The current crisis within our GP Practices calls for more support to be provided to GPs and different approaches to be adapted to strengthen GP practices in the NHS. We look at 12 ways to solve the crisis in NHS GP Practices.
Funding for Higher Education
Currently, students planning to study medicine at undergraduate level are only entitled to financial aid, through an NHS bursary in the fifth year of their course. The first four years of undergraduate study for doctors are thus supported by student loans, that cover both maintenance and tuition fees.
Although, the UCAS figures for the January 2018 intake demonstrate an increase of 9 percent in the number of applicants, more needs to be done to support students across the entire duration of their study.
Funding options such as maintenance grants and introducing additional, scholarship opportunities are key to encouraging more students to apply. If funding cannot be sourced via government bursaries, then it is essential we tackle staff shortages with other government approved schemes into medical subjects. These could include apprenticeships and online courses, alongside additional financial support for students studying part time via paid work experience or internships.
Cancellation Fees for Missed Appointments
NHS digital urges patients to ‘cancel appointments rather than not showing up’, and reports that of the 307 million consultations arranged with GPs, nurses and other health care professionals per year, five percent were missed.
These uncancelled missed appointments add up to an estimated 15.4 million missed slot and on a yearly basis is the equivalent of 1.2 million GP hours, which enlarges the crisis in GP Practices. Staff time is interrupted by missed appointments, and patients who were unable to be allocated an appointment receive delayed care and medical attention.
Despite NHS Digital’s recommendation advising patients to ‘cancel’ instead of not turning up, more precautions could be enforced to ensure patients make the move to either cancel or turn up on time. Penalties for late notice cancellations via fines will encourage patients to think twice before cancelling at short notice, consequently saving GP hours and granting patients struggling to book an appointment a consultation slot.
The Online Doctor
Private online services such as Babylon’s ‘GP at Hand’ are establishing online services allowing users mobile access to a GP in minutes and a face to face consultation at one of their local clinics, if necessary. The short video consultation with Babylon’s health professionals is free to use for registered users and offers guidance on a range of common medical conditions including allergies, blood pressure, chest infection, chlamydia, gout, insomnia, high blood pressure, sports injuries, joint pain, heat stroke and kidney stones.
Nonetheless, the requirement of a smartphone to gain access to the service means those who are not technology confident will have limited access to the service. An evaluation conducted by Ipsos Moriappears to supports this drawing attention to the fact that despite over 500 to 1,000 new individuals signing up to the service every week, there are a ‘significant number’ of individuals, who remove themselves from the service per week.
In order to verify that online consultations are not overlooking certain symptoms, it is vital further risk assessments are conducted. More online GP services that have undergone vigorous risk assessments could, though, offer a viable solution to the crisis in GP Practices by helping to tackle the shortage of GPs and management of patients in the future.
Innovating the NHS App
Currently, the NHS app allows users to make GP appointments, manage chronic illnesses, and apply for repeat prescriptions quickly; development of the app could offer faster and more wide-ranging services.
But the CEO of app provider NHSX, the new joint organisation of digital developments in the NHS, Matthew Gould, says he does not want ‘more features’ to be added onto the NHS app to avoid making it too difficult to use.
In his statement, he stressed allowing room for innovation within the app via enhancements, “This approach will harness the extraordinary talent and creativity that exists both in the NHS and in the health tech sector.”
Urgent Treatment Centres (UTCs)
Released in January 2019 by NHS Digital, the NHS Long Term Plan published a series of aims to sustain the NHS, one of which recognised the relevance of building more Urgent Treatment Centres to remove the pressure from GP practices.
At the moment, UTCs are open for a minimum of twelve hours every day and are managed by GPs. Emergency admissions treated by UTCs achieve faster discharge rates, while affording the best possible care for patients in more critical states. Subsequently, increasing the opening hours of urgency treatment centres could aid with resolving the extreme workloads at GP practices which characterises the current NHS crisis.
In addition to increasing the weekday opening hours of UTCs, it is necessary to consider extending opening hours of GP practices to weekends as well. The inclusion of a Saturday clinic can promote a better work/life balance for GPs by distributing working hours more evenly. Longer and less rushed consultations for patients would also benefit them as well as their doctors.
Increasing the Role of Pharmacies
Pharmacists are highly trained in giving clinical advice and recommend OTC medication for minor illnesses, for example abdominal pains, coughs and sore throats. There are other countless examples, where people can benefit from seeking advice through a pharmacist, such as obtaining information on travel vaccinations or making enquiries about stop smoking services.
In addition to this, an education program explaining and directing people to local pharmacists for minor ailments and simple health advice, instead of GPs would also greatly benefit GP practices.
The majority of pharmacists cannot, however, prescribe medication and for this you will have to see a doctor.
Automatic Repeat Prescriptions
Individuals, who require medication for long term conditions such as epilepsy, will be fully aware of the hassle of requesting a repeat prescription. Automatic repeat prescriptions will save patients time and reduce queues at GP practices for order requests. Moreover, automatic prescriptions cut down on potential delays in receiving medication, which can have severe implications for individuals taking medication for long term illnesses.
Reforms to Private Health Insurance Policies
Private health care practices play a pivotal role in alleviating the pressure on the NHS and provide benefits to patients as well, by allowing them to skip the queue and giving them access to longer and more personalised services. Nevertheless, an overwhelming number of GP referrals are created to direct patients for specialist treatment, as part of requirements set by the majority of private practitioners and private insurance companies. Scrapping GP referrals are essential to saving GP hours and resources and these reforms should be taken into consideration by the British Medical Association.
The lack of age diversity within specialist medical sectors is partly responsible for the shortage of GPs. An investigation conducted by Pulse, a leading magazine for GPs, highlights the result of practitioners being of similar ages - as they retire at around the same time, practices experience sudden and challenging staff shortages.
Advocating age diversity across all medical specialist areas is therefore paramount to preventing sudden shortages in hospitals, clinics and treatment centres.
Junior to Senior Doctor Ratios
Additional findings by Pulse, addressed the poor ratios of junior to senior doctors, with a limited number of senior, specialist doctors causing restricted access to health care, particularly in certain areas such as sexual health.
The review completed by the Health and Social Care Committee reported patients in certain parts of England had limited sexual health services, due to shortage in the number of experienced GP to carry out fittings such as contraceptive implants, injections and intrauterine devices.
The proper ratios of age and level of expertise is fundamental to providing patients with complete access to services and appropriate medical guidance.
Artificial Advancements within the NHS
Artificial intelligence developments within the NHS are relatively early at this stage; regardless, ground breaking AI initiatives are being explored as a way of answering concerns of patients and saving GP hours. The Hartree Centre teamed up with Alder Hey Children’s Hospital to create one of this year’s most significant AI revolutions in saving GP time.
AI and Data experts started their AI, chatbot intervention by collecting data from the hospital to develop a knowledge base. This would help the foundation of their new, chatbot system, IBM Watson, understand how the hospital operated. The collected data was used to create chatbot “Ask Oli” which was personalised to the hospital, by using the hospital’s mascot elephant character.
Guy Boersma, managing director of the Kent Surrey Sussex AHSN Networkbelieves that ‘when people see the benefits of allowing access to their data’ and hold ‘greater trust in the NHS’ we will be able to harness the full potential of AI in medicine and GP practices.
Ultimately, these twelve ways of resolving the crisis in GP practices will address that more support is provided to GPs and alternative approaches are integrated to maximise the efficiency of GP practices.