Thursday, April 20, 2017

May 11th Meeting at 6pm at Ilford Central Library on GP Shortage

The Redbridge GP shortage impacts upon care at King George Hospital. I explain how in a email below to Redbridge Councillors earlier today.



Dear Councillors

I attended the last Redbridge Clinical Commissioning Group board meeting on 30th March to hear Dr Metha, the Chair complain of a shortage of Redbridge GPs impacting upon care at King George Hospital.

This is due to patients turning up at King George Hospital because they cannot get a GP appointment. It was reported by Dr Metha that average GP list size in Redbridge is 2600 whereas some other boroughs it is as low as 1700. The situation seems set to get worse with GPs retiring not being replaced.

There is strong evidence that overcrowded A&E departments lead to worse patient outcomes, including longer stays in hospital and worse mortality rates (1). So we need more GPs in Redbridge as a matter of urgency to ease the pressure on King George A&E.

To discuss what needs to be done to improve the situation I have, after consulting with others, called a meeting at Ilford Library on the 11th May at 6pm just before full council. Redbridge Trades Council is promoting this meeting and I will hope other organisations will support too.

Jas has made a commitment to providing a statement about the issue for the 11th May meeting at cabinet earlier this month. I hope there will be some Councillor representation across the parties at the meeting as there was for a save King George A&E meeting at the library last year.

Should Councillors from the main parties attend I will ask the Recorder if one of their journalists would like to chair the meeting.

I attended a inner London Clinical Commissioning Group meeting yesterday to find this in the board papers (2).

“Workforce - Summary In order to meet the shortfall of supply of GPs in EL, (high retirement rates and a shortage of available new GPs) and to develop a more efficient, patient-centred service, we will need to develop and increase the numbers of practice nurses, physician associates and pharmacists to provide a full multi-disciplinary team (MDT) workforce model. We are currently on target to deliver physician associate training placements in 2017 and a workforce supply in 2019. We have a pharmacist pilot programme in Newham GP practices and will look to expand this across TST in 2017-18.”

It seems rather than replace GPs in East London (EL) with new GPs, the shortfall is to be made up with “practice nurses, physician associates and pharmacists”. On the face of it, this seems an inferior GP service to the current one and it must be a concern that a similar GP downgrade is being planned for Redbridge. Cutting the number of GPs in East London seems bound to make some patients pay for private GP consultations which is likely to reduce the number of NHS GPs available (3).

I am hoping that Redbridge CCG will send a representative to the meeting or make a statement about the GP shortage.

It is puzzling that current regulations seem to stop a single handed GP starting up from scratch in Redbridge in a converted house. Purpose built, multi-disciplinary and multi-partner surgeries may be better than single GP practices, but they are not happening in sufficient numbers to tackle the GP shortage.

I hope representatives from each of the parties will attend, even if the council meeting starting later in the evening means Councillors may not be able to attend for the whole meeting.

The meeting will be broadcast live on facebook.

Regards

Andy



  1. the key quote from the site above is:
There is strong evidence that the symptoms felt in emergency departments led to worse patient outcomes. We know, for example, that patients run a 43 per cent increased risk of death after 10 days if they are admitted through a crowded accident and emergency (A&E) department. (Richardson DB, 2006) Waiting for admission in A&E is also associated with significantly longer hospital length of stay – on average 2.35 days longer where a patient stays in A&E for more than 12 hours. (Liew D, Kennedy M, 2003)
We know that speed of treatment is vital in many conditions. For example, people with the most severe form of pneumonia have less than a one in two chance of surviving. Those chances improve considerably if effective treatment is started early.  However, research suggests that delays of more than four hours in administration of antibiotics to patients coming into hospital with pneumonia can affect 70 per cent of patients on days when an A&E is crowded. (Pine JM et al, 2005)This undoubtedly affects mortality

    1. The quote is from page 49
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