Appointments | Capacity at Norton Medical Centre

Reports of difficulty getting through to Reception/booking an appointment at GP Surgeries have increased nationwide, including at Norton Medical Centre. Unfortunately, we do not have unlimited resources and are currently working to maximum capacity. We have a standardised letter that explains this is a national problem and we are trying to provide the best service that we can. The full letter is written below and available for download. Thank you for your understanding.

Click here to DOWNLOAD our Appointment Capacity Letter. The contents of the letter is written below:

Re: Capacity at Norton Medical Centre

Dear Patient

We are sorry to hear of your difficulty in getting through to Reception/an appointment, this is not the service we strive to offer, but we, like many other GP Practices in the UK, are struggling to meet the current level of demand for our services. We will continue to do our best each day to deliver as many appointments as it is safe to do so. Ultimately, we do not have unlimited resources and are currently working to maximum capacity.

The reality is that there are simply not enough Clinicians or resources in General Practice to meet demand. In December 2022, the NHS lost the equivalent of 17 full-time fully qualified GPs compared to the previous month, and there are now 1,990 fewer fully qualified full-time GPs than in September 2015. This long-term decline coincides with a rise in patients. In Dec 2022, 62.2m patients were registered with practices in England, with a record-high average of 9,689 patients per practice. As a result, the average number of patients each full-time equivalent GP is responsible for has now reached 2,273 - a 17% increase since 2015 - demonstrating the mounting workload in general practice. Despite this, we were at the forefront of the NHS's response to the COVID-19 outbreak, delivering thousands of vaccines whilst maintaining non-COVID care for patients throughout.

The European Union of General Practitioners and British Medical Association (BMA) have recommended a safe level of patient contacts per day in order for a GP to deliver safe care, at not more than 25 contacts per day. At Your Service, published by the Policy Exchange and forwarded by Sajid Javid, states that 28 patient contacts per day is safe. Our GPs regularly have more than double the recommended patient contacts per day, but unfortunately it is still not enough to meet demand. This is a National-level problem that cannot be resolved at individual Practice-level.

Unfortunately, the increase in abuse, accusations and general negative attitude towards staff who remain working extremely hard in General Practice is not a good advertisement for more to join the profession, further compounding the problem. In February 2020, in a bid to reverse the stasis in GP workforce numbers, the Government announced a drive to recruit an additional 6,000 GPs by 2024, an aim in which Sajid Javid admitted would not be achieved. Thus, GP practices across the country are still experiencing significant and growing strain, with rising demand, declining GP numbers and struggles to recruit and retain staff.

Additional challenges:
• Patients generally have a lower tolerance for requesting help, with a large number of appointments requested for minor ailments that are usually self-limiting, such as sore throats, coughs and colds
o These conditions would previously have been managed at home without GP input and would be better dealt with at a Community Pharmacy
• General Practices can now be contacted in more ways: over the telephone, via online services, eConsultations and in person, but the number of GPs, and thus GP appointments to offer, has not increased
• The scope for more complex disease management has increased, and a large portion of the maintenance care of these conditions, such as Diabetes, has moved from Secondary to Primary Care
• GPs can make referrals into consultant-led outpatient services, however the pressures in hospitals means there is no capacity in secondary care, and those referrals are rejected.
o The number of GP referrals to consultant-led outpatient services that have been unsuccessful because there are no slots available has jumped from 238,859 in February 2020 to a staggering 401,115 in November 2021 (an 87% increase).
o When GPs are unable to refer into hospital services, the care for these patients does not disappear. Instead, these patients need to be cared for by GPs while they wait for hospital treatment to go ahead, adding to the backlog in primary care.

The BMA have addressed the mounting pressure on general practice in England with the Support Your Surgery campaign. To see how you can help, visit: British Medical Alliance - Support Your Surgery

Although I recognise there is still an unmet need, local data provided by NHSE Data Quality for March 2023 (the most recent data available) showed Norton Medical Centre provided 1 appointment for every 1.98 registered patients, which is higher than the Clinical Commissioning Group average of 1 appointment per 2.29 patients. This is an increase from December 2022, where we offered 1 appointment for every 2.48 registered patients (which was higher than the Clinical Commissioning Group average of 1 appointment per 2.71 patients). Sadly, local data from NHSE Data Quality also shows that Norton Medical Centre has a higher rate of patients who do not attend ("DNA") appointments, with 1 DNA per 29.02 appointments, compared to the local average of 1 DNA per 24.72 appointments, despite introducing a cancellation line.

I wish I was able to tell you that I will take the necessary action to rectify this situation, but in reality I can only guarantee that the staff and doctors at Norton Medical Centre will continue to work as hard as they can, to deliver the best service they are able to provide, within the limitation of the resources they have at their disposal. We appreciate that this must feel frustrating, and we share this frustration, as we really want to help you when you need us most. All our patients are equally important, but as previously stated the resources we have available to us does not always meet the demand; therefore, we have drafted the "Contact Information" document attached, to advise how we can best support our patients given the incredible level of demand we are receiving from our approximately 17,400 patients.

Having gone through the complaints procedures, if you are still not satisfied but do not wish to take the matter further within the practice, then you have the right to request an independent review of your complaint from the Parliamentary and Health Service Ombudsman (PHSO) within 12 months of the date of the final response letter.

The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London
SW1P 4QP
Tel: 0345 015 4033

Yours sincerely

Leigh Malloy
Practice Manager