Health services across Lanarkshire are experiencing more pressure than at any other point in their history. GP practices in Lanarkshire are similarly busier than ever, reporting around a 30 to 50 per cent increase in activity compared with pre-pandemic levels.
NHS Lanarkshire this week announced the cancellation of the majority of non-urgent planned care across their three hospitals, highlighting the pressures across the whole system which clearly impacts on general practice.
It is important to note that general practice has continued to provide services throughout Covid-19 and, in fact, are providing more appointments – albeit not always face-to-face - than they were pre the pandemic.
At the beginning of the coronavirus pandemic, the Scottish Government asked all GP practices in Scotland to increase their use of remote consultations by telephone or video. This means most people are now receiving the NHS care and advice they need from their own home to reduce the spread of Covid-19 in the community.
Most practices now operate a system where patients have to call the practice prior to being able to make an appointment. Practices have a wider healthcare team, in addition to GPs, so the patient will be clinically triaged and speak to the most appropriate person, for example the practice nurse or pharmacist. This way of working ensures the patient receives the right care from the right person at the right time and helps makes best use of the valuable and highly-skilled resources available. This has proved highly beneficial for patients to ensure their needs are met.
Capacity has been reduced due to social distancing and infection control, meaning many patients are unable to be seen as previously across all our health facilities. Two metre distancing will remain in place at this time as the Scottish Government requires GP practices and other healthcare settings to have different infection prevention and control and physical distancing measures compared to other places such as shops, pubs and other social and hospitality settings. This is to help reduce the risk to practice staff and to people attending the practice who may be at greater risk if they catch Covid-19. This means that GP practices will be operating differently.
For those patients that require a face-to-face consultation, this is being undertaken as required. GP practices are working harder than ever to ensure that they see everyone who requires a face-to-face consultation, for example, for physical examination or if tests need to be carried out.
As well as revolutionising how patients access services, GPs have also had reduced access to services to refer patients to. Patients are having longer to wait to access many services as well as there being a reduced ability for GPs to have patients seen than was previously the case.
A consequence of this is that many patients, having had their initial symptoms diagnosed and referral made to other services, are calling their GP back to request additional support, for example asking when they might be seen and/or seeking further assistance due to a change in/exacerbation of their condition. In turn, this is meaning a steep increase in the number of calls to be managed at GP level.
All of this activity is beyond what the GP would normally be expected to deal with and increases pressure on both telephone and appointment systems. We are currently working alongside Scottish Government to look at implementing changes that will help take some of the pressure off telephone lines at GP practices.
The pressures facing GP practices in Lanarkshire is not unique and are mirrored across the country.
The Scottish Government has this week announced its NHS recovery plan that outlines a range of reforms and investment across primary care. We await further details and implementation of this plan.
The people of Lanarkshire can play their part by ensuring they access the right help at the right time. There are lots of qualified experts in the community who can safely advise people on many health conditions.
NHS Lanarkshire’s Ask the expert guide offers a range of services that local healthcare professionals across Lanarkshire can provide - https://www.nhslanarkshire.scot.nhs.uk/expertsYou can go directly to the right healthcare professional for the help you need when you need it, without having to see your GP first or face a lengthy wait in A&E.
NHS Inform website, https://www.nhsinform.scot/ provides advice on self-care, NHS 24 can provide urgent health advice out-of-hours and your local pharmacy is the first port of call for minor ailments. This can also help free up appointments for those who need them.
It is important to note that there are multiple reasons why A&E departments are busier than would normally be in the summer, much of which is associated with lack of access for routine care over the past 14 months when acutely unwell Covid patients were being prioritised.
The net effect of that is that patients are now presenting much later in the care journey and often have much more serious issues as a result. In turn, this is meaning more people having to attend hospital at an earlier stage than would have been the case pre pandemic. It is a very complex picture and it is inaccurate to suggest that the only reason A&E departments are busy is due to a lack of appointments in general practice.
To help alleviate the pressures on all our services including A&E and general practice, we are asking the people of Lanarkshire to play their part by turning to the right place at the right time.