Morning booking rush for GPs must change to tackle ‘unprecedented’ demand

Health directors have admitted that the 8am phone rush has to change if GP demand is met in the face of of unprecedented levels.

The Essex Health Overview and Scrutiny Committee heard that whilst there was a reduction in demand on primary care services during the national lockdowns, the demand has significantly increased compared to pre pandemic (2019/20) numbers.

In Mid and South Essex, an additional 314k appointments were undertaken in 2021/22, in North East Essex, an additional 83k appointments were undertaken in that time and in West Essex, an additional 102k appointments were undertaken in 2021/22 compared to 2019/20.

The current demands on GPs have been described as “unprecedented”.

William Guy, director of primary care for Mid and South Essex, told the committee on Friday (June 10): “It is challenging for our population to get access to primary care and I think we need to acknowledge that that is the situation.

“There are different perceptions as to why that’s happening I think what we’re trying to demonstrate that is that that is largely driven by demand rather than by GPs shutting their doors as it’s kind of commonly perceived in in some areas

“I think it’s also worth noting that whilst the Covid pandemic has had a significant impact on the way primary care is delivered primary care has been the subject of a transformation agenda for a long time.”

The total number of GP consultations in Mid and South went from 5,772,059 in 2019/220 to 6,086,126 in 2021/22. In North East Essex they went from 1,956,943 to 2,040,476 and in West Essex they went from 1,436,089 to 1,538,586.

The stress on GPs services has come even with a sharp decrease in face to face appointments – from 83 per cent in 2019/20 to 65 per cent in 2021/22. Telephone appointments have gone from 11 per cent to 30 per cent during that time.

The GP workforce has remained relatively stable in numbers in West Essex and Mid and South Essex and have seen a reasonable increase in North East Essex.

But Mr Guy said increases in demands needs to be met with changes in the way people try to get an appointment in the first place – specifically the notorious rush at 8am when the appointment telephone lines open.

He said: “We’ve got to develop a system that can cater for the needs that present so the patients have got confidence that they can access services at a different time and get a response

“At the moment patients quite rightly are calling at 8am because they believe that’s the only way they’re going to be able to access primary care. You sit on the telephone and then keep redialing until you get through

“My need wasn’t urgent and I would have been quite happy to wait for a couple of weeks for an appointment but that’s not the system we’ve got at the moment.

“Therefore we do need to change that model in its entirety and differentiate that need and be really clear with the population this is how you can access those services and this is the confidence we can give you that those services will be there when you want to access them.

“It will take time to do that but but we’ve got to move away from that everybody presenting at eight o’clock in the morning or we’ll never be able to tackle demand at that point. Even if we had lots more call handlers it would still be a very warped system to try to manage.”


Piers Meyler

Local Democracy Reporter