Pressures in general practice

Kent and Medway Clinical Commissioning  Group (CCG) continues to work with general practice, the local medical committee and wider NHS partners to address pressures caused by the backlog of patients into GP practices, who have not been seen during the pandemic.

Some of the main reasons for the pressure on general practice include:

  • use of general practice appointments when they are not the most appropriate course of action
  • backlog of GP work from lockdown
  • general practice infrastructure challenges
  • lack of sufficient and timely access to diagnostics
  • workforce constraints.

Dr Navin Kumta, Clinical Chair of Kent and Medway Clinical Commissioning Group, said:

“We are very aware of the pressure GP practice teams are under and also of the frustrations felt by patients when they can’t get through to their practice or have to wait for an appointment.

"Plans are being developed to address the reasons for the pressures, some of which can be immediately looked at while others will require a longer term approach.

"A new strategy is being developed to reflect the impact the pandemic has had on GP practices and other health services like pharmacies. In the meantime, we are progressing some immediate actions to help reduce some of the pressures.’’

Actions include: 

• hospital waiting list queries – people on hospital waiting lists have traditionally had to contact their general practice for updates, which needs the practice to follow up with the hospital. We are working with all hospitals to implement direct enquiries services to make it easier for patients.

• medication on discharge – people leaving hospital often need continuing medication, but are routinely prescribed just two to three days of supply by the hospital, meaning people have to quickly contact their practice to arrange further supplies. We are looking at how we can increase the amount of medication prescribed on discharge.

• internal hospital referrals – if one hospital service sees a patient and identifies a need for an appointment with another service, the patient is normally directed back to general practice to make a new referral. We are investigating how an internal referral can be made directly from one hospital service to another.

• promoting alternative services – 111, pharmacies and urgent treatment centres can provide the advice and care that some patients need. We continue to work with practices and the public to promote suitable alternatives to contacting general practice.

• phone system capabilities – some practices have inadequate phone systems for the level of demand now being experienced. We are working with NHS England to pilot new systems and develop a national standard for primary care phone systems.

• remote monitoring solutions – during the pandemic, we developed a successful remote monitoring service for blood oxygen levels. A similar model is now being developed for blood pressure monitoring.

• increased capacity for blood testing – routine blood tests are a significant activity across general practice. We are developing plans to increase capacity for collecting samples and analysing results.

Pressure on general practice is also related to workforce and infrastructure challenges (such as buildings or systems), which existed before the pandemic and need longer-term solutions. The new primary care strategy will review work that has been going on in these areas and identify additional options for improvement.

All parts of the NHS continue to work extremely hard to meet the needs of patients, which built up through lockdown restrictions.

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