It is well established that the COVID-19 pandemic caused the already sizeable NHS backlog to increase markedly. According to the British Medical Association (BMA), the backlog of patients waiting for secondary care has risen from 4.43 million pre-pandemic to today’s figure of 6.48 million, and this continues to increase. But was this backlog mirrored in primary care? In this article, we will take a closer look at the impact of COVID-19 on gaining access to the primary care system and how this has impacted the health and well-being of patients.
What does the data tell us about the state of GP care in the UK?
The Ipsos Mori 2021 GP Patient Survey provides a revealing snapshot of the state of GP provision nationally. The large survey size (850,206 surveys completed) means that the results of this report provide a reliable overall picture. The headline findings of the survey were as follows:
- 83.0% of respondents described their overall experience of their GP practice as good (up from 81.8% in the previous year)
- 67.6% of respondents said they found it easy to get through to their practice by phone (up from 65.2% in the previous year).
- 70.6% said that their overall experience of making an appointment was good (up from 65.5% in the previous year)
- 67% were satisfied with the general practice appointment times that were available to them (up from 63.0% in the previous year)
- 65.6% said they had a good overall experience of NHS services when their GP practice was closed (up from 67.3% in the previous year)
While nearly 90% of respondents said they found their GP receptionist helpful, there has been an overall decline since 2012 in the ease of making a GP appointment. In 2012 19.2% of respondents said it was not easy to make an appointment, but this rose steadily to 34.8% in 2020.
A presentation at the 2022 GMC annual conference by Newham GP Dr Farzana Hussain provides another picture of what is happening in our GP surgeries. She told the conference that “conversations about delays to secondary care appointments were taking up a sizable chunk of GPs’ time each day and sometimes led to ‘aggressive’ conversations with patients concerned about their health”. In other words, the secondary care backlog is placing backward pressure on the primary health, with patients who are, understandably, concerned about their care. In one anecdotal example, Dr Hussain explained, “When I was in clinic yesterday, a third of [it] was patients asking [about hospital care]. One of them said to me that they had an 18-month wait for the respiratory clinic and asked if that was correct. They thought that they’d made a mistake. I had to say to them that it was actually correct”.
Unfortunately, the increasing difficulties of securing a GP appointment in recent years, as indicated by the Ipsos Mori survey results, and the downstream impact of the NHS backlog may be impacting negatively on the health of patients. As NHS England states in its Delivery Plan for Tackling the COVID-19 backlog, “Waiting longer for treatment can mean an existing condition worsens and as a result, more complicated surgeries or increased use of medications are required, and recovery is slower and outcomes worse, including reduced quality of life”.
A final point to consider is the impact of online appointments on GP diagnosis. During the pandemic, GPs had to heavily prioritise who they saw face to face, creating the potential conditions for a missed or incorrect diagnosis. In one case, for example, a 92-year-old former district nurse was advised to start end-of-life care after a GP incorrectly diagnosed her with organ failure during an online video consultation.
From the patient’s perspective, the harm caused by reduced access to GP appointments and incorrect diagnoses as a result of online appointments can be considerable. For this reason, we expect to see an increase in the number of medical negligence cases being brought against GPs as these effects come to light in the coming months and even years.
The importance of expert court reports in GP negligence cases
As a Solicitor representing a client bringing a claim for compensation due to GP medical negligence, it is important that you establish a clear understanding of what happened and that this is backed up with evidence. Expert GP witnesses are highly experienced current or ex-GPs and can perform a detailed analysis of your client’s case.
In order to make a successful GP negligence claim, it must be proven that:
- your patient was owed a duty of care by their GP
- they suffered harm, and;
- the harm was caused by the negligence of their general practitioner.
A GP witness will first gather as much information as possible to form a clear picture of what happened, including:
- The patient’s medical history
- When the relevant events that led to the harm occurred
- What happened at each appointment
- Whether assessments or further investigations were carried out
- The results of any tests, workups, and scans
- The advice and diagnosis given to the patient
- Whether the patient was referred – and if so, the details of the referral
They will then review the evidence and make an assessment of the cause of the harm, whether this constituted negligence, the impact, and the future care and health needs of the individual. An expert court report is then drafted outlining all of the key details of the case.
GP negligence is thankfully relatively rare, but where it occurs, the harm caused can be devastating. GP negligence can lead to prolonged pain, suffering, and poorer health outcomes. By engaging a GP expert witness to draft an expert court report, you can ensure that your client has the best possible outcome for their claim.