The Principal Democratic and Member Services Officer introduced the report of the Director of Law and Governance which provided the opportunity for the Committee to discuss and consider access to General Practitioner (GP) consultations. It was reported that the issue had been raised at Council by way of a question to the Chair of the Partnerships Committee, and consequently the Chair had undertaken to refer the matter to the Partnerships Committee in order for the Committee to be able to scrutinise it. The report provided the Committee with figures relating to access to GP Services as provided by the Wirral NHS Clinical Commissioning Group, with a breakdown of total number of attendances and the method of attendance such as in-person, virtual or telephone.

The Chair then invited Dr Rob Barnett, a General Practitioner from Liverpool to contribute. Dr Barnett outlined the background to the issue, reporting that access to GP services had always been an issue as far as he could recall. It was reported that in 2019 the government encouraged GPs to consider remote forms of consultations, but that GPs were eventually forced to incorporate remote consultations due to Covid-19, which Dr Barnett felt was ran well but presented challenges for those without access to internet or telephones.

The Committee was advised that within the NHS infection prevention and control measures were still in place and that GPs could not yet go back to pre-pandemic operations. It was reported that availability of consultations was fairly consistent across Cheshire and Merseyside. Dr Barnett felt that some people did like remote consultations particularly younger people, but he felt clinicians gained more from a patient from a face-to-face appointment. Furthermore, in some cases remote consultations were inefficient as a patient may initially access services via e-consultation, with a resulting phone consultation then taking place before eventually having a face-to-face consultation. It was however noted that due to demand, GPs would struggle even further to manage their workload should they return to total face-to-face consultations.

The Chair then invited members to ask questions of Dr Barnett. The issue of the number of GPs was raised and whether there were enough in the system to deal with the increased demand. It was reported that in 2015 the government announced that there was a shortage of 5,000 GPs which would need to be addressed by 2020, but that there were in fact now 1,500 fewer GPs than in 2015. Dr Barnett outlined that in his previous experience GPs were encouraged to retire, but over the last 20 years there had been a shift and GPs at retirement age were now being asked to continue. It was felt that one way to address this was to employ different staff within GP services such as physiotherapists and paramedics.

Another issue raised by a number of members was the triage process, with some raising concerns at the involvement of non-clinicians such as receptionists. It was noted that different GP surgeries operated different triage models, but that the receptionists in Dr Barnett’s surgery were trained to take basic details from patients to ensure that those requiring immediate access to GP services were able to. Dr Barnett acknowledged that some patients may find it intrusive and reinforced the rights of patients to not disclose the issue to the receptionist if asked.

A range of further questions were raised by members, including around the length of appointments given the increasing complexity of issues patients were presenting with. Dr Barnett advised that his surgery had moved from 10 to 15-minute appointments, but that in other countries the average consultation time was up to 40 minutes. It was felt that GPs had to balance the need for longer appointments with the increasing demands and that patients should be encouraged to access other primary care services when they were more appropriate to enable GPs to spend more time with increasingly complex issues with patients. Members also sought fought further information on the impact of access to GP appointments on Accident and Emergency, where it was noted that if there was evidence practices weren’t able to meet the demand further then it needed to be looked into, but that there had been instances where up to 50% of staff in surgeries had been self-isolating due to Covid-19 which had impacted on surgery capacity during the pandemic.

On behalf of the Partnerships Committee, the Chair thanked Dr Barnett for his informative contribution and thanked all GP staff for their work during the pandemic.

Resolved – That the report be noted.