A Bay of Plenty GP says workforce recruitment, managing the expectations placed on GP practices, and improvements to health literacy are needed. Photo / 123RF
A Bay of Plenty GP says workforce recruitment, managing the expectations placed on GP practices, and improvements to health literacy are needed. Photo / 123RF
The Bay of Plenty’s GPs are outnumbered by enrolled patients by more than 1000 to one, but doctors say the ratio could be higher when taking into account that the majority don’t work fulltime.
There is an average of 1000 enrolled patients per GP in the Bay of Plenty district, recently released Ministry of Health data reveals.
The data, released at the end of January, records primary healthcare enrolments according to the patient’s district of residence and primary health organisation records.
There are 255,789 people enrolled with GP practices in the Te Whatu Ora Bay of Plenty district as of January 31, an increase of 13,470 since December 31 2019.
Healthpoint’s records show there are 56 GP practices and 253 GPs across the district.
Tauranga GP Dr James Peckett said a large part of the GP workforce worked part-time or reduced hours, usually with enrolled patients proportional to hours.
Taking this into account, Peckett said a fulltime GP would have about 1200 to 1500 patients.
“It is becoming increasingly hard to provide core general practice services at this level of enrolled patients.”
Peckett said the increased workload created many pressures.
“The pressure on appointments, and within appointments, has created pressure that is not sustainable.
“The job is no longer attractive, so finding employees is difficult. We try to manage this pressure by getting creative with our workflow and optimising the skillset of other staff members.”
Peckett’s advice to enrolled patients was to “get proactive” with GP appointments.
“If you take regular medication and need a review, book an appointment a few weeks in advance,” Peckett said.
“Ask about other prescribers in your practice that may be able to help. Be open to phone appointments, which may be more convenient anyway.”
Peckett said adequate funding would enable services to provide timely, quality care.
“More funding means more employees. GPs that are not burnt out will be more likely to continue to work, rather than look for other roles or reduce their hours.”
Western Bay of Plenty Public Health Organisation clinical adviser and Mount Medical Centre GP Dr James Peckett. Photo / Supplied
Edgecumbe GP Dr Cecile de Groot said the important question to ask was how many patients there were per fulltime equivalent GP.
“In my experience many if not most of the GPs are working 0.8 FTE or less, some only 0.2. Many are also involved in non-clinical work such as research or positions with the PHO and Te Whuta Ora.”
De Groot said she did not have accurate figures but she estimated in the Eastern Bay of Plenty some GPs could be working with more than twice the recommended number of patients.
“We’ve lost 18 GPs in the last 14 months alone with only two or three new ones coming to our area.”
De Groot said GP workloads were becoming heavier.
“Not only are we needing to see more patients in the allotted time but patients are more complex and demanding than in the past largely due to an ageing population, and also due to so many new treatments available for long-term conditions.”
On top of this, De Groot said GPs needed to deal with “unmanageable” inboxes of patient reports from different organisations, specialists and hospitals, sometimes receiving more than 100 in a day.
“Pressure on practices is immense. We are booking up to two weeks ahead and are relying on nurses, nurse practitioners and healthcare assistants to manage patient requests in the meantime or turning patients away to be seen in ED or after-hours services.”
De Groot said workforce recruitment, managing the expectations placed on GP practices, and improvements to health literacy were needed.
Genpro chairman Dr Tim Malloy. Photo / Adam Pearse
There are three primary health organisations based in the Te Whatu Ora Bay of Plenty district: Eastern Bay Primary Health Alliance (29,572 enrolled patients), Western Bay of Plenty PHO Limited (205,553) and Ngā Mataapuna Oranga Limited (12,750).
According to the Te Whatu Ora Bay of Plenty website, the district serves 255,102 residents, including 199,751 in the Western Bay of Plenty and 55,359 in the Eastern Bay of Plenty.
GenPro represents GPs and chairman Dr Tim Malloy said the recommended level was 1200 patients per fulltime GP but he suspected the numbers were “seriously” higher than that.
“It’s probably closer to 1500 per GP at an estimate and in rural areas around Rotorua probably about 3000 patients per GP.”
Malloy said while the number of enrolled patients reported to the Ministry of Health was probably accurate, Healthpoint’s records of the number of doctors in each region depended on updates from individual practices.
“We don’t have time to update Healthpoint,” Malloy said.
Te Whatu Ora primary health care system improvement and innovation national commissioning group manager Adeline Cummings said the number of enrolments had increased since 2019 because of an increase in population.
“And, because of Covid-19, there has been a greater incentive to be enrolled at a GP practice.”
Cummings also said the number of GP practices had not changed since 2019.
“General practices may also close their books if they cannot safely take on any more patients, resulting in potential new patients being unable to enrol in a practice near them.”
Cummings said it was still important to enrol with a GP so that when needed there was a trusted relationship in place for healthcare support.
“A person can get the best healthcare when they have continuity of care via an ongoing relationship with the same healthcare team, and when their full medical records are available.”
A spokesperson for the Western Bay of Plenty Primary Health Organisation, which has the lion’s share of enrolled patients in the district enrolled across 39 practices, said it had opened three more general practices in the past three years while one of its practices, Cameron Medical, was closed last year and patients transferred to Chadwick Healthcare Ltd.
The spokesperson encouraged patients to enrol and said anyone looking for an up-to-date list of practices open for enrolment could find the information on the organisation’s website.
