should not forget that they are delivering not only a programme to work through a backlog of people trying to access services, but the vaccination programme. In my constituency in Barrow and Furness, they are doing a phenomenal job. Their day job is packed and stressful; delivering the vaccination programme before or after hours to get through those essential numbers as well is really difficult.

I held a roundtable with some GPs with my constituency neighbour, the hon. Member for Westmorland and Lonsdale (Tim Farron). I met four GPs from my constituency there, and spoke to another two beforehand. They all talked about having the same issues. After the meeting, one of my GPs sent me an email, and I want to put on record a quote about some of the challenges they are facing:

“During the pandemic we continued to provide face to face appointments despite any personal risk or even PPE in the early days...I have a memory of wearing a bin bag and a visor from B&Q for an early visit! We triaged all contacts as advised…we saw patients in a portacabin in the car park to protect staff… We are aware that not enough patients are being examined, and although we still do phone appointments first, my conversion rate to a face to face…within few days is about 40%...Our workload has increased by about 30% in the last few months. All the patients that ‘stayed at home to protect the NHS’ are now out in force and demanding to be seen, and some are really quite unwell, having suffered from self-imposed medical neglect for many months. Mental health crises dominate every day. Cancers and heart disease are presenting late. And there is a huge bottle neck in the system, as we cannot get anyone seen in secondary care as the waiting lists are so huge…This is a perfect storm”.

Another GP got in touch with me. He is now edging towards retirement. He is contracted to work three days a week, so he is only paid for three days, but he is turning up for six while also delivering the vaccine programme. His concern is not just getting through the waiting list but also the challenge of finding new GPs to backfill afterwards. If we do not get a grip of this crisis, that will be the next problem that we face.

The GP who wrote to me continued:

“If face to face is mandatory, there will be a four to five week wait for an appointment. Is that really the policy outcome anyone wants?”

Those are the challenges that we must lean into, and I would be interested to hear from the Minister what the Government plan to do about them. I know that they have announced money for general practice and the NHS, but we cannot magic up people and resources.

To my mind, we must look at improving access through technology, looking at challenges around phone calls and patient access systems, and easing information flows between GP practices and secondary care. Yesterday in the Chamber, my hon. Friend the Member for Bosworth (Dr Evans) said that 10% of GP time is spent chasing up appointments and medical records. We should be able to use technology to get that out of the way.

However, the crucial point is about communications and signposting. Pharmacies and 111 are fantastic resources, but we must make it clear to people why, under what circumstances and how they need to use those routes. We are not there yet. That responsibility falls on both Government and general practice. Something in the comms space is really important.

If we do not tackle this now, I fear that we are building up a problem for the future and that the recruitment issue is going to come back and bite us. I am interested in the Minister’s views on how we tackle that perfect storm. What we need now is a considered and coherent route out of it; otherwise, we will face a similar debate in six or 12 months’ time.