Doctors face a tidal wave of problems

Doctors are facing problems
Doctors are facing problems
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GP SURGERIES are facing a ‘tidal wave of problems’ amid fears some doctors do not want to work in the area.

Results of a Freedom of Information request by The News reveal many surgeries in Portsmouth and south-east Hampshire are under pressure, with one practice in Portsmouth having a staggering 3,382 patients per GP.

Today, as part of a week-long investigation, The News can reveal:

* Major increases in demand for seeing a GP;

* Areas such as Gosport are struggling to attract new doctors;

* Thousands of pounds being spent on locums to plug in the gaps;

* Practices finding it difficult to recruit partners or salaried doctors;

* Many doctors are taking early retirement due to workload.

Dr David Chilvers is a practice partner at Waterside Medical Centre, in Gosport, and is worried about recruitment.

He also leads the Fareham and Gosport Clinical Commissioning Group (CCG), which pays for healthcare locally.

Dr Chilvers said: ‘There is a tidal wave of problems as no-one wants to be a doctor.

‘In this practice we are desperately trying to recruit, but no one wants to come and work where there’s very little money and sicker patients.

‘Areas like Gosport are less attractive to work in due to higher levels of depravation meaning patients have more complex needs.’

Waterside Medical Centre has been looking to recruit for the past six months.


THE NEWS is running a week-long investigation into the increasing pressures GPs are facing.

We are asking readers to email in with their views, which will be run in the paper.

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Dr Chilvers added: ‘About 18 years ago, if there was a vacancy then you would get about 200 people apply. This time, we’ve advertised twice and only had one person apply.

‘And this isn’t something only this practice is facing. GPs don’t finish at 5pm, but are working until 8.30pm and the strain is being felt.’

A Freedom of Information request to every GP practice in our area has revealed how many patients are registered at each practice and the number of patients per doctor.

NHS England said these numbers can vary depending on the size of the practice and demographic.

On average in England, each doctor has around 1,850 patients.

Our figures show about 80 per cent of practices in Portsmouth, Gosport and Fareham are well above the national average at 80 per cent, with Havant at 73 per cent.

Campbell Surgery in Portsmouth has 3,382 registered patients per doctor, compared to The John Pounds Medical Centre which has the least at 1,290 patients per doctor.

These figures are a snapshot taken from the beginning of May but could vary depending on factors such as the use of locums, GPs retiring or moving on.

An NHS England spokesman said: ‘These statistics show a snapshot of the number of wholetime equivalent GPs in each practice in the area at any given time.

‘As with all statistics this does not account for any fluctuations in numbers of GPs retiring, moving or leaving.

‘These statistics are based on GPs that are partners or salaried only and do not account for any locums employed by the practice.

‘Alongside GPs many practices also employ nurses and other healthcare specialists who would provide services within the practice.

MPs raise concerns over number of GPs

POLITICIANS in the area say they are concerned about a GP crisis looming.

Mark Hoban, MP for Fareham, said he will be paying practices visits to see how they are working and coping with patient


He said: ‘I’m concerned the shortage will have an effect on patients.

‘There is also a disparity of numbers when it comes to patients being registered – some have so many that they are asking patients to go elsewhere.

‘I am planning to see GP surgeries and see how they are working.’

Meanwhile Caroline Dinenage, MP for Gosport, said her constituents have written to her about access to


She said: ‘There seems to be a real issue here about recruiting doctors to the Gosport area.

‘I have had letters written to me from patients who are concerned about waiting times.’

Portsmouth North MP Penny Mordaunt said that practices need to work in a different way.

She said: ‘There has been a move towards practice nurses taking on more responsibility for managing some conditions, which actually works out better for the patient as they get more time with the healthcare professional.

‘However for this to work we need to maintain the number of specialist nurses and there are fewer choosing to specialise.

‘We need to find ways to incentivise nurses to do


How doctors are paid

GP SALARIES vary depending on the number of patients registered at a practice, and the type of services it offers.

Since the NHS was set up in 1948, doctors have been self-employed practitioners, who mix private practice with contracted work from the NHS.

It means they are sub-contracted by the NHS, rather than working for the NHS – giving greater independence and variation on how a practice is run and what services it offers.

They were paid on the basis of the number of patients on their books and payments for specific activities, including out-of-hours visits, maternity care and vaccinations.

In 2008, a new GP contract was drawn up, in a bid to stop doctors leaving the profession, which allowed GPs to opt out of providing out-of-hours care, and a performance-related pay system enabled GP practices to earn extra cash through the Quality and Outcomes Framework.

Money comes from three pots, with the bulk of the cash coming in from NHS England. It pays a flat rate of £73.56 per patient registered at a practice.

This covers the every day reasons, such as coughs and colds.

Some money is paid by Public Health England to provide vaccinations, and lastly GPs get money from Clinical Commissioning Groups for local enhanced services.

For instance carrying out blood tests in a doctor’s surgery, which would avoid a patient needing to go to hospital for this to happen.

There are three types of GPs that can work in a practice and each get paid in a different way:

n Practice partner

A GP ‘invests’ into the business of running a GP practice. It means they own a portion of the practice and have a say on how things are run and what services are provided.

A practice partner’s salary can vary each month as the GP takes home whatever is left from the pot of money.

SALARIED GP - This type of GP is on a fixed, annual salary.

LOCUM - A locum is paid by an hourly rate, which can differ depending on the region and how often they are called.