GPs are facing burnout while patients find it harder than ever to see them as Knowsley doctors call for system change of a model that's no longer fit for purpose.
These were the stark words that emerged from a Knowsley Council health and social care meeting last night.
With just one item on the agenda, general practice access and quality, councillors and health professionals from across the borough discussed a report which laid bare some of the challenges facing the primary care sector in Knowsley and beyond.
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With over 800,000 consultations a year in the borough across 25 practices and 32 sites, the report notes that GPs have over 12 times the number of patient attendances than accident and emergency.
Put starkly, the report stated: "If general practice fails, the NHS fails."
The report, produced by head of primary care transformation Alistair Macfarlane of NHS Cheshire and Merseyside Integrated Care Board notes that changing health care needs of an ageing population and nationwide shortage of GPS are impacting on services.
Combined with a new approach to triage brought about amid the pressures of the pandemic and the increasing use of non-medical professionals this is leaving some patients with the perception of "barriers" to access.
Speaking at the health and wellbeing board meeting held at Huyton Muncipal buildings last night, this was a theme echoed by several councillors, who spoke of frustrated residents ringing up dozens of times and failing to get appointments.
Cllr Edna Finneran spoke of people's frustration at challenges with getting face to face appointments, Cllr Joanne Burke questioned the daily booking system used by many practices and Cllr Kevin Bannon said that system is "just not working."
Cllr Bannon said: "If I'm phoning up at ten past eight and they're telling me there's no face to face [appointments] left, you've got a phone consultation and you explain I need to see the doctor, they say well you'll have to phone up tomorrow.
"Nobody's asking me why what's the problem? Nobody's asking me how ill are you and that's not right, that's not a system we should be going down."
Health and Care Director for Knowsley, NHS Cheshire & Merseyside Alison Lee said that patients were still mostly accessing face to face appointments, although "It doesn't feel that way."
Ms Lee said: "Evertbody says GPs aren't back face to face but they are" adding that over 60% of all appointments were taking place face to face - compared to over 80% pre-pandemic.
She said it was a question of looking to those GP practices that don't provide as many face to face appointments to see what support they need to deliver them.
GP Dr Faisal Maassarani spoke of how little the system had changed since the NHS was introduced in 1948, adding "The model's wrong."
Dr Maassarani said: "There's only so much access available and there's been a budget cut of £1.4m to primary care that compounds the problem" adding "It is how do we create capacity out of thin air?"
He added that it was a question of: "how do we create a new model?"
Dr Maassarani said: "There is no quick fix here, this will take a decade" adding: "There's no new money so forget that."
He said: "We've got to be realistic, collectively on this side of the table, that side of the table, what pieces we've got on there to create a new model and be realistic on the timeline" adding this would take a minimum of five years but "realistically let's talk a decade."
Cllr Bannon said: "Any other system has got to be better than the one that's in place at the moment."
Another issue raised by Dr Maassarani was the increasing use of private agencies and locum doctors as GPs increasingly turn away from the administrative burdens of running general practice.
He said many GPs were also now only working three day weeks due to the long hours on top of clinical hours to complete paperwork. As a result, many new GPs entering the profession are favouring better paid locum positions with less administrative burden.
However, Dr Maassarani said: "There's only so much money circulating", stressing the need to "work out how to keep it for Knowsley"
He added: "Anyone trying to do a landgrab say no this is Knowsley's funds and it needs to go back in for the people of Knowsley."
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