Demand on general practice – message from Hertfordshire and West Essex ICB

Published: 25 August 2022

General practice is often the front door into NHS services and the way people get health advice, information, treatment and support.

In recent years, there has been an increase in demands on general practice. There are more issues that patients want help with and some of their needs are more complex than they were. Demands for general practice appointments have now risen to above the levels they were before the pandemic

There is a national shortage of GPs and other practice staff and locally, we are working to remedy this. The shortage of staff is making it harder for practices to provide patients with the care they need or are used to receiving.

Despite these issues, general practice has been at the forefront of the NHS's response to the COVID-19 outbreak, delivering thousands of vaccines while maintaining non-COVID care for patients throughout.

We would like to thank our colleagues in primary care for their ongoing dedication and commitment to continuing to improve the care offered to their patients.

What general practice is there for and how it has changed in recent years

The importance of General Practice to the health of local communities remains key, they are often the first point of contact for people seeking medical advice and support. With the vast majority of NHS patient contact being in general practice, demand on General Practice is increasing and also diversifying. Many people are living with long term conditions such as diabetes and heart disease or suffering with mental health issues and may need to access their local health services more often.

How services changed in the pandemic – and beyond

GP practices continued seeing and treating patients throughout the COVID pandemic. They have had to make some changes to the way they work to protect patients and staff from infection. This has meant not always seeing patients face-to-face but arranging phone or video appointments instead. We know that many patients have found this helpful and have been very happy to continue having their appointments without needing to go into the surgery. Appointments that did need to be face-to-face often took longer as additional time was needed for cleaning. The face-to-face option is always available to patients who request this. 

There is now more demand for services partly because some patients waited until the infection rates reduced before contacting the NHS. This means for some people symptoms have developed further and perhaps become more complex and urgent.

The backlog of people waiting for diagnostic tests in hospitals has led to increased administrative work, which has a knock-on effect on access to GP services. There has also been an increase in the number of people seeking help for mental health problems. This impacts on GPs and also specialist mental health services.

What are we doing to improve things?

Work is being done across Hertfordshire and West Essex to improve access in to services and managing demand. We received an additional £6 million in funding from the NHS last winter to make improvements across primary care services. 

These include:

  • More than 273,000 extra GP appointments took place over winter 2021.
  • improvements to telephone systems in practices. So far, 72 practices across Hertfordshire and west Essex have been approved for additional funds to upgrade their telephone lines. This means you will be able to get through on the phones more easily, as practices can manage telephone queues and can call you back.
  • We are working with practices and patients to introduce better online tools for people using GP services. The Community Pharmacist Consultation Service (CPCS) means our specially trained practice reception staff can transfer you to a community pharmacist for a same-day appointment for minor illness or an urgent supply of a regular medicine. This makes it easier for patients to get the care they need quickly and GP appointments are freed up for patients with more complex needs that can only be looked after by a GP.
  • Make changes to the storage arrangements for records and make premises alterations where necessary to increase the available space in practices for patient care
  • We also have several projects well underway that are intended to help recruit more GPs and develop other new clinical healthcare worker roles  

Understanding how your practice is working

Hundreds of patients telephone practices every day and there is only a finite team of staff to answer these calls. This team of staff also complete other admin tasks such as processing referrals and letters to patients. Some patients need extra assistance over the phone for various reasons, so that understandably lengthens the time of some phone calls.

The clinical staff in general practice often work very long days.  They work continuously through their lunch breaks and carry out home visits, deal with hospital letters and prescriptions. They are seeing more patients each day compared to pre-pandemic levels but team members will try to provide an alternative or let patients know what other services can help.

The reception staff are trained to support you to get the right appointment for your needs. They will sometimes ask you for information about your medical need that you may not wish to share with reception staff. However, our staff are trained to ask these questions so they can make an appointment for you with the person best suited to your needs. Sometimes this means you will get an appointment more quickly with the right person. This may not be a GP. All our staff treat your information it in the strictest confidence.

You may be offered an appointment with a nurse, a paramedic, a pharmacist, a healthcare assistant, or a physiotherapist who works at the practice rather than a GP if this is the best person to help you.

Please think carefully before contacting your doctor for things that will heal themselves with some help from a pharmacy.  This includes sore throats, hay fever, coughs, and colds. If you do see your local pharmacist, they will let you know if you need to see a GP.

Please use the NHS 111 service if you urgently need medical help/advice, but it is not a life-threatening situation. The call handler will assess your need and direct you to the most appropriate service. You can find more information about NHS 111 on their website.  

Phone 999 if your need is very serious or a life or limb—threatening emergency.

Getting involved, supporting general practice, or sharing your view

It is important for the local NHS and practices to understand things from the viewpoint of patients and their carers and hear about what matters to them. You can help us do this by getting involved in our work or joining your practices patient participation group.

Find out more about how to get involved on the Integrated Care Board website

If you have a concern about the treatment you received at your practice it is important to talk directly with your practice in the first instance. Everyone, each day, comes to work wanting to ensure patients are helped and cared for so they want to know if you feel you are not being cared for in the right way.

If you are unable to resolve your complaint with the practice, please contact NHS England as follows