Dr Laurence Dorman is Chair of RCGP Northern Ireland…
As Chair of the Royal College of General Practitioners in Northern Ireland, I wish to refute some of the comments made by Mr Terry Maguire on your website last week and to highlight the crucial work general practice has been doing throughout the global pandemic.
Like Mr Maguire, all GPs want to provide the highest standard of patient care including access and timely repeat prescribing. His comments are in significant contrast to the long and rich history of collaborative working GPs and community pharmacy teams have enjoyed over many years, particularly in rural communities.
The implication our GP doors are “closed” or our services have been diminished or reduced is not only incorrect but utterly demoralising to highly motivated and dedicated GPs and their teams. Time and again, the Royal College of GPs have heard accounts from patients during the pandemic of the extra lengths their practice has gone to ensure their health care needs are met.
Unfortunately, the main driver to some of the difficulties in patient access is the unprecedented demand GPs and our teams are facing at present, with up to 200,000 patients (10% of our population) contacting our surgeries per week.
Mr Maguire is accurate to highlight that things were not good before the pandemic and unfortunately there appears to be a romanticised view of what our services were like pre Covid-19. Before the pandemic, many patients had to wait for weeks to obtain a face to face appointment and these were unfairly weighted against patients who were in full-time employment or had family, caring or other commitments.
A key message to our patients during this difficult time is to encourage them to value their time speaking to their family doctor by telephone. Just because this is not possible in person due to infection control measures, it does not make it a second-rate service. Rather than describing this as “triage” or a “ring back” lesser service, we urge our patients to view this as a valuable and professional consultation which, if necessary, may end in a face to face assessment, further investigation or prescription sent directly to community pharmacy. For many patients, this is providing unprecedented access to their family doctor.
GPs are the bedrock of our healthcare system. We refute the notion that pressures in repeat prescribing are solely due to GPs and their teams – particularly when the author implies that these problems are universal. It is untrue to say practices do not care. The solutions to these challenges will require all parties, including patients, to engage but this will become more difficult if trust and respect are eroded.
Over 90% of patient contacts in our health and social care system is through general practice yet we receive less than 10% of the funding. Time and again, systemic reviews suggest more services should be moved to primary care yet the resource does not fully follow these. Our value to the entire healthcare system is epitomised by our role in the COVID-19 vaccine roll out and the upcoming booster campaign which will once again demonstrate our flexibility in working and unique knowledge of our patients.
All GPs are mindful of the difficulties some patients are experiencing in accessing our services. through our telephony systems, which we have had to use to ensure infection control within our surgeries. For many years we have urged Government to invest in our digital and physical infrastructure and we continue to call for this vital support. Systems such as electronic prescribing are progressing but are much more complex than they appear and will require patience and support from all parties.
Mr Maguire is correct when he identifies that the entire primary care system does need urgent reform, and this has already commenced. We urge him to consider working alongside some of our practice-based pharmacy colleagues to have a better understanding of our workload pressures. Considered engagement, with an appreciation of each other’s roles would be a better place to start rather than megaphone diplomacy which only serves to deepen our workforce crisis – not solve it.
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