Helen Salisbury: Knowing the size of the problem in general practice

No one is doubting that general practice is in trouble—but how much, and how can it be fixed? Repeated interventions have aimed to improve patient access through online booking, e-consultation forms, and new telephones. None of these have created new capacity, and some have contributed to increased demand.1 One attempt to plug the gap between demand and capacity has been the recruitment of lots of other clinical staff who are not doctors, through the primary care networks’ Additional Roles Reimbursement Scheme.On the face of it, this has worked. Activity is up, with four million more general practice appointments in January 2023 than January 2022.2 However, only half of all appointments were with doctors, and I’m concerned about efficiency. So, another question is: do we know what percentage of the other half were placed appropriately with a physio, paramedic, pharmacist, or physician’s associate working within their own area of expertise, and…
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