We release our GP Review 2020

GP Capacity

In Brighton and Hove patient caseloads have increased from 2,394 patients per doctor in 2017/18 to 2,479 in 2018/2019.  This is against an England average of 1,825 per doctor.

• The number of GP Practices has decreased from 48 to 35 from 2015 to 2019. There are also currently five branch surgeries that provide GP services.
• Two GP Practices have closed since 2018 and a further closure/merger is planned for early 2020.

Overall patient feedback

• 89% of patients rated the overall quality of care communication as good or very good, by either their GP or nurse combined, on seven criteria. Patient satisfaction with their GP Practice was also generally good.
• 70% of patients reported a positive rating for the service they had received. We assessed GP Practices using seven criteria of satisfaction and on average 70% of patients rated five from the seven criteria as good or very good.
• Variation of patient satisfaction on waiting times between surgeries was significant, with one surgery receiving an average satisfaction of 26% and another surgery with an average of 96% satisfaction. Eight surgeries returned an average of less than 40% satisfaction while seven surgeries were rated about 70% on average.

Accessibility

• Booking by telephone is popular but not always easy to use: 92% of patients book an appointment by telephone but only 68% of patients find booking this way to be easy. This mostly affects those less able to visit the GP Practice in person and/or those less likely to use online booking systems.
• Urgent GP appointments are not guaranteed: 81% of GP Practices could not guarantee same day booking for urgent appointments. The average wait for an urgent GP appointment was 1.8 days.
• One half of patients (49%, 436) received a routine GP appointment within three days but more than a quarter (26%, 237) had to wait a week for a routine (non-urgent) GP appointment.

Personalised care

• Awareness of preventative services is low. Of patients who should be targeted for preventative services, 37% are unaware of health checks for 40-74 year olds; 44% are unaware of abdominal aortic aneurysm screening; 25% are unaware of bowel cancer screening; and 53% are unaware of annual health checks for people with long-term health conditions.
• 70% of people referred to an NHS service with a mental or emotional health problem, felt not all their needs had been met or their needs had only been partially met (small sample size more research needed)
• Patients with long-term health conditions, including mental health, spoke to us about needing consistency of care. Patients wanted longer appointments, to allow complex conditions to be treated in full and to allow the diagnosis of more than one condition. Patients asked for medical staff that specialise in their condition.

Comment:

• The number of GP surgeries in Brighton and Hove continues to decrease.
• The number of patients per GP continues to rise.
• Waiting times for a routine GP appointment continues to rise, with a wide variation across the City.
• Screening by telephone is increasing, and this may be a positive development for many people, decreasing the need to visit a surgery.
• Satisfaction rates at the service received from GP’s and Practice nurses remains high and has increased slightly from 2018. But there is a wide variation across the City.

The impact of Covid19/Corona Virus

This report was prepared well before the spread of the Covid19 virus overseas and in the UK. The report identifies some deficits and areas for improvement in local GP services. This should not be taken as a comment on the capacity of the system to deal with a temporary and exceptional situation. Most NHS resources, Doctors and Nurses do not work in GP surgeries and there is strength and depth of expertise across hospitals and Community services.

Healthwatch advice is to follow NHS and City Council advice. Healthwatch is available to the public by email, phone and social media for people to make comments and raise concerns. This is one way in which Healthwatch can lift pressure off front line NHS services and help direct specialist advice to vulnerable communities.