York GPs have experienced people being diagnosed with terminal cancer after symptoms were not discovered earlier because they were reluctant to be treated during the pandemic, according to a new report.

The report by Healthwatch York also found that workloads on York GPs have continued to increase after the pandemic, with patients growing frustrated at long waits caused by the high demand.

One anonymous GP, quoted in the September interim report to explore access to GP services in York, said they continue to treat seriously unwell people who did not seek help during the pandemic.

Another has experienced “people sitting on cancers” and being diagnosed late.

“That has been stressful and sad,” they said. “We know a lot of our patients haven’t been coming in with certain symptoms. And in the last few months we’ve had quite a big influx of these patients who’ve come in with a 10-month history of this… haven’t come ’cause [sic] they didn’t want to put a burden on the NHS. And actually have gone on to have pretty bad, if not terminal diagnoses.”

The GP added that they “feared” diagnosis being missed, saying: “It’s the stress of knowing that’s probably going to happen more and more.

“And then the worry that actually, that’s going to just be blamed on GPs when actually a lot of that’s unfortunately been unavoidable just because of what’s been going on.”

Healthwatch York published the results of its GP survey in the report, which asked people in the city to rate their GP practice out of 10 and say what was good and bad about it.

The survey, which had 1,349 responses, revealed “some significant challenges” in accessing primary care services and found “widespread dissatisfaction among patients who are struggling to obtain care due to overwhelming demand”, the report states.

But it also found that people were “very happy with their GP practice”, with the report explaining: “We saw significant variation within the responses we received, including not only differences in larger practices between surgeries but also for individual surgery sites.”

The overall average score of the survey responses was five and a half out of 10, with 10 being excellent.

Nearly a third (29 per cent) of respondents scored their practice at eight or more out of 10.

Siân Balsom, Healthwatch York’s managerSiân Balsom, Healthwatch York’s manager (Image: Supplied)

Siân Balsom, Healthwatch York’s manager, said the key issues raised were about “access, communication, staff attitudes (good and bad) and information”.

According to the report, respondents found there were a range of contact options for accessing a GP appointment – in person, telephone, email, online forms – and described a system that “worked effectively”.

But “many other respondents described situations in which high demand and limited availability led to difficulty in booking appointments”, it adds.

On the quality of care, the report says “generally good care" was reported by "many patients” but adds: “However, there was a perception of GPs treating symptoms in isolation rather than considering holistic health.

“Some problems with prescription accuracy and timeliness were shared, as were concerns about being treated by unqualified or inadequately trained staff.”

Meanwhile, the report found “some disparities” in healthcare access and treatment for marginalised or vulnerable populations, including disabled people and “some specific issues of concern for female patients”.

“In addition, some respondents described a lack of regular health checks due to administrative oversights or resource and capacity limitations.”

On mental health and emergency response, the report found there were “some instances” where there was “felt to be an inadequate response to acute mental health problems”. These included suicidal thoughts and depression.

There was also “mixed experiences” with the NHS 111 service for urgent medical advice.

Care board to 'consider findings carefully'

Ms Balsom said: “The number of people who responded to our survey reinforces the strength of feeling people have about their GP practice.

“We heard a wide range of experiences, from people who couldn’t praise their surgery highly enough to people who were really struggling to access the care and support they need.”

Martin Braidwood, senior operational manager at NHS Humber and North Yorkshire Integrated Care Board (ICB), said: "The ICB acknowledges the huge amount of collective work that has gone into writing this report for the city of York, and will consider the findings carefully.

“Whilst the report has undoubtedly highlighted challenges, it is hugely encouraging to see the many positive comments regarding GP practices.

“The ICB will continue to work with general practices, Healthwatch and other system partners collaboratively to strive for the best health outcomes for the people of York." 

Recommended reading:

Dr Emma Broughton, GP partner at Priory Medical Group and joint clinical director for York Primary Care, added: “We thoroughly welcome this report, highlighting the immense pressure experienced by general practice as the front door to the NHS system.

“The pressure on our stretched workforce, trying to support continually increasing demand on our services, without the necessary increase in funding or workforce, is impacting on the whole system and leading to immense dissatisfaction from both clinicians and patients.

“We welcome opportunities to redress the workforce and funding imbalance co-designed with the voices of our patients to meet the needs of our population.”