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Anecdotal snapshot of GP frontline sheds light on ‘shocking’ working conditions

An Royal College of Physicians (RCP) publication released today collating the first-hand experiences of NHS staff on the primary care frontline aims to publicise the everyday difficulties staff face with keeping the NHS working under waning budgets.

The report, ‘Against the Odds’, brings together a range of anecdotes told by 50 NHS doctors working in hospitals between December 2016 and January 2017, as well as examples from the wider membership of the RCP’s Patient and Carer Network.

The royal college reiterated its recommendation for further investment in health and social care, as well as better support for NHS staff to improve their working lives and allow them to deliver excellent care to patients.

The experiences of patients and staff in hospitals formed a picture of an NHS on the brink of collapse, as staff were pushed to deliver care to a growing number of people on limited budgets.

One account reported the crisis A&E departments found themselves in, saying: “All hospitals in my area are trying to divert ambulances simultaneously. My hospital has 99 delayed discharges and 60 medical outliers in surgical beds.” A separate account claimed staff already started the day “73 beds down”.

Another doctor reported that on one shift, they were required to finish four hours later than originally planned just to ensure that patients were safe and that junior doctors were sufficiently supported.

The report also included a description of a hospital stay by a member of the royal college’s Patient and Carer Network: “I was shocked when I arrived at the admissions unit at 6.30am on the day of my surgery. There were about 30 patients waiting for beds before surgery could begin. I was beginning to feel as though I was held in a cattle pen … I began to feel that quality of life is not something the NHS is striving for. It is now purely about survival.”

Commenting on the findings, RCP president Jane Dacre said: “Against the Odds not only shines a spotlight onto the real experiences of consultant physicians when facing bed shortages, staff shortages and a lack of resources, but also shows their extraordinary dedication to duty, knowing as they do that patient safety depends on it. 

“I am so proud of our members for their commitment and grace under pressure, but it should not have to be like this – we need the government to start listening, investing, and supporting the NHS to give patients the service they deserve.”

The Royal College of GPs welcomed the findings, describing it as an “important snapshot of the pressures currently facing our health service, which threatens the care we are able to provide”.

Helen Stokes-Lampard, its chair, said: “The NHS was founded with one overriding purpose – to deliver patient care, free at the point of need to anyone who needs it. GPs and other healthcare professionals have been at the heart of delivering this important service for nearly 70 years, and it remains essential that we protect it, for the benefit of our patients for years to come.

“As our population both grows and ages, patient demand is escalating – and with the vast majority of patient contacts in the NHS delivered in the community in primary care, GPs and our teams know only too well what it is like to work on professionalism and goodwill alone as we strive to deliver the best patient care possible in incredibly difficult circumstances.”

Stokes-Lampard also urged the government to review its spending plan for the NHS, urging it to implement the pledges in NHS England’s GP Forward View – including £2.4bn extra a year and 5,000 more full-time equivalent GPs by 2020 – in order to keep the NHS afloat, and deliver the care patients need and deserve.

When contacted for comment by NHE, NHS Improvement executive medical director Kathy McLean said: “The NHS is under pressure as more and more patients are cared for in our hospitals but we know that staff in hospitals are working incredibly hard to deliver the best care they can in the available beds as efficiently as possible.  

“Of course, there is more that we can do to help them and we will continue to support providers so that they can deliver safe and sustainable care.  NHS staff up and down the country are working really hard and deserve our thanks and support.”

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