Letter to patients – July 2021

Dear Patients,

We are in unprecedented times, with all of us experiencing huge challenges and changes in how we live our day to day lives. We felt it was important to update you on how we are currently working at the Red House Surgery, the changes that we have made and plan to put in place and also to make you aware of the escalating levels of demand which we are now facing.

The past 18 months have been utterly unimaginable and it has affected every one of us. Whilst a lot of sectors and industries have shut or reduced their capacity in an effort to keep their employees safe, General Practice has not only remained open, but has increased the number of appointments available, ensured that all premises are COVID secure, changed the way we work overnight to maintain services safely, whilst at the same time delivering 75% of all COVID vaccines.

The Red House Surgery has adapted how we work to ensure that you continue to receive the care you need. Changes such as telephone and online triage were brought in, as requested by NHS England, not only to protect patients, but also to mitigate risk and protect the staff as much as possible, thereby ensuring that staff were able to come into work every single day throughout this pandemic. Whilst accessing us may have been different, we have always been open and have been seeing patients that needed to be seen.

During these challenging times for the country and the NHS, patients are, on occasion, expressing anger and frustration due to difficulties in how they access health care as a whole. Whilst most of our patients have sent messages of thanks and support, sadly there is an increase in verbal abuse that our reception staff and clinicians have had to experience. This, together with negative comments which are posted on social media, is demoralising when we are all trying our best to deliver care during these times and it has led to some staff feeling they need to reduce their hours or leave.

It has long been recognised that there is a huge problem in terms of recruitment and retention of GPs and whilst the Government have in the past pledged to increase GP numbers, the profession continues to see GPs leaving in large numbers with a predicted shortfall of 7,000 full-time equivalent (FTE) GPs in 2023/24 rising to 11,500 FTE GPs by 2028/29. In order to try to address this, NHSE made the decision that GP practices should start working together as Primary Care Networks (PCNs) and to fund aspects of Primary Care through these networks. The Red House Surgery is in a PCN with practices in Borehamwood, Elstree and Bushey. Despite the difficulties in recruiting GPs we are delighted to announce that we will have a new salaried GP starting with us in the next few months.

The Government has provided funding for PCNs which is ring fenced for employing certain staff, for example, physios, clinical pharmacists and paramedics and the Red House has welcomed these allied health care professionals to the practice. For this reason, when you call for an appointment you will be asked questions by our trained admin team as to the reason for your appointment. You may then be booked an appointment directly with one of these team members, who will be appropriately qualified to deal with your problem. For example, if you have an acutely painful knee you may be given an appointment with a physio, if you are not tolerating a medication you may be given an appointment with a clinical pharmacist. In addition we have a skilled and experienced team of paramedics and advanced nurse practitioners, all of whom are experts in dealing with a variety of minor illnesses.

Demand at The Red House, has been the highest we have ever faced, as we continue to deal with acutely unwell patients with Covid, as we attempt to support patients struggling to access secondary care due the immense backlogs resulting from the pandemic, as we adapt and change how we run the organisation in order to safely provide ongoing medical care to patients, as well as successfully delivering the largest and most important vaccination campaign in the history of the NHS.

On occasion, unfortunately some patients feedback that they struggle to get an appointment with a clinician in the timeframe they feel they need. As a result we reflected on this and we have reviewed our data. In April of this year we offered 7,333 appointments compared to 6,724 in April 2019, showing that in fact we have increased access by 609 appointments/month. We have also compared the waiting time to see GPs and there is no significant difference between 2019 and 2021; some GPs the wait was a little less, some a little more.

This increased access has been mirrored nationally with 8.4% more GP consultations in April 2021 than April 2019. GP clinical administrative workload – covering prescriptions, referral letters, messages to patients and other tasks – continues to increase and was 34% higher in April 2021 compared with the same period in 2019.

We are immensely proud of all our staff who have worked tirelessly, sometimes at a cost to themselves and their loved ones to ensure that patients get the best possible care that we can deliver under such challenging circumstances and understandably this has taken its toll. The risk of workforce burnout has been addressed by the Health and Social Care Committee chair, Jeremy Hunt, who said: ‘Workforce burnout across the NHS and care systems now presents an extraordinarily dangerous risk to the future functioning of both services. It will simply not be possible to address the backlog caused by the pandemic unless these issues are addressed.’

As we all continue to fight against this pandemic together, we ask that we show each other mutual respect and consideration. We will continue with our aim to provide the best care and support needed to our patients whilst keeping everyone safe.

Thank you.

Dr William Bagg, Dr Krish Gupte, Dr Bhavin Patel and Dr Violaine Carpenter

Partners – Red House Surgery