Hertfordshire health chiefs signal that GPs are under ‘huge pressure’

Health chiefs in Hertfordshire have signalled that – with winter approaching – GP practices in the county are already ‘under huge and significant pressure’.

Access to GPs was just one of the issues highlighted to a meeting of the county’s health scrutiny committee, during a discussion of ‘winter pressures’ on the NHS.

Committee members heard that the number of phone calls being made to GP surgeries has increased by 80 per cent since the start of the pandemic.

And it was said that with increases in Covid infection locally, infection rates amongst staff and an ongoing ‘struggle’ with workforce availability are also impacting.

Nevertheless, they were told that GPs are already seeing half of all their patients face-to-face – and taking measures to increase that further.

Speaking at the meeting, managing director of the Herts Valleys Clinical Commissioning Group David Evans stressed that GP practices had remained open throughout the pandemic.

And he said GPs had heard the message that patients wanted to see them face-to-face.

He even pointed to one Hertfordshire surgery that had set up an outdoor tent as a safer space for patients to be seen, as one of the measures GPs were taking to offer face-to-face appointments.

But with continuing need for ‘infection control’ he said the tradition of patients ‘collectively unwell in a waiting room’ was high risk.

And he said they would be promoting the ‘Think 111 first’ approach.

“At the moment 50 per cent of appointments are face to face and 50 per cent are online or via phone, ” he said.

“Telephone triage is used to make sure the right person is in the right place to be seen.”

That was a message echoed at the meeting by the managing director of the East and North Herts Clinical Commissioning Group, Sharn Elton.

She also pointed to the ”Think 111 First’ approach – stressing that face-to-face appointments are available for those that need that, but that a triage process would help to make sure buildings were safe and free from infection.

“We really want to mitigate busy waiting rooms in any building, whether that be in primary care or in hospital settings or in our minor injury units,” she told the committee.

“We need waiting rooms to only be containing those people that need to be in those environments – who need to have face-to-face appointments.

“So triaging and non face-to-face or video conferencing appointments are going to be really important to ensure that we are able to manage the needs of our local population over the winter – and to ensure that we keep our staff safe, so that they are able to still provide services as well.”.

Liberal Democrat county councillor Chris White – who is also leader of St Albans District Council – said it was ‘not going to be widely believed’ that face to face GP appointments were available.

And while he said he had no issue with his own practice, he said that he believed pressures on GP practices were uneven.

He highlighted one practice – that he said had had 10 doctors, but now had just four – that he suggested was ‘clearly struggling’ and was ‘under challenge’ to provide face to face appointments and accurate diagnoses.

“I do need to flag that up as a problem that I think increasing numbers of us are worried about,” he said.

“It’s not just a winter pressure issue – it does seem to be permanent in terms of a lack of GPs – and there are probably EU exit reasons for that as well.”

Mr Evans pointed to the new ways of operating – such as a call-back facility or going online.

He acknowledged that it was ‘not perfect yet’ but that 12 months ago many systems didn’t even tell callers where they were in the queue.

And he said the CCGs were working with individual practices to make sure that they have the best offer that they can.

The meeting of the county’s health scrutiny committee was held on Monday, October 11, and it can be viewed online.