Devon GP surgery accused of trying to deny treatments to patients
Practice in Newton Abbot forced to back down after it suggested that patients should not seek consultation for range of ailments


A GP surgery in the West Country has been accused of a trying to deny basic treatments to patients by proposing that anyone suffering from back pain, mental ill-health or with lacerations, cuts, grazes and wounds go elsewhere for treatment.

The practice in Newton Abbot, Devon, was forced to back down by national NHS bosses after it emailed its 10,000 patients recommending that they should not seek a consultation with one of its GPs for a wide range of common ailments.

Leaflets from the Kingskerswell and Ipplepen medical practice also detail “local alternatives to booking a GP appointment”. They list eight types of medical problems for which patients should seek treatment elsewhere and advise them where to go – for example to a pharmacy or local minor injuries unit.

Adults with “mental wellbeing concerns”, including panic attacks, agoraphobia and post-traumatic stress, were advised to instead ring a local NHS service specialising in anxiety and depression.

The GP practice’s email explained to patients that it was highlighting the alternatives to a consultation with a GP because “GP surgeries are under great pressure with the population ageing and an increasing incidence of complex and chronic illnesses such as diabetes and dementia”.

It added: “Demand for GP appointments often outstrips capacity. There is also a national GP recruitment crisis, which is unlikely to be resolved quickly and the portion of NHS funding allocated for GP practices has been declining for many years.”

But NHS England intervened to say the proposals were unacceptable. Dr Barbara Hakin, its national director for commissioning operations, said: “These leaflets have now been withdrawn. NHS England is urgently working with the practice as we are very concerned about the impact on patients. General practice has a vital role to play as the first contact for patients, especially those with mental health problems.”

Health organisations criticised the move as an alarming restriction on what illnesses patients should see a family doctor about.

Mark Winstanley, chief executive of the charity Rethink Mental Illness, said: “It is unacceptable that people in this part of Devon are being told not to approach their local GP for help for their mental health, because the surgery is too overstretched to cope with demand. This is fundamental support that everyone is entitled to, not a luxury service which GPs should be able to opt out of.”

Katherine Murphy, chief executive of the Patients Association, said although “GP surgeries have been under considerable pressure to cope in recent years, we are nonetheless shocked to learn of this unprecedented case where such a vast range of health conditions have been rejected by a GP surgery”.

Fears the surgery’s surgery’s advice could set an unwelcome precedent led the Department of Health to accuse it of letting down patients needing treatment and flouting the GP contract, which enshrines family doctors’ duties towards patients.

A spokesman said: “This is a breach of the GP contract, and it is unacceptable to turn away patients who are in need. But we recognise there are pressures in primary care, and have announced £1bn for new facilities to help.”

Dr Maureen Baker, chair of the Royal College of GPs, defended the surgery. She said it was sensible to direct patients to other services, some of which have specialist knowledge or may be more convenient. However, she added, while it was useful to publicise alternatives, “it does seem an awful lot to be telling people to go to other places with such a wide range of different conditions”.

The leaflets advised patients with “minor ailments and conditions” such as coughs, colds, sore throats and a blocked nose that “you will get faster consultation and advice and prescription if you go straight to your local pharmacy”.

Those with muscular/skeletal problems, including “back and neck pain, sprains and strains, whiplash disorders [and] sports injuries”, were told to “refer yourself straight to the NHS physiotherapy services”, which may be able to offer a same-day appointment.

Adults and children over three with lacerations, cuts, grazes and wounds were advised to go to the minor injuries unit at Newton Abbot hospital or Totnes hospital.

“Housebound patients with leg ulcers or needing help with dressings, enemas or catheters should ring the local community nursing team to seek their help, not the surgery’s.”

The practice has six GP partners and a seventh doctor, who is a salaried GP. It opens from 8.30am to 6pm every weekday and has over 10,000 patients on its list. The Care Quality Commission recently assessed it as one of the surgeries that maintains the highest safety standard and poses the lowest risk to patients.

In a statement the surgery said the leaflets were intended to reduce the difficulties patients faced in understanding and accessing the range of health services available in that part of Devon. Telling patients of services they can access directly, without needing to be referred by their GP, could speed up the help they receive, it added. Initial patient feedback showed the leaflets were useful.

“The practice has now been contacted by NHS England, who have asked that distribution of the leaflet be temporarily suspended while the specific wording within it is reviewed. The practice has agreed to review the wording in the leaflet with NHS England, and a meeting is scheduled for this Friday.”

Andy Burnham, the shadow health secretary, said: “This extraordinary email shows the impact of David Cameron’s raids on the GP budget. People with mental health worries must be assured they can see their own GP. This practice risks putting up yet another barrier to them seeking help.”

Bron: http://www.theguardian.com/society/...tments-patients
1 december 2014

Commentaar: Ik vind het niet kunnen dat een huisdokter zijn patiënten doorstuurt naar een andere dienst, zonder zelf eerst de patiënt te hebben onderzocht. Sommige mensen weten niet goed wat ze hebben, ze gaan naar de huisdokter om hier meer te weten over te komen en om te genezen natuurlijk. Ik heb het gevoel dat zij nu zonder verder uitleg of onderzoek doorverwezen worden naar een andere dienst. Als ik een patiënt van deze huisdokter was, zou ik me gegeneerd voelen en de volgende keer minder snel hulp zoeken.
Als je als huisdokter afstudeert, ga je een soort contract aan waarin je verklaart dat je mensen in nood zal helpen, dus niet zonder verder onderzoek zal doorverwijzen omdat je teveel werk hebt.
In het artikel staat niet vermeld of deze doorverwijzing succesvol is of niet.
Langs de andere kant begrijp ik de huisdokter, hij heeft veel werk en verwijst deze mensen dikwijls hoe dan ook door naar een andere dienst. Hij heeft deze mensen dan wel eerst onderzocht. Ik denk dat het probleem zich meer situeert in het aantal huisdokters. In het artikel staat dat de praktijk in Newton Abbot in Devon 10 000 patiënten telt. Dit is zeer veel. Ik denk dat de regering de studie geneeskunde meer moet promoten, zo zullen er meer huisdokters afstuderen, kunnen ze het aantal patiënten meer controleren en zullen deze minder aan stress onderhevig zijn.