‘Fragile’ GP system needs more help as Thanet struggles with low number of doctors


By Local Democracy Reporter Ciaran Duggan

Kent NHS bosses have pledged to offer more support to a “fragile” GP system.

In a virtual meeting last week, the Kent and Medway Clinical Commissioning Group (CCG), which oversees the running of 200 GP surgeries, revealed that Swale and Thanet continue to “struggle” with a low number of doctors.

Remote consultations are being delivered by some GPs to provide care in an “efficient” manner for some health conditions, such as asthma and diabetes.

More training is being offered as the size of the workforce has been steadily increasing, with more support provided by local paramedics and pharmacists.

In Thanet and Swale, Kent CCG bosses have engaged in talks with GPs about increasing educational support and advice on how best to use the extra staff.

Dr Suzanna Marsden said there needs to be a “minimum” core of GPs for the system to function. She said: “Sometimes even that feels like it is stretched.”

The Ramsgate GP added: “People are so overworked they do not have the bandwidth to engage in the additional support activities that are put in place.”

It has been suggested that GPs could be “harnessed” from other areas of the UK to provide video consultations for areas that desperately need help.

At the CCG primary committee on Thursday, Dr Simon Dunn, of Heron Medical Practice in Herne Bay, said: “How can we support a system that is a bit fragile?”

The total size of Kent’s GP workforce team has risen from 547 in September 2017 to 645 in September 2020, marking a rise of around 17% in three years. Under this, there has been a major rise in the number of health care assistants, growing from 40 to 255 over the three year period. Their main responsibilities include measuring blood pressure and giving advice.

CCG bosses said they are considering a range of options to help struggling surgeries.

Dr Dunn told the panel of GPs: “If we can get this solved for Thanet, that is going to help West Kent in five years time when they are facing similar problems with a whole group retiring.”


  1. How routine are the ‘Remote consultations’ being delivered by some GPs to provide care in an “efficient” manner for some health conditions, and how efficient are they? I have had to contact my GP, in the last month for the first time in over a year (and I’m 76), and wasn’t even offered a face to face consultation. It wasn’t for routine management of diabetes of asthma or diabetes either. It was for worsening of a longstanding condition for which I would have expected a proper consultation. Without giving details, I would now expect that GP services should be returning to normal now that Covid cases have dropped significantly. The practice still has the same number of doctors as before, so when can I expect normal service to return?

  2. Do not therefore expect to see your regular Dr who knows you their patient. Instead you could be a client of a Dr who has to spend more time researching your notes before seeing you. Thus taking up un-necessary time. Hence even more so you will only potentially be able to discuss one health issue because instead of 10 minutes per patient it will be reduced to 5 minutes.

    Of course if you have several issues you will have to make a further appointment. Hopefully, you are still alive or the issue has resolved itself.

    You could always amputate your leg from just above the knee to relieve you of the pain in the knee. or you could remove your leg at the hip thus saving a hip replacement. However, heaven help you if you have constant headaches.

    Seriously with 17.5 thousand additional houses how do the health services expect Dr to cope. By putting more services out to pharmacies who are over stretched anyway.

  3. Magsym – unfortunately I don’t think there will ever be a “normal service” again. This pandemic has changed the way lots of services operate and GP surgeries is one of them. There may well still be the same number of GPs at your surgery but how many more patients are there? This article is about the huge problem we have in Thanet of insufficient GPs – a couple of years ago that was 19 GPs short for the population and we also have many who are due to be retiring very soon. Consequently the surgeries have to adapt their way of working in order to cope and some of the changes that we will now see are as a result of the way they were forced to change over the past year. I am on the patient group of my local surgery and know that they are now able to handle patients much better by having initial phone consults as they are then able to offer appointments for those patients who need a face to face visit. No system is perfect, particularly when it is working at its maximum capacity as our local GPs are and so there could well be instances where a patient may feel they want to be seen personally but a GP doesn’t feel it is justified. Perhaps you could try phoning your surgery again and explaining your concern and hopefully they will then see you.

    And Doc Holiday – exactly – all very well for government to set housing targets and councils being forced to comply and developers wanting to make money, but perhaps some of those decision makers in Westminster should also look at employment, local GPs etc etc as well rather than just enforcing number of houses to be built for every area of the country.

  4. Get on to Jenrick, Gale. MacKinley et al – give them both barrells and ask them to explain how their government plans for 17,140 new homes by 2031 and even more after can be considered sustainable or even safe.

    • I agree.
      It’s government policies that have thrust these houses on us. Ask Craig Mackinlay what additional health (and all the other) resources are going to be put in place to support the burgeoning population?

  5. ‘The total size of Kent’s GP workforce team has risen from 547 in September 2017 to 645 in September 2020, marking a rise of around 17% in three years. Under this, there has been a major rise in the number of health care assistants, growing from 40 to 255 over the three year period. Their main responsibilities include measuring blood pressure and giving advice.’

    Overall increase of 98 staff, increase in HCA’s of 215 therefore 117 other staff left – doctors? Nurses? Other skilled staff?

  6. What I don’t understand is that people are moving to Thanet in their droves, including a huge community of qualified professionals. It makes no sense to me that the regeneration migration doesn’t include qualified health and medical professionals. Thanet is hardly the end of the earth, why can there not be an investment in an imaginative recruitment campaign for our isle?

    Lots of ‘hard to recruit’ areas used to do this.

    We’re an hour from London. We’re an area people are moving TO.

    Personally, I find lack of GP access leaves me feeling vulnerable about my health and healthcare. My GP here is absolutely wonderful but getting an appointment can be hugely stressful.

  7. We need an efficient private GP service here. I previously used Nuffield’s service in Glos., but cannot find anything here.

    20 minute consultations, always prompt, on time. Easy parking and even tea and biscuits in the waiting room.

  8. Each GP practice gets paid for everyone on their lists whether they see you or not perhaps the formula needs to change and gets paid when you see doctor. My practice you can phone at 8am after one hour they have no appointments or online face to face consultations. Constantly telling you to ring 111 that is at 9am then get told to contact your surgery.most practice still has a full number or GPS yet you can spot them up at the urgent care area at the QEQM. They should be in their practice.As most of the older patients and others have been vaccinated there is no excuse.

  9. Have phone my doctor’s surgery at 8 till 5 for 3 months in a row, never got through to them. It’s like they don’t answer calls, once appointments are full they don’t answer. It’s like they know who’s calling so select if they answer.

  10. Its not good the awful failure in getting appointments for medical issues. The trying to get appointments in the first hour of opening each morning by hanging on the phone up to an hour then being told they have none left is a big failure. They need to find a better and quicker way to get through. They took the online appointments and contact surgery service down and it hasn’t returned so everyone is forced into using the phone or queing up outside.
    People are being let down and nothing is done about it.

  11. I’m sick of the GPs hiding behind Covid it’s been the best thing that could have happened for lazy doctors they could not believe their luck. They might give you a call back if you are lucky enough to get a receptionist to answer the phone in the first place. The appointment system should be abolished it is just a means for doctors to avoid their responsibilities. We never had appointments when I was younger it worked then now with patients notes can be on the screen in a click there should be no need to make appointments in any event you never go in to the doctors room at the time you are given for the appointment.

  12. My surgery/doctors is great. It is a problem with doctors retiring and some surgeries having closed, we will really be in trouble when we get the 17,000 plus new homes. We do need to contact our MPs to implore them to speak up for us not being becoming a huge suburban sprawl with not enough health services or free things to do for the young and the youth joining the area.

  13. We should be naming and shaming. It doesn’t really help if we say our doctors surgery or doctor is rubbish. Yes there are GP shortages, for some unfathomable reason, and yes, surgeries are comprised financially, and hundreds of new houses in to the mix is just about the worst idea I can think of, but, unfortunately some GPs are also just lazy, and badly trained, and some surgery managers are really not doing their job.

  14. Birchington Medical Centre – 1 doctor several part timers and locums – more chance of a helicoptor ride on Mars than an appointment with a doctor.

  15. I have serious dislocated shoulder that needs attention they don’t take any notice of letters your right sack them and the receptionist were are you gale

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