Mind believe one in three people are seeing their mental health deteriorate while waiting for a GP appointment. However, GPs believe half a million bookable evening and weekend appointments are going unused, costing the NHS an estimated £15 million
So what is the state of play?
Let’s start by addressing Mind’s key concerns. It surveyed more than 8,000 people to get the picture on how we are navigating our way through consultations.
Getting an appointment is where the journey begins. The charity claims 47% of people surveyed were asked to provide a reason for why they needed to see their GP. Of those, 65% weren’t comfortable saying it was for their mental health. Of all respondents, 54% said they would prefer online booking. But, Mind says only 25% were able to do so.
Many will be concerned at the relatively low number of patients able to book an appointment on the web, particularly with the NHS keen to push online services.
Moving on to Mind's survey results on waiting times, one in three people reported waiting six days or more for their most recent appointment - usually being the first appointment available. Almost half of those surveyed found their wait to be longer than expected, and nearly a third believed their mental health worsened in the meantime.
Sophie Edwards, a 21-year-old from Kent, revealed her experience of going through her GP, after reaching out for mental health support three years ago.
She said: “My first GP appointment, was not helpful at all - I was brushed off and handed a leaflet. I had to go back several times to get the help and support I needed - begging to be referred for cognitive behavioural therapy.
“After finally being deemed a priority and endless letters from my doctor, I received the call to say my wait was over. During the seven months of uncertainty, my depression got much worse. A lot of things happened in my life, from losing family members to going through a breakup, which all made the waiting and relentless pressure to get the right support even more stressful.
“I also felt because of the long wait and my depression worsening, my therapy wasn’t really dealing with the aspect of my mental health which I was currently struggling with.
“Depression and anxiety is an ongoing thing, but for me, therapy was a really big part of managing my mental health, I use the techniques I learnt in CBT without even realising. GPs are the gateway to accessing this kind of support.
Sophie added: “I think it’s really important you are able to see your GP straight away and make those additional appointments when you need them, because it will help prevent a revolving door effect and people can get help for their mental health earlier.”
In addition to concerns over the time taken to refer patients for appropriate treatment, Paul Farmer, Mind chief executive, added that the charity’s survey also highlighted young people have had a better experience of care provided by voluntary organisations than GP services.
He said: “It’s unacceptable that so many people are struggling to access the support they need from their GPs when they need it. We know that there are many barriers to people seeking help from their GP in the first place but, on top of this, we are concerned that problems with booking appointments may deter people further.
“When people do manage to see their GP, experiences are mixed, and young people in particular seem to have much worse experiences of care. GPs do a hugely important job under immense pressure.
“Most people accessing support for their mental health will only be seen by their GP, so we need to ensure GPs have the right support and training, and that services have sufficient funding, to provide high-quality, timely and appropriate care to those of us experiencing mental health problems.
Now let’s look at it from GPs’ and the NHS’ perspective.
There are various estimates on the waiting time for GP appointments; one in four patients are waiting at least a week according to NHS figures released in August this year. However, GP magazine Pulse believes the average wait is around 13 days, in a survey of around 800 GPs.
The same publication also revealed this week concerns at the number of evening and weekend appointments going unused. A Freedom of Information Act (FOI) investigation found that, between April 2017 and September 2018, half a million bookable appointments went unused. This works out to roughly a quarter of all appointments offered during evenings and weekends - and is estimated to have cost the NHS £15 million.
Mind says it will now conduct its survey every year to “monitor whether services really are improving and using the data to hold services to account”.
Responding to Mind’s concerns, Claire Murdoch, NHS England’s National Director for Mental Health said: “Joining up talking therapy services in primary care settings is another big step forward for our patients and a key plank in putting mental health at the centre of the long-term plan for the NHS.
“We are on track to deliver 3,000 therapists in primary care, with over 800 in surgeries at the end of last year. And this handy guidance should convince those practices that are yet to take the plunge of the benefits.”
Dr Nikita Kanani, NHS England’s Acting Director of Primary Care, said: “General practice is the front door of the NHS. We continue to support the expansion of the workforce so patients have access to a range of different health professionals so that we can better support both their physical and mental health needs.”
We simply cannot ignore what GPs are saying.
They estimate that one in 20 people are missing appointments and, consequently, 10 million consultations are going down the drain every year.
A 10-minute slot with a GP costs the NHS around £25. Taking into account missed appointments, this equates to the health service taking a £250 million annual hit from DNA, or “Did Not Attend”, patients.
Most would agree that an immediate cure for the relationship between GP and patient is one of the most important in society. Better collaboration would go some way to alleviating concerns.