- Posted Wednesday February 20, 2013
FPM and Diane Abbott MP visit Manchester member practices to work shadow. First Practice Management (FPM) accompanied Diane Abbott MP, Shadow Minister for Public Health to visit member GP practices in Manchester on Thursday 14th February.
This visit was a follow-up from FPM’s interview of Mr Andy Burnham (Shadow Health Secretary) in January 2013. As part of Labour’s health and social care policy review, Labour is visiting practices across the country for work shadowing and First Practice Management assisted by arranging the visit with their practice members. Diane Abbott and First Practice Management visited the Borchardt Medical Centre and Kingsway Medical Practice in Manchester where Diane spoke with staff including GPs and Practice Managers.
Borchardt Medical Centre
Dr Nick Smith from Borchardt Medical Centre spent some time with Diane going through his views on how primary care has changed over his time in the profession, which spans 20 years. He discussed,
“Primary care used to be more of a reactive service where we were dealing with patients who were unable to handle minor illnesses or basic mental health issues. We were dealing with some major conditions, but more complex matters were being handled in hospitals. Now it is more proactive where we have things like drugs misuse clinics, chronic disease management clinics including heart disease and asthma, child health surveillance and more. I [and I dare say other GPs] are a lot busier than we have been. We have things like the QOF (Quality and Outcomes Framework) put on us, and between surgery, dealing with correspondence from secondary care, urgent appointments, home visits and supervising prescriptions etc, there are days that I don’t even have comfort breaks!”
Diane quizzed Dr Smith about how easy it was to get an appointment with the Borchardt Medical Centre and his honest answer was,
“It entirely depends on when you call us. We have two dedicated surgeries for appointments on the same day, but we also have routine slots for patients who can get telephone consultations and further advice. Our appointment system is a result of political pressures over the last 10 years. The system has been altered multiple times by the way of politicians leaning on the CCGs and advising that we have to do it a certain way. In my view, practices can never meet all demand because the easier you make it for patients to come in, the more influx you will see. For instance, when we used to do open access clinics we used to see more patients, but spend a very short period of time with each.”
“What do you think of walk-in centres then?” was Diane’s next question.
“I don’t think they worked to be honest and it was a waste of money. I’ve seen it from all sides and it all goes back to NHS Direct. NHS Direct was given a huge budget and there were times when patients were not seen by a qualified doctor or nurse and 1 in 20 patients ended up in a 999 ambulance. But that is just my opinion.”
Kingsway Medical Practice
First Practice Management and Diane then visited Kingsway Medical Practice in Burnage, Manchester and met with Mike Smith, Practice Manager and Dr Jonathan Kaye to find out more about what matters to them and their patients. Dr Kaye has been with Kingsway Medical Practice for 17 years and Mike Smith has been practice manager with Kingsway for 11 years. Diane asked if their jobs had changed much and how they had changed over this period of time. Mr Smith, Practice Manager at Kingsway said,
“There are a lot more patients now and there are a lot more targets to meet with the new contract. I find it a lot more onerous and I’m not quite sure where it is all going to end up. I think healthcare services might all end up in privatisation.” Dr Kaye added, “We are very busy and there is much that goes on in between surgeries that people don’t realise, such as correspondence from specialists to look at, going through test results, checking prescriptions, home visits and CCG meetings to attend as well.”
Dr Kaye also shared the number of items that Kingsway prescribed on a quarterly basis with Diane Abbott. He discussed,
“When comparing the number of items prescribed in 2003 to those in 2012, the figures have increased hugely. This is because of an ageing population, complex illnesses, new medications, increased number of patients and prescribing medicines on a weekly basis for those patients that need that kind of assistance.The QOF points in the GP Contract are important for patient wellbeing, but also an essential part of GP income. They are a measure of quality but there is a risk that when a patient walks in through the door, the doctor’s QOF agenda may take over the patient’s agenda. This can lead to long consultations with patients having lengthy waits.”
Diane said, “When I’ve spoken to hospital doctors about having GPs changing health service, they say having a GP running health services is like having corner shop operatives running Tesco. But when I’ve spoken with your colleagues I feel that it is working.”
Dr Kaye said, “It is working, but there is a feeling that there is a lot of box ticking.”
“In the new changes to the way the Health Service is to be run, some key services now provided in General Practice may be tendered out to alternative providers, once handed to Local Authority control. These Direct or Local Enhanced services provide essential Practice income without which, Primary Care could become destabilized by becoming financially unviable. If Local Authorities are short of money, they might try to commission cheaper alternatives, bypassing General Practice. If Practices fail, the essential services such as care of frail, elderly and terminal care patients could be lost also.”
Dr Kaye added, “From consulting with my patients, who have social care packages, I’ve learnt that these packages are going to be cut and they’re worried about how they’re going to finance them.”
Diane asked Dr Kaye what he would like to happen, to which he replied, “Less constant change, because no sooner do you adapt to one way of working, then new systems and procedures come into play and change everything. ”
Diane Abbott’s views about public health can be read on www.dianeabbott.org.uk.