Don’t get old. Don’t get ill.
That was the warning about life under a Conservative government 40 years ago, and it holds true today, as ANDREW FISHER, pictured left, discovered when checking out waiting times just to get an appointment to see a doctor in Croydon
Figures released today show that NHS waiting lists hit a record high in November and A&E departments in our hospitals experienced their worst performance on record.
Not in the best of health: NHS GP services are struggling to cope with demand, as the number of doctors declines
Yet examination of the waits for people in Croydon just to see their GP shows that the difficulties in getting treatment begins with our local surgeries.
Across England there are 4,600 fewer GPs than there were in 2013.
As we approach the depths of winter and the peak of ‘flu season, you’re likely to be waiting longer than ever for a GP appointment.
Figures from October show that almost 2million people in England had to wait more than 28 days for a GP appointment, while a further 4.3million had to wait more than two weeks.
Those national figures only tell us part of the story – this really is a postcode lottery. The lottery is both how long you’ll have to wait for your appointment but also whether you will get to see a GP at all.
In October alone, nearly 5,000 people in Croydon had to wait more than 28 days to get a GP appointment; 22,000 others had to wait more than two weeks just to see their doctor.
A few years ago, pre-pandemic, I recall being apoplectic when an older relative of mine who had recently suffered a stroke was given a check-up by their GP over the phone. Given the physical symptoms of a stroke, how on earth can even the best-qualified GP check that by a phone call?
While such instances were rare then, a GP consultation over the phone is now more common. Pre-pandemic (in late 2019) around 80per cent of all GP appointments were face-to-face. Today, only 60per cent of GP appointments are in person.
The move to remote consultations during the pandemic was, as the Royal College of General Practitioners said, “necessary for infection control and to keep patients – and GP teams – as safe as possible”.
But that this trend is continuing now is all down to GP shortages. Professor Martin Marshall, the chair of the RCGP, has called on the government to “urgently deliver on its election manifesto promise of 6,000 additional GPs”.
Figures from the British Medical Association show the number of GPs in England has fallen by more than 1,800 since 2015.
Croydon’s GPs do slightly better than the national average, with two-thirds of patients in Croydon North and in Croydon Central getting face-to-face appointments, while three-quarters in Croydon South got an in-person consultation.
But to demonstrate the extent of the postcode lottery, there were six GP practices in Croydon where fewer than half of appointments were face-to-face.
Five of these were in Croydon North: Family Practice Group; Eversley Medical Centre; London Road Medical Practice; Norbury Health Centre; and Brigstock and South Norwood Partnership.
The other where only half its patients got face-to-face GP consultations was at Friends Road Medical Practice, in Croydon Central.
At the other end of the scale, both Addington Medical Practice and Greenside Medical Practice, off London Road, saw all their patients face-to-face.
Keston Medical Practice was only just shy of achieving that too, having seen 99per cent of its patients face-to-face in October.
While some patients may prefer an appointment over the phone, many are frustrated at not being able to see their doctor in person. Nationally, just 1-in-5 patients are given a choice over the type of appointment they have.
In terms of the longest waits, in more than half of Croydon GP surgeries, fewer than 1-in-50 patients had been waiting more than 28 days for an appointment.
But at three surgeries, more than 1-in-10 patients had to wait for four weeks or more: Parkside Group Practice in South Croydon; Bramley Avenue Surgery in Coulsdon; and at Stovell House Surgery, Addiscombe. All three of these surgeries had better than average rates of face-to-face appointments.
However, we should treat this practice-level data with caution.
It represents a monthly snapshot which can be distorted by local outbreaks or skewed by GP illness. The RCGP recently wrote to the Secretary of State for Health to express their “major concerns” about the publication of this data, warning it could “fuel anti-GP rhetoric in the media and damage GPs’ relationships with their patients”.
The Care Quality Commission (CQC), the healthcare regulator, sets out on its website that:
- you should be treated with dignity, kindness and respect;
- you should be involved in decisions about your care and treatment;
- the appointment system should be easy to use;
- you should be able to have an appointment at a time that suits you.
What is beyond any doubt is that the NHS is under massive strain, with staff shortages, long waits for patients and industrial action looming as the Conservative government rewards dedicated staff with a real-terms pay cut.
There has all created a real crisis in prompt access to care.
Ambulance delays are also an issue of concern – with 8 per cent of areas across England currently missing the seven-minute target for Category 1 calls.
Croydon, it is good to note, was one of two areas meeting the 18-minute target for response times to Category 2 calls (which includes suspected strokes).
Forty years ago, the then Labour leader Neil Kinnock spoke to the country with foreboding about the return of a Thatcher government. “I warn you not to fall ill, I warn you not to get old,” he said.
Today, his words are more apposite than ever. Don’t get ill, everyone!
- From 2015 to 2019, Andrew Fisher worked as the Labour Party’s Director of Policy under Jeremy Corbyn. He is the chair of the Croydon Central Constituency Labour Party. Fisher is also the author of The Failed Experiment – and how to build an economy that works, and now writes regular columns for InsideCroydon in a personal capacity
Some of Andrew Fisher’s recent columns:
- Tory blame game over bankruptcy points finger at Westminster
- Higher energy bills, higher tax bills and worse public services
- #TheLabourFiles: It’s long past time to clean up the Party
- Forde Report exposes racism, bullying and factionalism in Labour
- If you have a news story about life in or around Croydon, or want to publicise your residents’ association or business, or if you have a local event to promote, please email us with full details at inside.croydon@btinternet.com
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“Keston Medical Practice was only just shy of achieving that too, having seen 99per cent of its patients face-to-face in October.”
Remarkable, because my family land in the 1% time and time and time again; and have done ever since the pandemic.
Unless, and Andrew doesn’t clarify, whether ‘face-to-face’ includes meetings by Teams or Zoom.
If it does, then we have been seen ‘face-to’face’: but not person-to-person-in-the-same-room since 2019.
Face-to-face means in-person, rather than an online video call.
It is of course likely that – in line with advice – when Covid incidence was higher or when we were in Tier 3 or 4 lockdown then GPs surgeries held more appointments online or via phone. So the data for October 2022 will likely be very different to what it would have been six months or a year earlier …
As you say: “However, we should treat this practice-level data with caution. It represents a monthly snapshot which can be distorted.”
The pandemic was done and dusted a year or more ago.
My practice-level 2019 – 2022 snapshot, which can be distorted, is that my family, when seeking an appointment at Keston House, falls into the October 1% 100% of the time.
I’m (currently) a patient at Friends Road and it’s unfortunate what has happened to this practice.
From my experience in the last 12 months, it’s now 100% telephone interviews at this practice with some random individual who may not even be a doctor (certainly never my GP), or fobbing you off with an initial visit to the “GP Hub” (up near East Croydon) who can meet you face to face but as they’re not GPs they’re not permitted to give a diagnosis as it “upsets the GPs” (I kid you not). Their role is basically to act as a buffer – weeding out the hypocondriacs, and arranging an interview with your actual GP for those with a genuine issue (face to face if your lucky but in my experience just telephone, with some random person, about 3 months later – good job it wasn’t critical!)
Unless Friends Road returns to 100% face-to-face interviews and ditches the GP Hub I’ll be moving to another practice. The pandemic is over – or at least something we just have to live with – and avoiding meeting patients is totally unacceptable – it’s disrespectful, and now makes me think twice about getting treatment as you’re being made to feel like you’re too much of a bother.