Inside the GP clinics struggling to meet patient demand amid Covid pressures

ITV News Health Editor Emily Morgan hears from a doctor about the pressures facing his medical centre in North London

They’ve been accused of hiding behind their laptops, of not returning to work despite being some of the first to be double jabbed and of failing to see patients face to face.

Even the Prime Minister has waded in, releasing a statement stating GP practices should be making that facility (face to face appointments) available to their patients.

Have GPs disappeared? Is it impossible to get an appointment?

We’ve all heard anecdotal evidence that someone’s had to wait three weeks for one, or that GPs who are only doing phone consultations or surgeries have sent out emails asking patients to only call if they have a genuine, medical problem.

We’ve heard it, but what are the facts? I spent the afternoon at a surgery in North London yesterday.

The first thing that struck me was how few chairs there were in the waiting room.

Why? Because doctors have to operate infection control, thus only allowing a certain number of patients inside at any one time.

The waiting room was full so at first glance it looked like an ordinary busy surgery. The second thing to note was that clinicians, buzzing in and out of their consultation rooms, were running everywhere.

They were literally running from reception and back, to other rooms and then to the waiting room. This went on all afternoon.

The phones in reception did not stop ringing and calls on hold, lit up frenetically.

Staff were said to be constantly answering the phone

This did not look like a surgery hiding from anything.

If anything it looked like a surgery doing everything it could to get through as many patients as possible. I then spoke to Dr Ehsan Alkizwini who talked me through why he thinks criticism of GPs over the last few weeks has been inaccurate, vitriolic and insulting.

He says his surgery is now dealing with more patients than before the pandemic.

He calls what he does a blend of face to face appointments, telephone and online consultations.

The online appointments come in at anytime during the day, all of which they are compelled to answer and many are still being dealt with at 11pm from home.

The phone appointments are used for ease and only for patients who don’t appear, initially, to need to come in.

He says patients prefer them and all patients who need further investigation are asked to come in and see someone.

There are benefits for both doctor and patient, not just because he can get through more patients- but he is also streamlining his work better so he can see his more urgent or worrying patients in the flesh.

Yes, he says, he is seeing only 50% of his patients face to face but he claims it's working for everyone, mainly because of the huge increase in patients and the large drop in staff.

Staff is the next problem. None of his clinicians work full time.

He cannot recruit and retain staff because there are simply not the doctors out there and when he finds them they either leave or insist on working part time.

I’m not talking about busy parent doctors who need to work part time in order to also balance life with children; I’m talking about doctors who don’t have children, grown men and women who can’t cope with full time work because of the pressure and amount of work expected of them.

If that isn’t a sad indictment of where general practise is right now, I don’t know what is. Then there’s the increased work load.

Dr Alkinwini is running a Covid vaccine hub, he’s had to increase the number of flu jabs given this year, he’s still looking after patients who are on waiting lists to be treated in hospital and shouldn’t be in his care anymore, he spends hours trying to refer patients to hospital but is kept on hold on the phone so long he has to ring off and he’s seeing patients with more complex issues than he did 10 years ago, oh and he’s also dealing with Covid patients.

That list doesn’t even go near what he spoke to me about but it would fill this page so I’m trying to just give a taster of the extra workload they are dealing with, with fewer staff. An afternoon at the surgery taught me quite quickly why doctors are seething at abuse they are getting.

But is it completely unfounded? Patients across the UK have come forward with horror stories about being misdiagnosed because their doctor didn’t see them face to face.

In York, Nicole Freeman says she’s lucky to be alive after her doctor missed her mouth cancer symptoms despite sending photos via email.

She has since had her tongue removed and is now campaigning for doctors to guarantee appointments in person.

Then there’s Tracey, whose mother had consistent telephone appointments about her stomach ache.

She was prescribed gaviscon again and again and it wasn’t until she ended up in hospital did they discover she had cancer and died within weeks.

These are real people, with real ailments that may not have looked or sounded bad on the phone but might well have been spotted in person. So how do you solve these issues? Dr Farah Jameel, from the British Medical Association, says without more staff it is simply not achievable to see more patients face to face.

Doctors are doing everything they can in a system that is broken.

Dr Jameel explains the pressures faced by GPs amid the pandemic

A lack of staff and hospital backlogs are having a huge impact on primary care.

She wants action from the government and not more diktats which just fuel the abuse and hatred they’re receiving.

A statement from the Health Secretary though appears to backtrack on the prime minister's words earlier this week.

It says the NHS has been clear GP practices must provide face to face appointments, alongside remote consultations, and over half of all appointments in July were face to face.

A concession maybe blended appointments work? I asked Dr Jameel what the answer is and she sighed ‘I don’t know.. I wish I did’.

She did concede that if staff were better treated, more appreciated and had less the do it would help but much of that comes down to recruiting more doctors and that, she said, is just not happening.

Her parting gambit to me was ‘stay well, for heavens sake, stay well’.

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