For years the NHS has been short of staff – including GPs. The Health Foundation shows that the UK has only 3.93 doctors per 100,000 people- the lowest in Europe. It has just 2.42 beds per 1,000 people, the second lowest in Europe. It also ranks low down in the international league table for its supply of nurses, CT scanners and MRI scanners. We are also critically short of GPs with many leaving the profession faster than they can be replaced. Ironically, the Government recognised the problem with GP services and promised 26,000 extra personnel for practices in England but, as Denis Campbell of The Guardian reports (9 Jan 2022) only 9,500 have been recruited. No wonder it is hard to see a GP. Here is the Guardian article:
A manifesto pledge to hire 26,000 extra health professionals to work in GP surgeries is set to be broken by the government, health leaders have warned, leaving family doctors straining under a heavier workload.
About 9,500 of the promised physiotherapists, pharmacists, mental health therapists and other clinical staff so far have been recruited to help GPs and practice nurses.
Senior doctors have warned that patients will pay the price for the slow delivery of extra personnel by facing persistently long waits for an appointment.
In one of a raft of NHS pledges in the Conservatives’ 2019 general election manifesto, Boris Johnson promised to employ 6,000 more primary care professionals by 2024 to work in GP practices in England. This was on top of the 20,000 that NHS England had already promised in its Additional Roles Reimbursement Scheme (ARRS).
The plan was to free up family doctors’ time by having physiotherapists see patients with sore backs, pharmacists undertaking medication reviews, counsellors supporting people with mental health problems and dieticians advising those with food-related problems.
Those 26,000 staff, alongside the arrival of “6,000 more doctors in general practice” in a separate pledge, would help GPs and their teams offer 50m more consultations, the Conservatives said. But in November the health secretary, Sajid Javid, admitted that Johnson’s often-repeated 6,000 extra GPs pledge would be missed.
Official NHS workforce statistics highlighted by the Royal College of GPs (RCGP) show that by September only an estimated 9,464 extra clinical staff had been recruited – far short of the 13,000 that should have been in post by then at a rate of 5,200 a year for five years, given the ARRS scheme had begun in March 2019.
“Whilst progress in meeting this target is better than the GP [recruitment] target, it’s still slow and very concerning that this could be another promise that won’t be met,” said Prof Matin Marshall, the chair of the RCGP.
“The impact of not having enough staff in general practice is being felt acutely both by GPs and our team members who are working to their limits, and our patients, who are facing longer waits for the care they need. Meeting this [extra staff] target – and the GP target – will be vital to addressing this.”
NHS workforce statistics show that in September there were still only 14 podiatrists, 38 dieticians and 79 mental health therapists working across the 6,600 GP surgeries in England. There were also just 47 health support workers and 252 health and wellbeing coaches, who advise on lifestyle.
There has been much more progress in recruiting pharmacists, whose numbers soared from 153 in March 2020 to 2,626 last September. Similarly, the numbers of paramedics rose over the same period from just two to 256 and of social prescribing link workers – who direct people to non-medical activities, especially to tackle loneliness and depression – from 112 to 1,427. The number of physiotherapists in post at GP practices has also risen considerably, from six to 652.
It is vital to recruit enough of all these kinds of personnel, Marshall added, because “these professionals, alongside GPs and our established nursing colleagues, can provide both excellent and appropriate care for patients but also free up GPs’ time for patients with complex health needs, who are most likely to benefit from our medical expertise.”
Labour seized on the slow progress towards meeting the 26,000 target. “The Conservatives are on course to break another promise,” said Wes Streeting, the shadow health secretary.
“Their failure to invest in the GP workforce and the primary care staff that support them means that people are struggling to see their GP and end up turning up at A&E, which inconveniences patients, puts hospitals under greater pressure, and costs the NHS more money. The Tories’ incompetence is costing people dearly.”
The Department of Health and Social Care insisted that recruitment of the 26,000 staff was on track. “The new recruits will be a core part of local primary care teams, reducing pressure on general practice and ensure patients can see or speak to the right clinician,” a spokesperson said. “We have invested £530m to expand GP capacity during the pandemic, on top of £1.5bn until 2024 and we have a record number of GPs in training this year, with 4,000 accepting places.”