A group of leading doctors has called for out-of-hours GP services to be offered alongside emergency departments at hospitals to stem the "overwhelming" number of A&E patients.
Doctors from the College of Emergency Medicine, the Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons, want every emergency department should have a co-located primary care out-of-hours facility.
Patients should not be expected to determine whether or not their injury is serious enough to warrant a trip to A&E or minor enough to contact a GP and should have access to both levels of care, doctors said.
However, the recommended it was inappropriate to expect A&E to deal with "anything and everything".
The Government has defended its funding of GP services, saying two-thirds of the NHS budget is controlled by local family doctors and finding extra cash will "mean reductions elsewhere".
An NHS England spokeswoman said:
Two thirds of the NHS budget is now controlled by local GPs and like them we want to see more investment in primary care, including modern buildings.
While the NHS budget has been protected, which is welcome, finding more money in one area will inevitably mean reductions elsewhere.
Some 39% of GPs feel the premises they see patients on is in too poor shape to properly care for them.
According to a poll of 4,000 GPs:
- Two thirds said they had been prevented from developing or refurbishing their premises because of a lack of cash.
- And a number raised concerns about the impact of "hot-desking", or sharing consulting rooms with colleagues, saying that it hampered their ability to carry out a full range of services.
Patients are not getting the care they need as many GP surgeries are "unfit for purpose", according to the British Medical Association (BMA).
Crumbling surgery buildings are preventing patients getting access to the services they need "undermining" care, the union said.
One of Britain's top GPs, Dr Chaand Nagpaul, warned many surgeries had seen "no real investment" over the last 10 years.
Dr Nagpaul, chair of the BMA's general practitioners committee, said: "Far too many practices have seen no real investment in their buildings in the past ten years, leaving them in cramped, unsuitable conditions that are hindering the ability of many to even offer basic general practice services.
"Practices also reported being prevented from relocating to more suitable premises because of a lack of resources."
A survey of GP patients in England suggests they are less satisfied in the service provided than they were two years ago.
Of the 903,357 adults questioned in the Ipsos Mori survey for NHS England:
- 34% have a "very good" experience of making an appointment compared with 38% in June 2012
- 36% were "very satisfied" with their surgery's opening hours, down from 40% in June 2012
- 86% were successfully able to get appointment to see or speak to someone at their surgery
- 34% would prefer to book their appointments online compared with 29% in June 2012
- 78% would recommend their GP surgery to someone who moved to the local area, which is down from 82% in June 2012
GPs face being named and shamed if they repeatedly fail to spot signs of cancer in their patients, it has been reported.
Doctors will be marked out with a red flag on an NHS website if they are deemed to be missing too many cases or patients have to make repeated visits before being referred for tests, according to the Mail on Sunday.
Health Secretary Jeremy Hunt said tough action must be taken to bring standards at practices with poor cancer referral rates into line with those who have the highest standards.
He told the newspaper: "Cancer diagnosis levels around the country vary significantly and we must do much more to improve both the level of diagnosis and to bring those GP practices with poor referral rates up to the standards of the best."
The Department of Health has dismissed claims GP services are "imploding" as "scaremongering" and claimed the number of family doctors has risen by 1,000 since 2010.
A Department of Health spokeswoman said:
It is scaremongering to say that GP services are 'imploding'.
The number of GPs has gone up by 1,000 since 2010 and we've taken tough decisions to protect the NHS budget so we can strengthen family doctoring, reform out-of-hospital care and improve GP access for 7.5 million people.
GPs agreed to be at the heart of our radical plans for more personalised community care in return for cutting their targets by more than a third to free up more time with patients.
GP services are crumbling under the "total mismatch" between a sharp rise in the number of patients needing appointments and the NHS' shrinking capacity to provide care, a health expert warned.
The BMA's Dr Chaand Nagpaul explained:
What we are witnessing is a total mismatch between the rapidly rising demands on GP appointments and a shrinking capacity to provide that care.
Waiting times are inevitably getting longer because the increased demand has not been matched with increased capacity.
GPs will rightly prioritise urgent problems, what is being squeezed are patients with routine problems....
It's common that patients wait over a week, some two weeks. The Royal College of GPs have done a survey which shows that waits will increase to two weeks in a large number of practices in the coming year.
A two-week wait for an appointment to see the family doctor may become commonplace, as GP services are "imploding", a health chief warned.
Dr Chaand Nagpaul, who chairs the British Medical Association's (BMA) general practitioners committee, warned patients would suffer because of rising demand on GP services and "disinvestment".
Instead, patients will have to wait a fortnight as standard before they can see a GP, he said.
Dr Nagpaul also warned of toll the "conveyor belt of care" took on GPs as they try to see as many patients as possible.
Speaking to the BMA's annual representative meeting in Harrogate, Dr Nagpaul said that in the last five years the number of patients seen by family doctors has increased by 40 million each year.
A 95-year-old pensioner who was "de-registered" from her GPs because their services were overstretched said being shut out from her family doctor was a "bit worrying".
Lily Dove, 95, told Good Morning Britain she could remember when "the doctor used to come out and visit with a horse and trap" and said the Watton Medical Practice should have spoken to the services "before they got in this muddle".
Watton Medical Practice manager Mary Osborne said the decision to de-register Mrs Dove was "a matter of patient safety".
"We were informed by the local area team for NHS England that we could not be discriminatory and ask some residents to move and ask others to stay – that would have been unlawful.
"The decision was made on geographical area, where there is an alternative practice to cover a patient’s primary care."