GP demand, it’s official: “Nobody knows”

Far more interesting this week than the spending review was the National Audit Office report “Stocktake of access to General Practice in England”.  I know what you’re thinking, but some of my closest friends say I’m not just a data nerd.

NAO headline figures are £7.7bn cost for 372m consultations.  Cleverly they divide one by the other and come up with £21 per consultation.  Let’s be even cleverer and divide 372m by the population of 53m and get to 7.0 consults per person per year.  Of course nearly half of those are not with a GP, the cost each depends on the clinician and so on.

But they are the first to admit that 372m is copied from an RCGP report in which Deloitte extrapolated a series from QResearch which ended in 2008-9.  So, Alan has the correct answer… “Nobody knows”.

Does it matter?  Well, you could say that knowing the top line for a vital national service where 37,000 GPs deal with over 90% of patient demand in the NHS can be left entirely to guesswork.  I’d beg to differ.

The NAO has done its best with what’s available, much of it from surveys, a poor relation to operational data, but it’s a scandal that we don’t know.  A figure they quote is that 89% could get an appointment when they tried, worryingly down from 91%.  Our audit data is very close at 88%.  Let’s put that the other way round, taking their figure.  11% of patients who tried to get an appointment with their GP could not.

11% of 372m is 162,000 people told every working day (5 days!) to go away.  It is my personal mission to wipe out that number.  We don’t have any money.  We have a method.

Dr Sara Cowell


PS  From macro to micro, have you been watching “Doctor in the house”?  I happened upon this on BBC1, expecting trashy reality TV, but it’s a real doctor, in a real house, with real patients.  I know very few patients can have that much attention, but Dr Rangan Chatterjee is terrific, showing what GP is about, changing lives.  This should be the best recruiting story for any medical student.  Well worth a catch up on iplayer.

His toughest patients are the middle aged men who never want to bother the GP, and in our series of real patient histories this week’s is one such with an embarrassing problem.  He might find it difficult to explain to a GP, let alone a receptionist to get the appointment, but has been very open with a computer.  Take a look and vote on your first response.

PPS If you are already curious about the method, spend 5 minutes hearing from a practice on this video.

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