UK’s biggest chain of GP practices lets less qualified staff see patients without supervision


Britain’s biggest chain of GP practices has been caught letting patients be seen by less qualified staff without supervision.

Operose Health runs 70 surgeries across England, caring for around 600,000 NHS patients.

An undercover BBC reporter, who worked as a receptionist at a practice in London, was told the company hired ‘cheaper’ physician associates.

Physician associates — who start on a £27,000/year salary — have been hailed as a way of propping up general practice, allowing overstretched GPs to focus on more complex cases.

But critics say they are doing jobs that should really be performed by doctors, who earn £100,000/year, on average.

BBC Panorama found that physician associates were not being properly supervised at one surgery in the capital, which it did not name. 

It wrote: ‘PAs told the undercover reporter they saw all sorts of patients, sometimes without any clinical supervision. 

‘They said the practice treated them as equivalent to GPs.’

Panorama found Operose, owned by US health giant Centene Corporation, employs 0.6 full-time GPs for every 2,000 registered patients, half the national average. 

The company also employs six times more physician associates than the NHS average, according to health service data. 

One anonymous GP, who used to work for Operose, said: ‘They were doing the same job as us, with less experience, less qualifications and earning less money.’

Additionally, the investigator was also told that important patient referral documents went unread by doctors or pharmacists for months.

One admin worker at the company said they were tasked with getting through 200 documents a day and deciding which were important enough to be seen by a GP or pharmacist.

Some said they had to use Google to decide what to do with some documents.

Professor Sir Sam Everington, a senior GP in London, accused Operose of ‘putting profits, money ahead of quality of care’.

Operose told MailOnline the BBC had opted for sensationalist reporting of a national GP shortage.  

‘It is deeply disappointing that the BBC decided to deliberately mislead and secretly record our GP practice staff, including junior members of the team, to cover a story they report on almost every day — a national shortage of GPs,’ they said. 

‘Like all practices around the country, we are facing probably the most challenging period in the NHS’s history.’

The spokesperson added: ‘Despite these challenges, we have a strong track record of performance, recruitment and investment in our staff and services. 

‘This success is due to our staff, who go above and beyond every day to care for patients.’

Operose added that the safety watchdog Care Quality Commission (CQC) rates 97 per cent of its practices as good or outstanding.

Physician associates, a role that originated in the US in the 1960s, were introduced by the NHS in 2003. 

They are health professionals with two years of post-graduate studies on top of a science degree. 

For comparison, a GP undergoes a decade of training and education before being allowed to practice.

Physician associates can take medical histories, perform physical examinations and analyse test results, but should always work under supervision. 

They are not allowed to prescribe drugs or refer patients for procedures. 

Recent analysis has found that some areas of the country have just one GP for every 2,500 patients.

Meanwhile, there are 1,500 fewer fully qualified family doctors working in England compared to five years ago. And a third of those working now want to retire in the next five years, surveys have suggested.

GPs have highlighted problems with rising workloads, increased demands from patients and having ‘insufficient time to do the job justice’. 

It comes amid a continuing row over a lack of face-to-face appointments for Britons wanting to see their family doctor. 

In-person consultations GP’s have failed to return to pre-pandemic levels.

Just 63 per cent of consultations were done in person in England in April, up just 1 percentage point in a month — despite the worst of Covid being over and GPs told to get back to ‘normal’.

Prior to the pandemic over 80 per cent of GP appointments were held face-to-face.  

The Panorama investigation will air on BBC One at 8pm tonight.

An investigation claims England’s biggest chain of GP practices is allowing less qualified staff to see patients without supervision from a doctor

Official figures show just 63 per cent of consultations were carried out in-person in England in April. At the current rate, it would take until September 2023 to reach the more than 80 per cent of appointments being made in person seen before the pandemic

Official figures show just 63 per cent of consultations were carried out in-person in England in April. At the current rate, it would take until September 2023 to reach the more than 80 per cent of appointments being made in person seen before the pandemic

England's GP postcode lottery was laid bare today as official data showed some areas have half as many doctors per patient as others. Nuffield Trust analysis shows there are 39.5 GPs caring for every 100,000 people in Portsmouth. People in Thurrock have 40.3 family doctors for every 100,000 people in the area and in Hull there are 41.9 per 100,000

England’s GP postcode lottery was laid bare today as official data showed some areas have half as many doctors per patient as others. Nuffield Trust analysis shows there are 39.5 GPs caring for every 100,000 people in Portsmouth. People in Thurrock have 40.3 family doctors for every 100,000 people in the area and in Hull there are 41.9 per 100,000

The GP Worklife survey found more than half of family doctors worked for six sessions a week or less every week in 2021, with each session being four hours and 10 minutes. Nearly a fifth of the workforce saw patients for four sessions or less, while 12.4 per cent worked for five sessions and 27.9 per cent worked for six

The GP Worklife survey found more than half of family doctors worked for six sessions a week or less every week in 2021, with each session being four hours and 10 minutes. Nearly a fifth of the workforce saw patients for four sessions or less, while 12.4 per cent worked for five sessions and 27.9 per cent worked for six

GPs are still offering too many remote consultations and need to strike a better balance for patients, NHS boss says 

Family doctors have not struck the right balance between in-person and online appointments, a top NHS official has admitted.

Shera Chok, deputy chief medical officer at NHS Digital, said some patients preferred to see a doctor face to face.

‘Because of the pandemic, everything pivoted around two-and-a-half years ago,’ she told the Cheltenham Science Festival.

‘So we were told to do more remote consultations in 2020 to try and reduce the risk and to keep people safe.

‘We’re trying to find our way back to the right balance. I don’t think we’re there yet.’

On the move to remote consultations, which typically involve phone and video calls, the east London GP added:

‘Some patients really like remote consultations, that they are typing queries at 10 o’clock at night, and get somebody to call them within a few days. Other patients really don’t like it.’

Around 80 per cent of GP appointments were face to face before the pandemic but this fell to just 47 per cent in April 2020. 

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