BGS voices support for primary care following criticism

15 September 2021

Older people have always been the largest group to use NHS services and the initial way they access such services is through primary care. General Practice has provided high-quality care for older people throughout the pandemic and is now responding to the combined demands of COVID-related illness and the backlog of non-COVID conditions.

The COVID-19 pandemic has had a devastating toll on older people, with 90% of the 130,000 deaths to date occurring in those aged over 65 years. For many older people, conditions such as frailty, dementia, reduced mobility and mental health have worsened as a result of isolation, and their need for primary care services has increased.

General Practitioners (GPs) and their teams had to change the way they worked during the pandemic, offering more telephone triage and remote consultations in order to protect patients from the risks of infection associated with visiting the surgery during the height of infections.  

It is important to note that for many people, including those older patients who are comfortable using digital technology, remote consultations can be beneficial and even preferred. They can be more convenient for patients who need to balance their medical appointments with work or caring commitments. However, for many older people with complex long-term conditions, face-to-face GP appointments remain important; these have been available through the pandemic. 

There has been criticism of GPs in recent weeks with assertions that remote consultations are unsafe and have been introduced for reasons of convenience to GPs. We believe these claims to be untrue, misleading and damaging to patient/doctor relationships. GPs have adapted the care they provide based on clinical evidence and on guidance provided to them by the Government and the NHS. GPs and their colleagues in primary care have worked tirelessly throughout the pandemic, in an extremely challenging environment, to provide continuity of care and keep patients safe.  

The issue that merits more public attention is the risk posed by the significant shortfall in health and care workforce capacity. 95% of all patient encounters with the NHS are managed in general practice and yet primary care is allocated only 9% of the NHS budget. While there are considerable pressures across the whole NHS and social care workforce, the shortage of skilled practitioners is felt particularly acutely in primary care.  

The Royal College of General Practitioners (RCGP) has warned that GP numbers have fallen by 4.5% since September 2015. At the same time, demand for GP services has risen with a 31% increase in appointments delivered as well as the significant additional workload involved in the ongoing delivery of the UK vaccination programme. The COVID vaccination programme is the largest in NHS history and is estimated to have saved 105,900 lives in England alone and prevented 24,088,000 infections. 

The pandemic is not over. It is likely that this winter the NHS will again face extremely challenging circumstances. We know that the NHS works best when it works together. It is essential over the coming months that different parts of the NHS, including those delivering primary care and hospital care, continue to support each other. 

Prof Adam Gordon, President Elect of the British Geriatrics Society, said: 

The BGS expresses solidarity towards colleagues in primary care who have managed the vast majority of patients during the pandemic and are exhausted and burnt out. We know that older people comprise a significant proportion of most GPs’ workloads. GPs work incredibly hard to support the health and wellbeing of older people in the community. It is vital that the Government addresses workforce shortages across the NHS and social care in the coming months, not just by promising to recruit more GPs but also by supporting new ways of working and better integration between services. Primary care is the first port of call for older people with frailty and complex conditions, and its staff must be supported to deliver high-quality care.’