'Hidden crisis' of GP surgeries with some Dorset patients waiting WEEKS for appointments

Experts are warning 'significant change' needs to happen if the situation is to improve.

Surgeries across the county are reporting that they have changed the way they work to cope with ever-increasing pressures caused by patient demand, staff shortages and lack of investment.

One reader, a patient at Dorchester Road surgery in Weymouth, said he was told he would have to wait four weeks for a non-urgent appointment to see a GP. A spokesman for Dorset CCG said the waiting time at this surgery at the end of last week was 13 days.

The situation is less critical in other practices, but one GP warned that, if nothing changes, the situation will worsen until many are facing closure.

Dr Jon Orrell, a GP at the Royal Crescent Surgery in Weymouth and a Weymouth and Portland Borough Councillor, said waiting times are a symptom of ‘a much bigger problem right across the whole country’ and pointed the finger of blame at the government, rather than individual practices or the CCG.

And Dr Nigel Watson, CEO of the Wessex Local Medical Committees and a practising GP, said the issue is a particular problem in Dorset because of an ageing population. While this has been a problem for around two decades, he said it has really 'ratcheted up' in the last three.

Dr Watson said: "The demand is unsustainable. More people are coming in with complex, multiple illnesses or long-term conditions and the capacity has not expanded to meet that demand. Surgeries are trying their best but it is almost like firefighting. There are insufficient staff to see to everyone's needs."

Cllr Orrell said: “At the moment it’s A&E departments getting the headlines, but there is quite a prominent hidden crisis in primary care. General practice is drowning, and it’s aggravated by a recruitment problem. Older GPs are retiring early after getting fed up with the extra paperwork they now have to do and there are not enough to replace them.”

Cllr Orrell said that of eight practices in Weymouth, there are currently four having ‘real problems’ with recruitment.

He added: “When I applied for general practice, there were around 100 applicants per job. Now, some practices are advertising a position and getting no applicants.”

Portesham Practice has been one GP down since April 2016.

Practice manager Alison Dunbar said they have a waiting time for non-urgent appointments of three days.

She added: “We used to be able to see people on the same day. There used to be government guidelines that you had to see people within 48 hours but that changed a couple of years ago. We have found in the last few years that it is getting harder. Demand is increasing all the time and the winter is always busier.”

She said that staff vacancies, as well as patient demand, is an issue. Four years ago the practice had a vacancy and seven GPs applied. But when another GP retired in April last year there were just two applicants, who both dropped out of the process.

“We are a three-GP practice and have only had two GPs for nine months. We have a fantastic team of locums which does help.”

In December, Dr Helen Stokes-Lampard, chairman of the Royal College of GPs, warned that patients could be forced to wait weeks to see their GP as medics struggle to keep waiting times down over the busy winter period. She added that extended waiting times can pose a 'serious risk' to patients.

Cllr Orrell said while GPs are paid enough, funding is at the root of the problem, with 80 to 90 per cent of patients seen across the NHS every day going to general practice, which receives only eight per cent of the budget.

“This is a national problem, and it’s not something that Dorset CCG can solve. We need to make sure there are enough places on training schemes. Nurses now have to pay for their own training. We depend on nurses and anything that makes it harder to recruit them is going to make the situation worse.”

He added: “What we are seeing nationally is that if practices can’t recruit they become impossible to run. They close down and then waiting times become even longer for patients. It’s over to our MPs to change this.”

Changing practice to cope with demand

SURGERIES are working hard to accommodate as many patients each day as possible.

The Dorset Echo contacted every GP surgery listed with the CCG in Weymouth, Dorchester, Portland and West Dorset.

Of these, several declined to comment on whether there were waiting times for non-urgent appointments and others said they would call back. We have not received a response.

Of those who agreed to talk to us, Portesham offers phone calls from a GP once daily appointments are booked up in the morning. Doctors assess patients over the phone and, if it is urgent, they will be seen.

A CCG spokesman said this service is also offered at Dorchester Road surgery.

Puddletown practice holds a drop-in session every morning between 8.30am and 10.30am where there is a guarantee patients will be seen on the day. Practice manager Marcus Pawson said these sessions are now running longer than they used to because of growing patient demand.

Wyke Regis Surgery said patients can opt to book up to eight weeks in advance if their condition is non-urgent.

Dr Watson began in general practice in 1987, when a typical day consisted of seeing around 20 patients in six-minute appointments from 8.30am, three or four home visits and a lunch break at home before returning at 4pm for an afternoon surgery. But today, he said, GPs are working from around 7am to 8pm 'full on' with phone lists numbering up to 100 people.

He added: "If there was an easy answer we would have found it. But what is happening now is that we are at a tipping point where the challenges faced by practices in this area are such that something significant has to be done, and it has to be done quickly."

Call for review to tackle crisis

MP for West Dorset Oliver Letwin said: "‎There is no doubt that we need more GPs nationally - and that is why efforts are now being made (and why money has been made available) to recruit and train more of them. But this is not something that can be done overnight, because it takes a long time to train up GPs. Meanwhile, we have a particular problem in Dorset, which is that many of our GPs are currently reaching the age when they think of retiring. I'm clear that we need locally to look at ways of persuading more of our existing GPs to stay in post for a little longer or to come back part time when they retire. "

Richard Drax, MP for South Dorset, called for a non-partisan review 'by people who know what they are talking about' into NHS funding to tackle the issue.

He added: "All those in the NHS are doing a fantastic job, and there is no doubt GPs are under huge pressure. I do not think we can go on like this. Something might snap."