Tonight's BBC Panoroma investigates Britain's biggest GP network, the US owned Operose Health, which provides GP services to the NHS. It has 70 surgeries including five in Nottinghamshire, and more than half a million registered patients. Panorama reporter Jacqui Wakefield went undercover for the programme, which airs tonight at 8pm, and claims the investigation revealed not only a shortage of GPs but also some less qualified medical staff working without adequate supervision and a backlog of patient paperwork.
In tonight's programme (Mon June 13), a reporter spent time working as a receptionist at one of the Operose Health's 51 London surgerie. While the BBC does not name the practice or the staff, one of the GPs said they were eight doctors short and the practice manager said they hired less qualified medical staff called physician associates (PAs), because they were "cheaper" than GPs.
READ MORE: Police stop car in Nottingham and find cannabis after noticing 'strong smell'
The BBC reports said that Physician Associates, who were first introduced by the NHS in 2003 to enable doctors to deal with more complex patient needs, but should still have the oversight of a doctor, were being given jobs which were normally the responsibility of GPs. Physician Associates or "PAs" are healthcare professionals who have completed two years of post-graduate studies on top of a science degree. A GP by contrast must have 10 years of education and training.
During tonight's episode of Panorama, evidence is shown that PAs were not being properly supervised at the Operose practice where the reporter worked undercover. The BBC reports that PAs told the reporter they had seen patients, sometimes without any clinical supervision, and that the practice they work at treated them as equivalent to GPs.
The BBC reports that there is a UK-wide shortage of GPs and BBC Panorama analysed NHS data for 6,500 practices across England finding the following:
- For every 2,000 registered patients, there are on average the equivalent of 1.2 full-time GPs
- But at Operose practices the average is half that, at a little over 0.6 full time equivalent GPs
- Operose employs six times as many physician associates as the NHS average, according to NHS data
- While undercover, Panorama was also told about a backlog of important patient referral documents, often unread by doctors or pharmacists for months
For the programme, Panorama also spoken to several other former employees from across the Operose group. The BBC reports that one GP said she saw the way PAs were used where she worked. She told the BBC: "They were fantastic colleagues and trained to do certain roles, but not trained to basically do as much work as a GP. They were doing the same job as us, with less experience, less qualifications and earning less money." .
The Panorama investigation also highlights a backlog of medical test results and hospital letters on Operose computer systems. Administrative workers processed documents for about 30 Operose GP practices and one worker said they were expected to get through 200 documents a day and even decide which were important enough to be seen by a GP or pharmacist. One member of staff, worried about making mistakes said they sometimes used Google to help them work out what to do with the documents.
Prof Everington told Panorama: "If a letter destined for the GP is not being acted on for six months, that is a massive risk to patients, both in terms of the development of a more serious disease and them dying earlier."
Operose Health lists the following as Nottingham Primary Care
Balderton Primary Care Centre, Lowfield Ln, Balderton, Newark
Broad Oak Medical Practice, Strelley Road, Nottingham
Kirkby Community Primary Care Centre, Portland Street, Kirkby in Ashfield
Southglade Medical Practice, Southglade Road, Nottingham
The Practice St Albans and Nirmala, Hucknall Lane, Bulwell
Operose Health says that its document workflow has been commended by NHS England and that it "helps to ensure that clinicians receive accurate and well-coded documentation in a timely manner". It also says its processes are "audited monthly for quality and safety".
The company denies putting profit before patient care and says that it has recruited 38 GPs in the past 12 months and is in the process of recruiting 14 more. It says that 97% of its practices are rated "good" or "outstanding" by the Care Quality Commission regulator and that it works "in the best interests of patients, providing access to the highest quality of care".
Watch Undercover: Britain's Biggest GP Chain on BBC1 at 8pm.
