Let patients refer themselves to specialists, urges doctor who warns GPs are seeing 150,000 more patients a day than just seven years ago 

  • Increase in patient numbers blamed on ageing population and migration
  • Claims GP numbers have not increased at same rate to cope with demand 
  • Chairman of BMA's GP committee Dr Chaand Nagpaul says move would free up appointments for other patients

Family doctors are seeing 150,000 more patients a day than seven years ago, a leading GP has warned.

Surgeries are struggling to cope with the combined pressures of the increased demand blamed on an ageing population, migration and a recruitment crisis of family doctors.

It has led to calls for patients being able to bypass GPs and cut out the 'middle man' to get help from physiotherapists and for mental health problems such as stress.

Dr Chaand Nagpaul, chairman of the British Medical Association's (BMA) GP committee, said more must be done free up GP appointments for other patients.

GPs are seeing an additional 150,000 patients a day than seven years ago, the chairman of the BMA's GP committee, Dr Chaand Nagpaul, says. However, the numbers of GPs are rising fast enough

GPs are seeing an additional 150,000 patients a day than seven years ago, the chairman of the BMA's GP committee, Dr Chaand Nagpaul, says. However, the numbers of GPs are rising fast enough

The London GP said some areas offer direct access to services but more must be done to roll out the service around the country.

'Patients have direct access to extended scope practitioners, so patients who have got back pain, musculoskeletal problems, will go to a physiotherapist directly,' he said.

'But it is staggering how many patients we see only to get the referral to the physio, that happens commonly.

'There are areas that have got direct access to minor mental health services so instead of a patient coming to the GP to say they have work-related stress or are going through a difficult time there is access directly.'

It follows the BMAs call to increase the number of days people can self-certify sick leave from one week to two, without needing a doctor's note.

They believe employees can be trusted to declare themselves as ‘unfit’ for work and said writing out the letters takes too much time. 

But campaigners warned that the system would become a ‘skivers’ charter’ with patients signing themselves off to have a two week holiday or if they felt mildly unwell. 

Dr Nagpaul said most patients would prefer to self-refer as it would mean 'cutting out the middle man'.

'They don't have to wait two weeks to see their GP and then be referred,' he said.

While the policy was outlined in NHS England's five-year plan for GPs, doctors believe more must be done to make the plans a reality.

Patients should be able to refer themselves for physiotherapy which would cut out the 'middle'man' says Dr Nagpaul. This would free up appointments for others

Patients should be able to refer themselves for physiotherapy which would cut out the 'middle'man' says Dr Nagpaul. This would free up appointments for others

Dr Nagpaul said there are 150,000 more people walking through the doors of GP surgeries every day compared to seven years ago. 

But GP numbers have not risen in order to meet demand.

'There is a real need for the Government to acknowledge there is a mismatch between escalating demand and capacity so there needs to be an honest discussion how to ensure quality and safety within that system.

'As it is now it is not sustainable.'

He said other solutions to the problem include patients seeing pharmacists for mild ailments.

'This is about empowering patients, why would anyone want to sit in a GP surgery for an hour when their care could be more effectively managed in a different way?'

Previous work has concluded that around a quarter of GP appointments are potentially avoidable, he added.

He also warned that GPs are struggling with a lot of administration work for hospitals.

'We are actually spending a significant amount of our time and appointments not seeing people who are ill but actually becoming administrators.'

Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy, agreed the proposal would :

‘Our modelling shows that providing this direct access in practices would free up GPs to spend an extra five minutes with their patients, as well as saving the average practice £1,000 a week.

'Musculoskeletal patients can account for up to 30 per cent of caseloads so it's no surprise that GPs are increasingly bringing in physios to work alongside them as a first point of contact.

'As Dr Nagpaul notes, however, many patients still miss out on this faster access to treatment so we urge decision-makers across the UK to roll it out.'